Recently Diagnosed With PV and ET

Hello,

I am new here as I’ve only recently been diagnosed with Polycythaemia vera ('PV') and Essential thrombocythemia ('ET'). I also have the JAK2 mutation.

I have been offered the hydroxy but I’m really unsure if I want to take it or not.

I also have severe ME/CFS so I’m 100% housebound and at present 100% bedbound.

If I suffer now with debilitating exhaustion and fatigue to the point were some days I cant manage to eat or drink. How am I going to be on the chemo?

I have my next appointment with my hematologist 7tj Sept. I just don’t want to feel pressured into the chemo. They have already said once my platelet count comes down I should start to have more energy.

Any advice from anyone please would be much appreciated

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Welcome to the forum @jojo888
I’m so sorry to hear how much you’re dealing with at the moment.

My own blood cancer is a different type, so I can’t speak directly about taking hydroxy, but there are plenty of members here with Polycythaemia vera ('PV') and Essential thrombocythemia ('ET') who I’m sure will jump in with their experiences. It’s completely normal to feel unsure about starting a new medication, and you definitely shouldn’t be made to feel pressured by your team.

In case it’s useful to read through before your appointment on 7th September, here are a few good resources:

Blood Cancer UK: Polycythaemia vera (PV) information**

Blood Cancer UK: Essential thrombocythaemia (ET) information**

Myeloproliferative neoplasms ('MPN') Voice: Resource for MPN conditions**

Take things one day at a time, and keep posting whenever you need a bit of support.

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Hello there @jojo888, welcome to the forum. I’m really so sorry about your recent diagnoses, and I hear your concerns about taking hydroxyurea. You are not alone with any of this and have found just the right place.

Perhaps I can offer my experiences as someone living with Polycythaemia vera ('PV') and taking hydroxyurea after finding I have the JAK2 gene mutation, just like you. I also live with a couple of other chronic ailments which have made me think twice about taking chemotherapy. Isn’t it a lot to take in?!

I see Jules has shared the great Blood Cancer UK information about Polycythaemia vera ('PV') and Essential thrombocythemia ('ET'). You likely already know that they are rare, closely related types of Myeloproliferative neoplasms ('MPN'), and from my non-medical understanding are rarer still as a double diagnosis. Here’s the BCUK information about Myeloproliferative neoplasms ('MPN') for reference: Myeloproliferative neoplasms | Blood Cancer UK

I was fortunate not to have any typical Polycythaemia vera ('PV') symptoms before diagnosis, but must admit that I experienced pretty disabling fatigue after starting hydroxyurea. Not everyone around the forum taking hydroxyurea say they experience fatigue. Cancer-related fatigue (CRF) is apparently really common though, according to my haematologist and research, but there are a few things that can help.

One was to keep active and moving in ways I could manage, and I appreciate that being bed-bound will affect this. Yoga is meant to really help boost energy for those of us living with blood cancer, and there are adaptations for doing yoga in chairs that might work for you too. Maybe check with your ME/CFS specialists what sort of movement is okay for you. I find the purposeful stretching and breathing inherent in slow yoga really helps me feel less overwhelmed, maybe for you too?

Another main thing that really helped me was finally sorting out my terrible sleep and developing a bedtime routine. Waking around the same time each day, getting daylight into my eyes early on to stabilise my circadian rhythm, and keeping to the same bedtime has incredibly sorted out my lifelong insomnia! Daylight bulbs at home can help with this too, helping us produce vitamin D like we get from sunlight.

My fatigue faded over about 3 months, and occurred again more weakly when I changed dosage a year later, but I’d say it’s mostly gone now 3 years later. I do need to watch that I don’t expend my energy too early in the day or else I’ll be exhausted by the evening. But I think, with hindsight, that it was other chronic diagnoses also affecting how quickly the chemo came to stabilise my blood cells.

You haven’t mentioned venesections AKA phlebotomy but we survivors of Myeloproliferative neoplasms ('MPN') often need to have blood removed after diagnosis as it can get rather thick/viscous, having a higher than 45 % haematocrit. Over time these venesections help bring down our platelet and other blood cell numbers into less risky and normal ranges.

I know other forum members who have kept having venesections without taking chemo, in discussion with their haematologists, but there are often anaemia complications if blood keeps being removed in the long-term. My own haematologist said he wanted to free me from phlebotomy, which he did after 2.5 years!

In my case, I no longer need venesections as the hydroxyurea has stabilised all my blood cells. I’ve been in awe at how it keeps my blood just the right sort of thin enough to flow safely with fewer clotting risks. I also enjoy having the time back from all the hospital appointments I no longer need.

So I’d say do keep list of all your queries @jojo888 and then you can ask your specialists. I often find my nurses share great practical tips so do ask when you see them too. Early after diagnosis I think it can really help to have a loved one go to appointments with us to help take notes, be a second set of ears, and to bring us home when it’s a bit much.

Don’t forget you can always call the lovely Blood Cancer UK specialist nurses on 0808 2080 888 for medical advice and other resources before you see your specialist.

If you want to find others around the forum who live with Myeloproliferative neoplasms ('MPN') or take hydroxyurea then use the search box at the top. Here’s one thread of note: Question to other PV and ET patients

Hope that helps a little and sorry for the wall of text, do let us know how you get on @jojo888.

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Hi @jojo888

Thank you for your post and welcome to our forum. We are sorry to hear about your recent diagnosis of Polycythaemia vera ('PV') and Essential thrombocythemia ('ET'), alongside living with severe ME/CFS. We can imagine this is an overwhelming time for you. It’s completely understandable that you have concerns about starting hydroxycarbamide and how it might affect your fatigue and quality of life.

When it comes to decisions about treatment, your haematology team are really the best people to help you weigh up the potential benefits and risks for your individual situation. They should be able to talk through why hydroxycarbamide has been recommended, what they hope it will achieve, any possible side effects, and how it may interact with the symptoms you’re already experiencing from ME/CFS.

It’s important that you feel informed and comfortable with any decision you make. Before your next appointment, it might be helpful to make a list of questions and concerns so that you can discuss them fully with your haematologist. For example, you could ask how hydroxycarbamide might affect your fatigue and what alternatives might be available if you have concerns about side effects.

There have already been some really helpful replies from others on this thread, including useful links and shared experiences.

You may also find this hydroxycarbamide leaflet from our colleagues at Myeloproliferative neoplasms ('MPN') Voice helpful, as it provides more detailed information about the treatment, this can be accessed via: https://www.mpnvoice.org.uk/wp-content/uploads/2025/11/Drug_Hydroxycarbamide_March2025_A5_WEB.pdf

Do keep us updated!

Warm wishes,

Emma (support services nurse)

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