Spleen removal as a treatment

Hi, I read these msgs every so often, then I think of something I want to ask. Your stories here help me a lot and it's a wonderful site.
Anyway my question is, is spleen removal still an option for treatment in Itp. I ask cos a doctor was pushing me to get it and I refused point blank and switched doctors. I found a nice doc who said no as there were no guarantees. Do you think the benefits outweigh the bad things when it comes to spleen removal. Is it necessary when there are many options available. I just wanna know from you guys in different countries.

When I was first diagnosed they mentioned it as a last resort. Yet some doctors say you should others not at all. Thanks in advance

A splenectomy is rarely ever considered to be necessary for ITP. One of the top ITP specialists does not even recommend them at all any more. As time goes on, research is showing that there are more problems that spleen removal can cause besides risk of infection.

I think that the doctors who push for it may not be up to date with current ITP protocol and treatments. The doctor who told you that there are no guarantees was right, there aren't. I think that splenectomy might have its place in the treatment line up, but only when the patient is ready to go that route after trying other options, or if nothing else works and the patient is seemingly refractory.

I do not think the benefits of splenectomy outweigh the risks in most cases. That is a personal decision though and everyone has to do what they feel is best for them.

Only after having ITP for two weeks.. the Dr told me I needed my spleen taking out.. At the time I disnt know any better so I agreed... so three weeks in I had my spleen removed.. eng my platelet level was at zero when i first saw the Dr.. its been a yr now and my platelets will not go up past 20,000.. so for me... it didnt help

ashy it is a personal decision - I did not have one 24 years ago because it was not proven to me that it was a cure, that it would work. When you come right down to it there are no guarantees with any of the treatments - I've been in "remission" after 1 WinRho IV in September 2002, that hasn't happened for everyone who has had WinRho.

What needs to be done is the person should research and then make the decision that is best for them - not be pushed into a decision because a doctor insists or because someone said you should/shouldn't do it.

Splenectomy was mentioned to me when I was first diagnosed as an option for if my spleen was enlarged. After they did an ultrasound and found that my spleen was not enlarged, it wasn't mentioned again.

Ashy, you were wise not to blindly follow your first doctor's advice.

I am convinced that, for most people, a day spent reading and asking questions on this website and following the various links will qualify you to make better ITP decisions than 90% of the doctors out there, most of whom are just too busy (or too lazy) to keep up with best practices and the most recent research in ITP, and too arrogant to admit how out of step they really are.

I am also convinced that the most knowledgeable people on this website collectively know more than do 99% of the individual doctors treating ITP. I am eternally grateful to you all!

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Having your spleen removed is an option if you click on the treatments page of the PDSA it will show you all different types of treatment options available. You must research and learn as much as you can to make a proper decision.

If you have your spleen removed one of three things can happen:
1. You go into remission and never have ITP again.
2. You go into remission for weeks, months or years than ITP comes back.
3. You never see a remission and still have ITP.

To help you make your decision think things like the following:

What treatment options are out there?

What are the side effects of the treatments?

Are there long term effects of treatments I need to be concerned with?

What if I opt not to treat?

If I have my spleen removed and it doesn't work am I ok with that?

Most importantly if you answer yes to the following question than what ever you decide is the right decision and no matter what happens you won't regret it.

Have I done my research, am I willing to accept what ever happens as a result, and did I make this decision?

To add to Winnifred's list of questions..

Am I aware of the possible complications of living without a spleen?

Thank you Ann knew I was forgetting something!

Not to complicate things to much, but can I add another.....

Am I aware of the risks associated with the anaesthetic and operation itself?

Thanks for all the info guys. It is amazing though how in ten years treatments have changed. My first doc in ireland was amazing and although he mentioned splenectomy he said it was most certainly a last resort and that they would try as much as they could to fix it before that. Luckily my platelets go crazy once every couple of years so I usually respond. The time I had a drop in platelets in London that doc was so pushy about splenectomy and until I got it wanted me to stay on a high dose of steroids even though nothing was working.

Last year, my itp stayed and annoyed me much more yet my second doctor in London(who I must mention specializes in itp) told me I did the right thing coming to him and he weaned me off steroids. Got put on an immunosuppressant and after three months they rose. My latest count at home is 236. Had I listened to that doctor, I'd still be on high dose prednisolone and be spleenless. He was so rude telling me how he was a doctor and when I used tell him how awful those pred made me he said I was strong and not to give up. Rob, I agree I'm grateful for this site. It educates me and helps me a lot. Winnie they are great points. Il take note of them . I think a spleen most only be used if no option is available.