The goal of Cancer treatment, either chemotherapy or radiation thereapy, is to interfere with the growth of cancer cells and ultimately destroy them. However, some of your body's normal cells, the hair follicles, the blood cells and the cells lining the gastrointestinal track are sensitive to these treatments and may also be damaged. Thus treatments also affect these cells causing symptoms known as side effects.
Fortunately, your body has the ability to repair the damage in normal cells, making the majority of the effects temporary. Some treatments can slow or depress the production of blood cells. That's why during the course of your therapy, the doctor will take samples of your blood to closely watch your blood cell count.
Where Blood Cells Are Formed
Blood cells are produced in the bone marrow and can be found in the skull, breastbone, ribs, backbone and pelvis. Each type of blood cell plays an important role in your body's normal functioning. There are there major types of blood cells:
- Red Blood Cells, which carry oxygen tothe body's tissues
- Platelets, which aid in the clotting of blood
- White Blood Cells, that help fight infection
Red Blood Cells
One functin of the red blood cells is to carry oxygen to the tissue in your body. Hemoglobin and hematocrit are the tests used to evluate the red blood cell. When tehse measures are low, your body tissues don't get enough oxygen to do thier work. This results in a condition called anemia.
If you are anemic, you may feel:
- Unusually tired or weak
- Dizzy
- Shortness of breath
- Pounding in yor head or ringing in your ears
- Chest pain or heaviness, if so, call 911
REPORT THESE SYMPTOMS TO YOUR NURSE OR DOCTOR.
What to do when you are anemic:
- Get plenty of sleep
- Save energy by having short periods of activity and by resting between activities
- Avoid dizzyness by moving slowly when transitioning from a laying position to standing; sit up for sevearl minutes before standing
- Add iron containing foods to yor diet when possible such as dark green leafy vegetables or over-the-counter iron tablets
Although some anemia improves on its own, yor doctor may want to give you medication or a blood transfusion.
How to rrecognize low platelets
If there are not enough platelets in your blood, you may notice signs of bleeding (either internal or external) such as:
- Nosebleeds
- Bleeding gums
- Easy bruising
- Prolonged bleeding from a cut
- Black or bloody stools
- Brown or red urine
- Tiny pinpoint sized red or purple spots on your skin (called petechiae)
Be sure to notify yor nurse or doctor of any of these symptoms.
What to do when your platelet count is low:
- Avoid taking aspirin or aspirin containing medications
- Use a soft tooothbrush and do NOT floss teeth
- Use caution when using knives or tools
- Shave with an electric razor
- Avoid contact sports
- Wear protective gloves while working in the yard or doing dishes
- NOTES:
- If you should cut yourself, put a clean cloth or tissue over the cut, apply preasure for several mintues. If bleeing does not stop, call your nurse or doctor or seek immediate medical attention.
- If you should have a nosebleed, apply pressure and ice over th bridge of our nose for several minutes. If the bleeding does not stop, call your nurse or doctor.
- If you fall and hit your head, report to the emergency department or call 911 immediately.
White Blood Cells
White blood cells help protet the body by fighting bacteria that cause infection. Therefore, it is especially important to protect yourself against infection when you white blood cell count is low.
How to recognize an infection:
If you have an infection when your white blood cell count is low, the usual warning signs such as pus formation, redness and swelling may not always be present. Signs you should watch for may include:
- Oral temperature of 101 degrees or higher
- Shaking or chills
- Diarrhea for more than 2 days
- Burning feeling when urinating
- Frequent urination
- Cough or sore throat
- General feeling of tiredness or flu-like symptoms
- Redness, swelling, yellow or green drainage at an outer wound site.
If any of these symptoms occur, be sure to notify your nurse or doctor promptly.
What to do to help prevent infection:
When your white blood count is low, your own body can be the source of infection. The bacteria that normally live in your body and or your skin can be the cause of an infection. Certain areas of the body are frequent sites of infections. Regular examination of these areas and careful observation for signs of infection can lead to early detection.
Common Sites of Infection
Mouth
Good mouth (oral) care is extremely important. You should examine your mouth routinely (if you have dentures they should be removed during the examination), paying close attention to the areas inside and around the lips, under the tongue, around the edges of the teeth, on the roof of the mouth and on the inside of the cheeks. Oral infections may appear to be tender red areas, ulcers, cold sores or white patches. (Please refer to oral care information)
Skin
The skin is the first line of defense against infection. When the skin is broken, the chance of infection increases. Avoid cuts and scratches. Regular self-examination of your skin is very important. Any changes (rashes, sores or cuts) should be reported to your physician.
Preventative measures
- Wash hands with soap frequently, and always before a meal and after using the bathroom
- Wear shoes and or socks at all times
- Wear gloves when working in the garden or washing dishes
- Use lotion or oil to soften dry skin
- Clean a scrape or cut immediately with warm soapy water
Lungs
The lungs are the only major internal organ of the body exposed to air and easily reached by airborne germs. It is important to recognize early signs of lung infection and report them to your nurse or doctor promptly. Possible signs of lung infection are:
- Shortness of breath
- Coughing up sputum (Phlegm)
- Fever
Preventative measures
- Avoid crowds if possible
Prescribed Medications for Blood Related Treatment Issues
If your blood count becomes affected by your cancer treatment, medications may be prescribed for either your white or red blood cells. For white blood counts, Neupogen or Neulasta may be prescribed. For red blood counts Procrit or Aranesp are options. As with all medications, there may be side effects to their use. Some of the side effects of each class of medications is listed below along with special instructions each patient should be aware of.
Neupogen/Neulasta
- Side effects
- Bone Pain
- Dizziness, headache
- Hair Loss
- Nausea
- Constipation, diarrhea
- Fatigue
- Fever
- Low Platelets
- Taste changes
- Insomnia
- General weakness
- Swelling of hands and feet
- Mouth sores
- Reoccurrence of some pre-existing skin conditions
- Allergic reaction
- Rarely occurs but is exhibited by one or all of the following: rash, itching, swelling, thick tongue, shortness of breath, difficulty swallowing. If an allergic reaction is suspected, take 2 Benadryl (25mg each) and call 911 or go to the Emergency Room.
- Special Instructions
- Do not take aspirin or aspirin containing products unless prescribed by your physician
- You may use Tylenol, 2 tablets every 4 hours for 24-48 hours if needed for bone aches and flu-like symptoms
- Neulasta must be taken 24 hours after chemotherapy, and 11-14 days prior to starting chemo
- Neupogen should not be taken within 24 hours before chemotherapy and within 24 hours after chemo treatment unless ordered by your physician
- Call you doctor if any of the following occur while taking these drugs:
- Encounter unusual bleeding or bruising
- Have new pain
- Have a fever over 101F
- See blood in urine
- Have signs of an allergic reaction
You must get immediate medical attention for this. If you are unable to get medical attention, contact your doctor right away, then go to the Emergency Room.
Procrit/Aranesp
- Side effects
- Increased blood pressure (may aggravate pre-existing high blood pressure)
- Infection
- Fever
- Headache, dizziness
- Muscle ache, muscle soreness, muscle weakness, joint pain
- Nausea and vomiting (infrequent)
- Diarrhea or constipation
- Leg and or arm swelling
- Chest pain
- Redness, swelling or itching at injection site
- Formation of blood clots
- Fatigue
- Flu-like symptoms
- Allergic reaction
- Rash covering entire body
- Shortness of breath
- Wheezing
- Drop in blood pressure
- Swelling around mouth and eyes
- Fast pulse
- Sweating
- Special Instructions
- Call your doctor if any of the following occur while taking these drugs
- If you experience an allergic reaction take 2 Benadryl (25mg each) and call your doctor or 911
- If you are on hemodialysis and feel your vascular access is blocked
- if you have heart disease and experience changes outside of your established guidelines
- if you are unable to eat or drink for more than 24 hours
- if you develop any pain or swelling
- if you develop headaches, faintness, dizziness or high blood pressure
- if you develop loose stools for more than 4 days
- if you develop a fever over 101F and or experience chills
- Call your doctor if any of the following occur while taking these drugs