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Polycythemia vera is a form of cancer of the blood. It causes your bone marrow to produce an abnormally large number of red blood cells. These extra cells thicken your blood, delaying its flow and even causing major complications like blood clots.
Polycythemia vera is uncommon. It normally develops gradually, and you may have it for years without realizing it. Often, the problem is discovered through a routine blood test.
Polycythemia vera can be fatal if left untreated. However, adequate medical care can help alleviate the disease's indications, symptoms, and complications.
WHAT ARE THE SYMPTOMS OF POLYCYTHEMIA VERA?
Many persons with polycythemia vera have no symptoms or indicators. Some people may experience vague symptoms like headaches, dizziness, lethargy, and blurred vision.
More specific polycythemia vera symptoms include:
- Itchiness, particularly after a hot bath or shower
- Hand, foot, arm, or leg numbness, tingling, burning, or weakness
- A feeling of fullness immediately after eating, as well as bloating or pain in your left upper abdomen as a result of an enlarged spleen
- Bleeding that is unusual, such as a nosebleed or bleeding gums
- Painful swelling of a single joint, usually the big toe
- When lying down, you may experience shortness of breath and difficulty breathing.
WHAT ARE THE CAUSES OF POLYCYTHEMIA VERA?
Polycythemia vera develops when a gene mutation causes a difficulty with blood cell development. Your body normally regulates the number of each of the three types of blood cells — red blood cells, white blood cells, and platelets. However, in polycythemia vera, your bone marrow produces an abnormally large number of certain of these blood cells.
The cause of the polycythemia vera gene mutation is unknown, although it is not usually transmitted from your parents.
WHAT ARE THE RISK FACTORS FOR POLYCYHEMIA VERA?
Polycythemia vera can strike at any age, but it is most frequent in adults aged 50 to 75. Men are more likely than women to get polycythemia vera, while women develop the disease at a younger age.
WHAT ARE THE COMPLICATIONS OF POLYCYTHEMIA VERA?
Polycythemia vera can lead to the following complications:
- Blood clots: Increased blood thickness and decreased blood flow, as well as platelet abnormalities, increase your risk of blood clots. Blood clots can cause a stroke, a heart attack, or a blockage in a pulmonary artery or a vein deep within a thigh muscle or the belly.
- Enlarged spleen: The spleen assists your body in fighting infection and filtering undesirable material such as old or broken blood cells. Because of the increased quantity of blood cells caused by polycythemia vera, your spleen works harder than usual, causing it to grow.
- Problems caused by an excess of red blood cells: Too many red blood cells can cause a variety of additional problems, including open sores on the inside lining of your stomach, upper small intestine, or esophagus (peptic ulcers) and joint inflammation (gout).
- Other blood diseases: Polycythemia vera can, in rare situations, lead to other blood illnesses, such as a progressive sickness in which bone marrow is replaced by scar tissue, a condition in which stem cells do not mature or function normally, or blood and bone marrow cancer (acute leukemia).
HOW IS POLYCYTHEMIA DIAGNOSED?
Your doctor will take a thorough medical history and conduct a physical examination.
Blood tests
Blood testing may reveal the following if you have polycythemia vera:
- There are more red blood cells than usual, as well as an increase in platelets or white blood cells.
- A higher proportion of red blood cells in total blood volume (hematocrit measurement)
- Increased quantities of the iron-rich protein that transports oxygen in red blood cells (hemoglobin)
Biopsy or bone marrow aspiration
If your doctor suspects you have polycythemia vera, he or she may propose a bone marrow aspiration or biopsy to acquire a sample of your bone marrow.
A bone marrow biopsy involves the collection of a sample of solid bone marrow. A bone marrow aspiration is frequently performed concurrently. During an aspiration, your doctor takes a sample of your marrow's liquid part.
Specific gene testing
If you have polycythemia vera, an examination of your bone marrow or blood may reveal the disease-causing gene mutation.
WHAT ARE THE TREATMENTS FOR POLYCYTHEMIA VERA?
Polycythemia vera has no known treatment. The treatment focuses on lowering your chances of problems. These remedies may also help to alleviate your discomfort.
Blood withdrawals
The most common treatment for polychythemia vera is regular blood draws using a needle inserted into a vein (phlebotomy). It's the same process as donating blood.
This reduces your blood volume and the number of extra blood cells in your body. The frequency with which you must get blood obtained is determined on the severity of your disease.
Itching relief treatments
If you have itchy skin, your doctor may prescribe antihistamines or recommend UV light treatment to alleviate your discomfort.
In clinical trials, medications used to treat depression, such as selective serotonin reuptake inhibitors (SSRIs), helped alleviate itching. SSRIs include paroxetine (Brisdelle, Paxil, Pexeva, and others) and fluoxetine (Prozac, Sarafem, Selfemra, others).
Drugs that limit the quantity of red blood cells in the body
If phlebotomy alone is insufficient, your doctor may recommend drugs to reduce the quantity of red blood cells in your bloodstream. Here are several examples:
- Hydroxyruea (Droxia, Hydrea)
- Interferon alfa-2b (Intron A)
- Ruxolitinib (Jakafi)
- Busulfan (Busulfex, Myleran)
Heart medicines
In addition, your doctor will most likely prescribe medications to treat risk factors for heart and blood vessel disease, such as high blood pressure, diabetes, and abnormal cholesterol.
To lower your risk of blood clots, your doctor may advise you to take a low-dose aspirin. Low-dose aspirin may also aid in the relief of burning pain in your feet or hands.
HOME REMEDIES FOR POLYCYTHEMIA VERA
If you have polycythemia vera, you can take efforts to make yourself feel better. Make an effort to do the following:
- Exercise: Walking, for example, can help enhance your blood flow. This lowers your chance of blood clots. Stretching and exercising your legs and ankles can also help your blood circulation.
- Tobacco should be avoided: Tobacco use can cause your blood arteries to constrict, raising your risk of a heart attack or stroke caused by blood clots.
- Avoid being in low-oxygen environments: Living at high altitudes, skiing, and mountain climbing all deplete the oxygen levels in your blood even more.
- Take care of your skin: Bathe in cool water, apply a gentle cleanser, and pat your skin dry to prevent itching. Adding starch to your bath, such as cornstarch, may assist. Hot tubs, heated whirlpools, and hot showers or baths should be avoided.
Scratching can cause skin damage and raise the risk of infection. To keep your skin moist, apply lotion.
- Extreme temperatures should be avoided: Poor blood flow raises your risk of harm from extreme heat and cold. Always wear warm clothing in chilly conditions, especially on your hands and feet. Protect yourself from the sun and drink plenty of fluids in hot weather.
- Look out for sores: Sores on your hands and feet, in particular, might be made more difficult to heal due to poor circulation. Inspect your feet on a regular basis and report any sores to your doctor.