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Cancer cells grow and multiply rapidly, and chemotherapy specifically attacks rapidly growing cells. Healthy cells may also be affected by chemotherapy because they naturally reproduce faster than other cells in your body. Healthy cells that may be negatively affected by chemotherapy include those in the hair follicles, in the mucous membranes, and in the bone marrow where blood cells are made.
Prior to each cycle of chemotherapy, your physician will order a complete blood count (CBC) to make sure it is safe to administer your treatment. Blood counts begin to decrease after chemotherapy, and reach their low point, or nadir, 10 to 14 days after the first day of your treatment cycle. We will schedule an appointment for you at that point to check your counts and see how they have been affected by the chemotherapy.
We will specifically be looking at the following results:
White blood cells fight infection.
Signs of infection include:
Notify your physician or nurse immediately if any symptoms of infection develop. A CBC will be checked and oral antibiotics may be prescribed. If the white blood count is especially low and signs of infection are present, your physician may decide to admit you to the hospital for intravenous antibiotics for a few days. We also may decide to prescribe oral antibiotics at your nadir visit even if you are feeling well, just to prevent the need for hospitalization for infection.
When the white blood count is low, avoid crowds and close contact with sick adults and children. Save dental work until after the white blood count improves. Prevent oral infections by reporting any sores in the mouth and following our guidelines for preventing mouth problems. Watch for rashes or sores on the skin. The single most important way to prevent infection is through frequent hand washing after contact with other people, before eating, and after using the bathroom.
In some cases, your physician may decide to prescribe a medication to raise the white blood count, called GCSF (also known as Neupogen), for injection at home. In those cases, a nurse will instruct you in how to do the injection, and will arrange to supply you with everything you need to take this medicine comfortably and safely.
Red blood cells carry oxygen to all the cells in your body. When the red blood count is low, you become anemic.
Signs of anemia include:
Some people are anemic when they begin their treatments due to underlying disease; others develop anemia over time due to the effects of chemotherapy. If symptoms of anemia develop, get plenty of rest, and take breaks between activities. Avoid dizziness by getting up slowly from a lying to ,a standing position. When we check your CBC in the office, we will monitor you for anemia. In some cases, your physician may decide to prescribe Procrit in order to raise your red blood count. Procrit is a medicine injected at home on a weekly basis. In these cases, a nurse will instruct you in how to do the injection, and will arrange to supply you with everything you need to do the injection safely and comfortably. In certain cases, a blood transfusion may be needed in order to treat your anemia rapidly.
Platelets help your blood to clot. Signs of a low platelet count include:
When the platelet count is low, avoid aspirin and aspirin-containing medications, such as those for cold/flu symptoms, since aspirin interferes with normal platelet function. Avoid flossing your teeth, and use a soft brush. Shave with an electric razor and be careful when using sharp tools and knives. Avoid contact sports, and always wear a helmet when bike riding or roller lading. Dental work should be delayed until the platelet count recovers. If a nosebleed develops, apply ice and pressure to the bridge of the nose until it stops. If any of the above signs of low platelet count develops, call your physician. A CBC will be checked and in certain cases, a platelet transfusion may be required when the count is extremely low.
The overall message in here is to call your physician or nurse if any of the above symptoms occur. Also call Uncontrolled nausea, blood in the urine, or with any questions you may have. We encourage frequent communication with the office, especially in the beginning when everything is strange and new. Feel free to use this outline as a guide, but not as a substitute for contact with the physician or nurse. During the day the oncology nurses are available by phone and voice mail, and a physician is available 24 hours a day and on weekends, through our main office phone number, (415) 923-3012.
2100 Webster St. #225, San Francisco, CA. 94115 |
Phone: (415) 923-3012
Fax: (415) 928-4840
Fax (New Patient Referrals): 415-423-1718
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