Diagnosis
Your healthcare professional takes a medical history and do a physical exam.
Blood tests
If you have polycythemia vera, blood tests might show:
- More red blood cells than usual and, sometimes, an increase in platelets or white blood cells.
- A higher portion of red blood cells that make up total blood volume, called hematocrit measurement.
- Higher level of the iron-rich protein in red blood cells that carries oxygen, called hemoglobin.
Bone marrow aspiration or biopsy
A healthcare professional who suspects that you have polycythemia vera might suggest getting a sample of your bone marrow through a bone marrow aspiration or biopsy.
A bone marrow biopsy involves taking a sample of the spongy tissue in bone marrow. A bone marrow aspiration often is done at the same time to get a sample of the liquid portion of your marrow.
Gene testing
Study of your bone marrow or blood might show the gene change that's linked with the disease.
Bone marrow exam
In a bone marrow aspiration, a healthcare professional uses a thin needle to remove a small amount of liquid bone marrow. The marrow often is taken from a spot in the back of the hipbone. A bone marrow biopsy removes a small piece of bone tissue and its marrow. The procedures often are done at the same time.
Treatment
There's no cure for polycythemia vera. Treatment aims to lower your risk of complications. Treatments also might ease your symptoms.
Blood withdrawals
The most common treatment for polycythemia vera is having blood withdrawn often. This is done using a needle in a vein, called phlebotomy. It's the same procedure used for donating blood.
This lowers your blood volume and reduces the number of excess blood cells. How often you need to have blood withdrawn depends on how severe your condition is.
Treatments to reduce itching
If the condition causes itching, medicines such as antihistamines or treatments with ultraviolet light might give you relief.
Medicines that are used to treat depression, called selective serotonin reuptake inhibitors (SSRIs), helped relieve itching in clinical trials. SSRIs include paroxetine (Brisdelle, Paxil) or fluoxetine (Prozac, Symbyax).
Medicines that lower the number of red blood cells
If phlebotomy doesn't help enough, these medicines can lower the number of red blood cells in your blood:
- Hydroxyurea (Droxia, Hydrea, Siklos).
- Interferon alfa-2b (Intron A).
- Ruxolitinib (Jakafi).
- Busulfan (Busulfex, Myleran).
Heart medicines
Your healthcare professional also will likely prescribe medicines to control risk factors for heart and blood vessel disease. These include high blood pressure, diabetes and high cholesterol.
You also might take a low dose of aspirin to reduce your risk of blood clots. Low-dose aspirin also may help reduce burning pain in your feet or hands.
Self care
Here are ways to feel better if you have polycythemia vera:
- Exercise. Gentle exercise, such as walking, can improve blood flow. This helps lower the risk of blood clots. Leg and ankle stretches and exercises also can improve blood flow.
- Don't use tobacco. Using tobacco can narrow your blood vessels. This raises the risk of heart attack or stroke due to blood clots.
- Don't go places with low oxygen levels. Living at high altitudes, skiing or climbing in mountains all reduce the oxygen levels in your blood.
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Be good to your skin. To reduce itching, bathe in cool water, use a gentle cleanser and pat your skin dry. Adding starch, such as cornstarch, to your bath might help. Don't use hot tubs or heated whirlpools. Don't take hot showers or baths.
Try not to scratch. Scratching can hurt your skin and raise the risk of infection. Use lotion on your skin to keep it moist.
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Take care in hot and cold temperatures. Poor blood flow increases your risk of injury from hot and cold temperatures. In cold weather, always wear warm clothing. Keep your feet and hands warm.
In hot weather, protect yourself from the sun. Drink plenty of liquids.
- Watch for sores. Poor blood flow can make it hard for sores to heal. Look at your hands and feet often. Tell your healthcare professional about any sores.
Preparing for your appointment
You're likely to start by seeing your primary health professional. If you have with polycythemia vera, you might be sent to a specialist in blood conditions, called a hematologist.
Here's some information to help you get ready for your appointment.
What you can do
Make a list of:
- All your symptoms and when they began.
- Key personal information, including other medical conditions and family medical history.
- All medicines, vitamins or supplements you take, including doses and how often you take them.
- Questions to ask your healthcare professional.
For polycythemia vera, questions to ask include:
- What's the most likely cause of my symptoms?
- What tests do I need?
- Will this condition go away, or will I always have it?
- What treatments are available? Which do you suggest?
- I have other health conditions. How can I best manage them together?
- Should I see a specialist?
- Will I need follow-up visits? If so, how often?
- Are there brochures or other printed material I can have? What websites do you suggest?
Don't hesitate to ask other questions you have. Take a family member or friend along, if possible, to help you remember the information you're given.
What to expect from your doctor
Your healthcare professional is likely to ask you questions, including
- Do you have symptoms all the time, or do they come and go?
- How do your symptoms affect your life?
- What, if anything, seems to make your symptoms better?
- Does anything make your symptoms worse?
