The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Content within the patient forum is user-generated and has not been reviewed by medical professionals. Other sections of the Melanoma Research Foundation website include information that has been reviewed by medical professionals as appropriate. All medical decisions should be made in consultation with your doctor or other qualified medical professional.

Anemia question

Forums General Melanoma Community Anemia question

  • Post

      Hello all!

      I hope you all had a wonderful Thanksgiving and are enjoying the holiday season.  

      A little back story…I was dx in Dec. of 2017 with Stage 4 with mets to Liver.  I started bi-weekly treatment of Opdivo only in Jan. 2018 (Opdivo only due to history of coliits).  I have had little to no side effects (except for my thyroid taking a dump in June), and I have had a complete resolution of all liver mets in my last 3 PET scans. However, about a month ago my Red blood cell count and Hemoglobin have been taking a nose dive. I've been on Iron pills since and my onc ordered an endoscopy and colonoscopy for last week.  The GI Dr. said my stomach was clear, with no signs of ulcers, and my colon was clear with no signs of active colitis. He took some biopsies just to check if there was any microsopic signs, but he didn't think the anemia was due to anything stomach or colon related. I have another PET planned for Dec. 14th to take another look around.

      I have been reading about side effects of Opdivo and anemia is not a well documented side effect.  I was wondering if anyone has had any anemia issues due to the opdivo and what solutions helped resolve the issue.  I have an appt and infusion (if counts are back up) this week and I know we will go over this, but I always like to be a little informed if there are any issues before we meet.

      As always, thank you so much for your help and well wishes . This forum is an invaluable resourse that I rely on daly.

      Have a wonderful week.


    Viewing 4 reply threads
    • Replies
          Hi SRVilly,
          I can give you my experience with anemia. I am on keydruda and in March I started with low HB count. Had 3 blood infusions was on iron tablets too. Had scans and colonoscopy too with all signs clear. I started getting pains which did go to doctors who told me to take busacpan. Anyway did not felt helpt me at all. Took myself to hospital and two days later vomating and could not stop. I had another scan I had a blockage 3cm tumour in small bowel which was not picked up. When I asked how could you miss it I was told it was growing behind the bowel so scans looked normal. Hope you get it sorted least they doing pet scan.
          SCOOBY x

              Thanks Scooby! 

              I appreciate the feedback. I’m looking forward to talking to the Doc this week and getting this figured out. 



              I had the same issues with Keytruda. My primary care doc put me on iron pills. They made me nauseous, so I stopped taking them and at my next oncology appointment 3 weeks later, I asked my onc if he could have my blood iron levels tested. We tested it just prior to my next follow up appointment and infusion (3 weeks)….. iron levels were fine. The anemia was assumed to be caused by "inflammatory response"… in other words an autoimmune issue. The other possibility was low B12 (pernicious anemia). These anti-pd1 drugs mess with the immune system in different places in each of us. As mentioned, it seems that anemia is going by as a rather unmentioned adverse side effect. Some patients have had B12 injections resolve this issue. I was able to get by with supplements. I started off at 2000 mcg per day, but since stoppage of Keytruda (July 2016), I have found that I'm still doing well at only 1000 mcg per day now. 


                Hi there. I am on Opdivo and had anemia early on. I started on iron pills and then went to just B12 as a supplement and added red meat to my diet (it is the best food source of heme protein which is the more easily absorbable iron). 

                By the next month after testing, I tested in the normal range. 

                Best of luck to you!



                  Hey SRVilly,

                  Have you had a test for blood in the stool?  Back in 2013 I was NED following surgery for a stage III diagnosis.  Started getting anemic.  Doctor recommended a test for blood in my stool.  Came back positive which then led to a battery of scans and scopes.  It can be tough to find mets in the GI tract.  Eventually they found through a pill endoscopy that I had mets in my small intestines.  A pill endoscopy involved swallowing a pill with a camera that takes pics through the whole tract.  I'm hoping you are just experiencing a side effect from Opdivo but just wanted to tell you about my experience.



                      Hi Brian,

                      Thanks for the reply.  I did have that blood test and it was positive.  I met with my Onc today and went over all the biopsies from colonoscopy.  All were clear so that is good.  My Red Blood cell count and Hemoglobin were still low, but were steady so she let me get my infusion.  I am also scheduled for the pill endoscopy in a couple weeks. Gonna be a busy December!!

                      Thanks again for the reply.  Have a great weekend.



                        Hi SRV, I was wondering how everything turned out for you?  I have a relative in the exact same situation and am wondering if this is a side-effect from Opdivo.

                          Hello – I’m so sorry I missed your question. I ended up having two “spots” on my small bowel found via a PET/CT scan. I opted to have surgery since nothing was working to get my Red Blood cell or Hemoglobin up and we had to find out if it was a recurrence of Mel or inflammation due to the Opdivo. The surgical oncologist removed the two spots on my small bowel, tied them back up, and tested them. It ended up being melanoma on both spots. After 5 crummy days in the hospital, I was released and within a few weeks I was feeling 100% better and all my blood work has been back to normal. I’m back on my bi-weekly Opdivo treatments and feeling great. My last PET/CT was “fairly” clear, a couple bright spots here and there, but nothing that my onc was concerned about.

                          So, it ended up not being a side effect of the Opdivo, which was good, so I could continue treatment, but it was a recurrence while I was on Opdivo. The surgery removed all findings of Mel so since I did have such a good response to Opdivo, we opted to start back up on the Opdivo only. I think if anything else pops up, we may move to the Ipi/Nivo combo. But for now, I’m taking my bi-weekly trek for my infusion, enjoying a couple hours of “relaxing and music” and living life. A couple months of inconvenience, but hopefully back on the right track.

                          Best of luck to you, your relative and everyone else.


                          Yep. I’m anaemic but the doctors just shrug and say it’s due to the disease. I feel ok. But I’ve been anaemic for 4years. They don’t seem to want to do anything about it. As  I’ve had some lung removed and have inflammation through my body it’s hard to tell if breathlessness could be from anaemia or something else  


                      Viewing 4 reply threads
                      • You must be logged in to reply to this topic.
                      About the MRF Patient Forum

                      The MRF Patient Forum is the oldest and largest online community of people affected by melanoma. It is designed to provide peer support and information to caregivers, patients, family and friends. There is no better place to discuss different parts of your journey with this cancer and find the friends and support resources to make that journey more bearable.

                      The information on the forum is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.

                      Popular Topics