Hello there @Folkert, welcome to the forum, fellow Myeloproliferative neoplasms (MPN) survivor. I’m so sorry to read you were diagnosed with Essential thrombocythemia (ET).
Sounds like, so far, aspirin has been your only treatment. This would be my ideal treatment, but alas, our blood cells can tend to do their own thing when we live with Myeloproliferative neoplasms (MPN) and we often end up needing additional treatments like phlebotomy and cytoreductive medicines like hydroxyurea or interferon. Sure you’ve read about typical treatments.
Don’t know if this would be of interest but the lovely specialist Blood Cancer UK nurses offer us space in the forum to ask about various aspects of our blood disorders. Recently we spoke of whether typical treatments for Myeloproliferative neoplasms (MPN) are considered active monitoring AKA watch and wait: Active Monitoring (watch and wait) - Ask the Nurses - #6 by Duncan
The way my haematologist put it to me is that taking aspirin alongside hydroxyurea will, respectively, thin my blood and decrease the overproduction of blood cells, decreasing my need for phlebotomy and minimising clotting risk. Phlebotomy alone can lead to anaemia which can bring its own physical effects. So the way I understand treatment for Myeloproliferative neoplasms (MPN) is that we each find an individual balance between thinning our blood, slowing blood cell proliferation, and avoiding/tolerating anaemic and other side effects.
But really I defer to the expertise of my haematologist and phlebotomists. No matter what horror stories are out there about hydroxyurea, for example, I’ve come to trust my specialists. In my experience they have tailored my treatments to how my body is responding, which can obviously vary month to month.
Most months I don’t need phlebotomy as the hydroxyurea does a good enough job at slowing the blood cell overproduction. The aspirin keeps my blood nice and thin so I don’t have to worry so much about clotting risks. And in months where my haematocrit is higher than 45 % then having a pint of blood drained seems pretty simple.
So I’d agree with @Erica that your treatment has to be your decision. I’d say be open to trying treatments your specialists suggest as they’ll be basing it on decades of research and not just prescribing stuff willy-nilly.
Do let us know how you get on and what you decide @Folkert. Maybe have a look around the forum for others with a similar dilemma.