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These may or may mot be a problem for you!
Chemotherapy is made to kill rapidly dividing cancer cells.
However, some normal cells in our bodies, such as blood cells and cells
in hair follicles, digestive tract (mouth, esophagus, stomach, intestines), and
reproductive organs also multiply quickly and can be affected by chemotherapy.
It is this damage to normal cells that causes side effects.
While it is not possible to predict how each person will react to
treatment, we will do our best to prevent or reduce the duration of any side
effects you experience. It is your
responsibility to report side effects to Dr. Carroll, Kate, Barbara, Debbie, or
Dorothy for adequate symptom control. It is important to remember that every person will
not get every side effect, and some people will get few, if any.
It is also important to know that the number or severity of side effects
does not indicate how well the chemotherapy is working; if you have few or mild
side effects, it does not mean the treatment is not working.
Most side effects are temporary and will subside when treatment ends,
although, in some cases, this may take weeks or months.
Anxiety is a normal reaction when you have been diagnosed with cancer. You may have anxiety about the cancer itself, or about surgery, chemotherapy, or radiation therapy. Anxiety can interfere with your ability to rest or sleep, increase nausea and vomiting, increase feelings of pain, and interfere with your ability to perform normal activities. Let Dr. Carroll or Kate know if anxiety is severe or interfering in your daily life; you may need medication on a short-term basis to reduce anxiety. To
help relieve anxiety:
Many
of our patients will receive the drug Cyclophosphamide, commonly known as
Cytoxan. It is well known that
Cytoxan can irritate the bladder lining as your body breaks down the drug.
The lining of the bladder can become swollen or ulcerated, which causes
bleeding. Usually this side effect
does not occur at the doses given for breast cancer, but it is worth practicing
a few preventative strategies.
To help prevent bladder irritation:
Bone
marrow is the tissue inside some bones that produces all the blood cells in your
body. White blood cells (WBC)
help fight infections. Red blood
cells (RBC) carry oxygen
throughout your body. Platelets
help stop bleeding by forming clots to seal damaged blood vessels.
These cells are rapidly reproducing, and thus are prone to damage by
chemotherapy.
Neutropenia
is the medical term for a low WBC count. If
your WBC drops, it does not mean that you will get an infection, however, you
are at greater risk for infection. The risk of infection is directly related to the amount of
time the WBC count is lower than normal and to how much lower than normal it
drops. The nadir, or lowest WBC
count after treatment, usually occurs 10-14 days after therapy.
One way to calculate your risk of infection is by figuring out your
absolute neutrophil count (ANC). The
ANC is calculated by multiplying the total WBC by the percentage of neutrophils
(granulocytes); see copy of lab work for this information. ANC>1500
no increase risk of infection ANC
1000-1500 moderate risk of infection ANC
500-1000 high risk of infection ANC<500
extremely high risk of infection Please
notify us if you have any symptoms of infection, such as: fever, shaking chills, sore throat or sores in mouth,
productive cough, burning during urination, diarrhea, redness, swelling, or
drainage from incision. If your ANC
is <500 and you have a fever, you may need to be admitted to the hospital for
IV antibiotics. Tests will be done
to find the source of infection. You
will be able to go home once your WBC count returns to normal and you are no
longer running a fever. Depending
on the therapy you are receiving, you may need a growth factor such as Neupogen
or Neulasta to help keep your WBC within normal range. These drugs are given as injections in the back of your arm. Here are some hints to help prevent infection while you are receiving chemotherapy:
The
medical term for low red blood cell count is anemia.
Hemoglobin (HgB) is the portion of the red blood that carries oxygen.
Hematocrit (Hct) is the percentage of total blood volume occupied by red
blood cells. These are the lab
results we check to see if you are anemic.
Anemia may cause: increased
heart rate or irregular heart beat, shortness of breath, fatigue, weakness,
dizziness or lightheadedness when changing positions, headaches, pale skin,
chest pain, or irritability. Notify
Dr. Carroll or Kate if you are having any of these symptoms.
Anemia related to chemotherapy is temporary, however, if you are anemic
and having symptoms such as those listed above, you may need a growth factor
such as Procrit or Aranesp. These
drugs are given as injections in the back of your arm.
If your RBC count drops too low (which rarely happens with the treatments
for breast cancer) you may need a blood transfusion. Call
the office for:
Thrombocytopenia
is the medical term for low platelet count.
Platelets help your blood clot. If
your platelet count is low you may: bruise
easily or develop very large painful bruises (ecchymosis or hematoma) or
petechiae (small reddish-purple spots under the skin); bleed longer than normal
if you cut yourself; develop bleeding gums or nose bleeds.
Risk
of bleeding is based on your platelet count: 100,000
–normal little to no
risk 50,000-99,000
increased risk with injury 20,000-49,000
increased risk without injury 10,000-19,000
greatly increased risk without injury Less
than 10,000 risk
of spontaneously bleeding If
your platelet count drops too low (which rarely happens with the treatments for
breast cancer) you may need a platelet transfusion. If
your platelet count is less than 50,000:
Call
the office for:
Short-term
memory loss, being easily distracted and having trouble concentrating,
difficulty multitasking, difficulty understanding new things, and difficulty
with math and/or language skills are some of the impairments cancer patients
undergoing chemotherapy may experience. These
symptoms are often referred to as “chemo brain.” It has
been shown in various studies that a woman receiving chemotherapy for breast
cancer has a decrease in mental activity compared to a healthy woman.
It is not known if the chemotherapy itself is to blame, or if it is
related to decreased estrogen as a result of the chemotherapy.
Supportive medications such as antiemetics, antianxiety medications, and
pain medicine also need to be taken into account.
In addition, anemia, fatigue, depression, and anxiety have been shown to
contribute to cognitive dysfunction. Most
people return to “normal” by 1-2
years after chemotherapy finishes. However,
about 20% of patients may suffer from long-term cognitive dysfunction. Here are some suggestions to combat chemo-brain:
Constipation
is the infrequent passage (usually with discomfort) of hard, dry stool.
You may also experience excessive straining, bloating, increased gas,
abdominal cramping, or pain. Excessive straining to pass stool can lead to hemorrhoids or
rectal fissure. Constipation
affects about half of people with cancer. Risk factors for developing constipation include:
Preventing constipation is easier than treating it once it occurs. A prevention program consists of increasing dietary fiber and fluids, along with an increase in exercise.
We
realize that nausea/vomiting may interfere with proper diet, and fatigue may
interfere with exercise. The addition of fiber tablets on a daily basis will be
helpful in adding fiber to your diet. Be
sure to take with a full glass of water as directed on the package.
You may need to add an over the counter stool softener such as Colace
(100mg twice a day) or mild laxative such as Senna (up to 8 tablets per day) to
prevent constipation. If this
doesn’t work, you may need to add a stronger intestinal stimulant such as
Dulcolax or Milk of Magnesia to your bowel regimen.
You can also try Lactulose or Sorbitol. If you
have not had a bowel movement in over 2-3 days, call us for further
instructions. Do not use enemas or
rectal suppositories without first checking with us—if your white blood cell
or platelet count is low it can be risky to use these due to increased risk of
infection, abscess, or bleeding. The
rectal area can become quite uncomfortable due to constipation and straining.
Take care to keep anal area clean. Warm
baths or soaks can make you feel comfortable, followed by a soothing ointment
such as A&D ointment, Desitin, etc. If hemorrhoids are a problem for you,
you may want to try using Lanacane or Preparation H ointment, or Tucks pads.
As always, call us if these remedies are not making a difference for you. It is
normal to have some degree of depression after being diagnosed with cancer.
However, if the feelings of depression last more than a couple of weeks,
or interfere with your daily activities you may have clinical depression.
About 25% of cancer patients suffer from clinical depression. Symptoms
of depression include:
Things
to do:
Diarrhea
can be defined as an increase in the number of bowel movements per day, an
increase in the amount (volume) of stool per day, or a change in the way your
stools look (consistency). Abdominal
cramping, bloating, excessive gas, the sudden urge to defecate, or accidental
movement of stool may accompany diarrhea. Diarrhea
occurs in about three out of four people receiving chemotherapy.
Diarrhea can be serious or life threatening if dehydration, electrolyte
imbalance, or infection occurs. You
may take Immodium-AD up to 8 capsules per day if needed.
It is important to let us know if diarrhea persists after taking Immodium,
especially if abdominal cramping, bloody stool, or fever accompanies it.
You may need to come into the office to be evaluated. Some
dietary guidelines for controlling diarrhea include:
The
rectal area can become raw and irritated from diarrhea.
Keep area clean and dry, and apply a protective skin barrier such as
Balmex, Desitin, A&D ointment, or petroleum jelly to anal area after each
bowel movement. Use warm sitz baths
(available at pharmacy or drug store) several times a day to soothe skin.
Use unscented baby wipes or warm wash clothes to clean skin after each
BM; gently pat area dry. Call
the office for:
Dry
mouth (xerostomia) can occur as a result of chemotherapy drugs (Cisplatin,
Cyclophosphamide, Doxorubicin, 5-Fu, and Methotrexate to name a few) or from
supportive therapy drugs such as, antihistamines, antiemetics, anti-anxiety
medications, narcotic pain medications, antibiotics, and anti-depressants. In most cases, xerostomia is a temporary condition and will
improve once the offending medication is stopped. While xerostomia is not a life-threatening condition, it can
negatively affect your quality of life, causing difficulty chewing, swallowing,
talking, and even sleeping. Dry
mouth can be exacerbated by dehydration caused by nausea, vomiting, or diarrhea. If your mouth is dry:
Fatigue
is one of the most common side effects of cancer and cancer treatments.
The exact reason for cancer-related fatigue is unknown.
In addition to the cancer treatment or cancer itself, possible causative
factors of fatigue include anemia, medications, emotional stress, difficulty
sleeping, poor nutrition, dehydration, decreased levels of hormones, decreased
physical activity, increased energy needs of the body to repair cell damage
caused by chemotherapy or radiation therapy, changes in metabolism, and pain.
Fatigue usually resolves when therapy is completed, although this may
take several months and some patients may never return to their pretreatment
level of energy. With
fatigue caused by chemotherapy, you may also experience these feelings:
weariness, irritability, impatience, or lack of motivation; weakness;
lack of energy; difficulty thinking, inability to concentrate, or forgetfulness;
decreased ability for physical activity; and lack of interest in normal
activities. To help combat fatigue:
Flulike
syndrome (FLS) is a side effect of several medications, including Aranesp,
Gemzar, Herceptin, Neulasta, Neupogen, Procrit, Taxol, or Zometa.
You may experience fever with chill, headache, muscle or bone aches,
nasal stuffiness, dry cough, diarrhea, or fatigue.
These symptoms may decrease with subsequent doses as your body gets used
to the medication. Although the exact cause of FLS is not known, there are things you can do to relieve or reduce symptoms.
Hair
loss (alopecia) is a common side effect of many chemotherapeutic agents.
The trend toward combining two or more chemotherapeutic agents with
differing mechanisms of action increases the likelihood of producing hair loss. The
following drugs have a high potential to produce alopecia:
Adriamycin, Cytoxan, Taxol, and Taxotere. The
following drugs have a moderate potential to produce alopecia: Cisplatin, 5-FU,
Methotrexate, Mitoxantrone, Navelbine, Topotecan, and Vincristine. The
following drugs have a low to no potential to produce alopecia:
Carboplatin, CPT-11, and Gemzar. Hair
loss typically begins to appear about 2 weeks after the first dose of
chemotherapy, with continued loss over the next 3-4 weeks.
Alopecia from Taxotere usually appears 2-3 weeks after the beginning of
therapy and is often sudden and cumulative (all hair on body).
Hair loss may extend to hair on legs, underarms, eyebrows, eyelashes, and
pubic hair. Hair
loss is nearly always temporary when caused by anticancer drugs.
Hair sometimes starts to regrow during treatment.
Once systemic therapy has stopped, your hair will typically grow back
although this may take several months. When
your hair grows back, it may have a different color or texture then before
treatment. Hair
loss may affect the way you feel about yourself. Always remember that hair loss is temporary.
Most women find that is helps the acceptance process if their hair is cut
fairly short prior to its falling out. Think
about getting a wig, hat, or scarf early in your treatment schedule, before you
lose your hair. We can write a
prescription for a wig that will facilitate payment by your insurance company. Some organizations provide wigs free of charge, however, they
may not have a wide selection available. Try
Cancer Care (1-800-813-4673), Y-ME National Breast Cancer Organization
(1-800-221-2141), or your local American Cancer Society (1-800-227-2345).
And, if you want to go without a wig, that’s okay too! Remember that your scalp is suddenly exposed to the elements and must be protected:
How
chemotherapeutic agents cause joint pain (arthralgia) and muscle pain (myalgia)
is uncertain, and there is no specific treatment for these side effects.
Pain in the large joints of the legs and arms can occur any time from
48-72 hours after you receive chemotherapy and can last from 4-7 days.
The discomfort can range from a mild ache to severe pain.
You may also have trouble getting out of bed or a chair due to pain or
stiffness. This muscle and joint
pain can be more noticeable if growth factors such as Neupogen, Neulasta,
Procrit, or Aranesp are part of your treatment.
This side effect may not occur with every treatment; you may experience
pain after one treatment and not feel any aches after the next.
You are at increased risk for arthralgia and myalgia if you are being
treated with a drug, such as Taxotere or Taxol, that causes numbness and
tingling in extremities, or if you have a history of diabetes, alcohol abuse, or
arthritis. These
are some ideas how to manage this pain at home:
Anorexia
is a decrease in or complete loss of appetite.
Patients may develop anorexia related to alterations in taste, changes in
gastrointestinal function (N/V, diarrhea, constipation, feeling full, dry mouth,
etc.), depression, anxiety, pain, fatigue, or due to the cancer itself.
In most cases, loss of appetite is temporary.
It is important that you are able to get enough protein and calories
while you are on chemotherapy to help you maintain your strength and energy, and
be better able to tolerate treatment. Here are some helpful hints for dealing with anorexia:
Lymphedema
is an abnormal increase of protein-rich fluid (lymph), which causes swelling of
the affected body part, most often your arms or legs. Lymphedema can also affect the breast area because fluid from
there must drain through the underarm to get back into circulation.
Normally, the lymph fluid is carried via lymph vessels, through lymph
nodes, which act as strainers to remove cellular waste or bacteria, and back
into the bloodstream. When your lymphatic system is damaged by surgery (i.e.
axillary lymph node dissection) or radiation therapy it is not able to move
fluid as efficiently, resulting in lymphedema.
Fluid accumulation is usually slow, and typically begins in your fingers
or toes and progresses up the affected limb.
This accumulation of protein-rich fluid increases your risk of infection
in the affected limb. There
are three stages of lymphedema. In stage
I, there is little to no swelling. Your
fingers may be a little swollen and you may notice your jewelry is tight.
In this stage, swelling is usually reversible with elevation of the
affected limb. Stage II
lymphedema is characterized by increased swelling of the affected body part. The skin may feel tight and firm to touch; it may be shiny.
You may have pitting edema, where if you touch your fingertip to the skin
it leaves an obvious imprint. In
this stage, fluid can only be moved out of the affected limb with physical
therapy, massage therapy, and/or a compression sleeve to force fluid out and
prevent recurrence. Stage III
lymphedema is a severe, prolonged swelling in the affected body part.
The skin may have a leathery feel and take on a darker or brownish tint.
Papillomas, wart-like bumps on the skin, may form and actually leak fluid
if lymphedema progresses without intervention.
At this point, the body is unable to evacuate the fluid on its own, and
even with intensive therapy the fluid may not be totally eliminated.
Women
with cancer may develop estrogen deficiency as a result of natural menopause, or
prematurely as a consequence of surgery or chemotherapy.
For younger women, menopausal symptoms brought on by chemotherapy may be
temporary. The closer you are to
natural age of menopause, the greater the chance the symptoms may be permanent.
Even if you are having symptoms of menopause you may still be able
to get pregnant and it is important to use an effective form of birth control if
you were premenopausal prior to starting treatment. Symptoms
of menopause include: hot flashes,
vaginal dryness or irritation, headaches, dizziness, thinning of hair, irregular
or no menstrual period, weight gain, insomnia, anxiety, depression, and
increased urinary or vaginal infections. Women
with a history of breast cancer are advised not to take hormone replacement
therapy due to concerns that estrogen may activate cancer cells in
hormone-sensitive breast tissue. To relieve or reduce menopausal symptoms:
Even
with the newer medications to prevent and treat nausea and vomiting (N/V) it is
still a prevalent side effect of chemotherapy.
Since each person receiving chemotherapy reacts in a unique manner, it is
not possible to predict the onset, severity, or duration of N/V for any
individual. However, we do know
that certain drugs, such as Adriamycin and Cytoxan, are more likely to cause N/V
and we can take steps to help prevent this side effect. For example, you will be given two antiemetics (anti-nausea
medication) through your IV prior to your Adriamycin and Cytoxan therapy.
You will also be given antiemetic samples and/or prescriptions to take at
home. Different drugs may work for
different people; let us know if your medication is not working for you so we
can prescribe something else. Here are some tips for handling nausea/vomiting:
Call the office if any of the following occur:
Peripheral neuropathy
(inflammation or injury of nerves) causes tingling, burning, weakness, numbness,
or pain in the hands and feet. It
is associated with some chemotherapy agents, including Cisplatin, Navelbine,
Taxol, Taxotere, and Vincristine. Development
of neuropathy is usually gradual, and symptoms are sometimes delayed or peak
after chemotherapy is finished. Symptoms usually improve after associated drug is stopped,
although it may take several months to resolve, and more severe symptoms may not
ever completely resolve. You are at
greater risk for this complication if you have problems with malnutrition,
alcoholism, diabetes, kidney failure, or hypothyroidism. Symptoms you may experience with peripheral neuropathy include:
Things to do:
Sexual attitudes and
behaviors vary greatly from person to person, thus sexuality means different
things to different people and is defined individually by people according to
personal attitudes and cultural or religious values. Generally, sexuality includes not only the act of sexual
intercourse, but also the psychological, emotional, and behavioral aspects of
the people involved. After being diagnosed with
breast cancer and having treatment that usually includes surgery, chemotherapy,
and radiation therapy, difficulty with sexual intimacy is common.
These difficulties may be caused by several factors, including:
menopausal symptoms, changes in body image after surgery or hair loss,
depression or anxiety, loss of libido, fatigue, N/V, mucositis, and diarrhea. There is not just one
“right” way to express your sexuality and you may need to find new ways of
expressing intimacy because what worked for you and your partner before may not
work after undergoing treatment for breast cancer. For instance, your favorite position for making love may no
longer be comfortable, if only for a little while, such as during recovery from
surgery or radiation therapy. Here are some suggestions to help you maintain sexual intimacy:
Shortness of breath, or
dyspnea, is the feeling of having trouble breathing. You may also feel anxious, like you cannot get enough air, or
like you are smothering or drowning. You
may have pain when taking deep breaths, or feelings of chest tightness.
Many things can contribute to dyspnea, but the most common cause is this
setting is anemia. Some
chemotherapy drugs, lung damage from smoking, infection, obesity, or congestive
heart failure may also contribute to being short of breath or may be the
causative agent. Other contributing factors could be pneumonia, airway
obstruction, narrowing of airway (bronchospasm), stress, fluid in lungs or
around heart, or inflammation of the lung after radiation therapy. If you experience severe
dyspnea at any time, please call the office so we can evaluate the underlying
cause and start treatment as soon as possible.
Treatment may consist of the following:
Things you can do to minimize shortness of breath include:
Call the office:
Many people develop minor
skin or nail problems during chemotherapy, including flushing (redness), rash,
itching, dry skin, acne, brittle nails, bands or lines on nails, and darkened
skin. Skin reactions are usually
treated symptomatically and rarely require that chemotherapy be changed or
stopped. Skin reactions are
generally not serious, however, any break in skin integrity can increase your
risk for infections. Flushing, caused by dilation
of the capillaries, produces a temporary redness of the face, neck, chest, or
back. Drugs such as Adriamycin,
Carboplatin, Cytoxan, 5-FU, Taxol, and Taxotere are associated with flushing.
This is not a serious side effect and the flushing will usually fade
within 48-72 hours. However, if
flushing is accompanied by hives, facial swelling, or difficulty breathing,
notify Dr. Carroll immediately. You can develop a red, bumpy
rash anywhere on your body during chemotherapy, but it most commonly occurs on
the chest, abdomen, or back. Generally,
this rash is just a side effect of the chemotherapy and not an allergic
reaction. However, if you develop
any rash you should notify Dr. Carroll or Kate.
Dry skin may be associated
with scaling or flaking of the skin, peeling, areas of roughness, and itching.
In addition to damage from chemotherapy, other factors contributing to
dry skin include dehydration, extreme weather conditions, products with perfume
or alcohol, and allergies. The exact cause of itching (pruritus)
is unknown, however, it is a side effect of several chemotherapies, including
Adriamycin, Carboplatin, Cytoxan, Megace, Tamoxifen, Taxol, and Taxotere.
Allergies, dry skin, a warm, dry environment, radiation therapy, or a
reaction to other drugs such as opioids can also cause itching.
Pruritus is generally not a serious side effect, but it can be very
distressing if it interferes with your daily activities, rest, or sleep. To help prevent and treat dry skin and itching:
Chemotherapy can make the skin more sensitive to the sun. This is called photosensitivity. It is important to use sunscreen with SPF 30 or higher when out in the sun, or wear protective clothing such as long-sleeved shirts, pants, sunglasses, and a wide-brimmed hat. Tanning beds or sun lamps should not be used. Remember, even people with dark skin need to protect themselves from direct sunlight while undergoing chemotherapy treatments. Darkening of the skin (hyperpigmentation)
is a side effect of several chemotherapy drugs, including Adriamycin, Cytoxan,
5-FU, Methotrexate, Navelbine, and Taxotere.
You may notice darkening of the nail beds, tongue, gums, or skin over
joints or other areas of pressure. If
chemotherapy is given peripherally, you may notice darkening of the vein in
which it was infused. Hyperpigmentation
is usually noticed within 2-3 weeks of starting chemotherapy. The discoloration should gradually resolve after chemotherapy
is stopped, although occasionally it may be permanent.
Any chemotherapy known to
cause oral mucositis also has the potential to cause vaginal or vulvar
irritation and/or inflammation. Symptoms
may include: vaginal discharge with
or without odor, itching, redness, pain or painful sex, bleeding, swelling, or
ulcerations. If any of these
symptoms occur, notify Dr. Carroll, Kate, or your gynecologist. To help relieve vaginal irritation:
Nail changes have been
reported with many of the chemotherapy drugs, including Adriamycin, Cytoxan,
5-FU, Methotrexate, Taxol, and Taxotere. The
nails may become loose, or separate from the nail bed.
Other changes include darkening of the nail bed, white discoloration of
the nail, and depressions or ridges in the nail.
You may also experience warmth, pain, or tingling under the nail bed.
These changes are temporary and usually resolve once the drug is stopped
and the affected nail grows out. To help protect your nails:
Sleep disorders are common in
people undergoing cancer treatment and may be caused by several factors
including: anxiety, depression,
pain, treatment drugs, itching, fatigue, night sweats, hot flashes,
nausea/vomiting, or diarrhea. You
may experience insomnia (the inability to fall asleep and stay asleep) or
hypersomnia (excessive sleepiness). There are several things you can do to promote a healthy sleep pattern:
Mucositis, an inflammation of
the lining of your GI tract (mouth, throat, stomach, intestines), is a side
effect frequently experienced by chemotherapy patients.
It can affect just your mouth or throat, or extend throughout your entire
GI tract. It may start as redness in your mouth or throat and progress
to painful ulcerations or white patches. Your
tongue may feel “coated”. Mucositis
usually starts 3-7 days after chemotherapy is given, and can last 1-2 weeks.
You may have difficulty chewing, swallowing, or talking. Things you can do to prevent and treat mucositis:
Many people taking
chemotherapy report changes in taste. These
changes occur because chemotherapy drugs can damage your taste buds that tell
you what flavor you taste. Commonly
reported taste sensations include: a metallic or medicinal taste; food tasting like
“nothing”; decreased or increased tolerance for bitter foods; increased or
decreased tolerance for sweet foods; or an increased desire for salty foods.
Your taste preferences may change from day to day.
Finding foods that taste good to you will be a trial and error process.
Experiment to find foods that appeal to you. Here are some tips to cope with taste changes:
WBC
(white blood cell)=number of white blood cells per volume of blood LYM
(lymphocytes), MID, and GRAN (granulocytes) are types of WBC.
Granulocytes are the body’s primary defense against bacterial
infection. Granulocytes may also increase due to severe stress,
inflammation, or certain medications such as corticosteroids.
Lymphocytes are the body’s main defense against viral infections,
producing antibodies to attack and destroy germs. RBC
(red blood cell)=number of red blood cells per volume of blood HGB
(hemoglobin)=amount of oxygen-carrying protein in the blood HCT
(Hematocrit)=percentage of volume RBCs take up in the blood MCV
(mean corpuscular volume)=measurement of average size of RBCs.
If RBCs are larger than normal (macrocytic) the MCV will be elevated;
this could indicate vitamin B12 deficiency.
Some chemotherapy medications can also cause the MCV to be elevated.
If RBCs are smaller than normal (microcytic) the MCV will be decreased;
this could indicate iron deficiency anemia. MCH
(mean corpuscular hemoglobin)=amount of oxygen-carrying hemoglobin inside the
RBCs. Larger RBCs tend to have higher MCH values.
Likewise, smaller RBCs tend to have lower MCH values. MCHC
(mean corpuscular hemoglobin concentration)=percentage of hemoglobin in the RBCs RDW
(red cell distribution width)=variation in the size of the RBCs.
May be elevated due to anemia. PLT
(platelet count)=number of platelets per volume of blood
Tumor
markers are substances (usually proteins) in the blood that are made either by
the tumor itself or by the body in response to the tumor. They can be detected by combining a patient’s blood with
antibodies made to react with that specific protein. The most common tumor markers for breast cancer are CEA and
CA27-29. Tumor
markers are not elevated in every person diagnosed with cancer, especially if
the cancer is in the early stages. Therefore,
tumor markers are not used to diagnose disease.
If these markers are elevated when metastases are found, they can be used
to evaluate your response to treatment. If
you have metastatic disease, such as spread to bones, liver, or brain, Dr.
Carroll may order tumor markers to be drawn.
The markers will be tested with each cycle of chemotherapy, usually every
3-4 weeks. If the results decrease
or are stable it means the tumor may be responding to treatment. If the results increase it means the tumor may not be
responding and a different therapy may be needed.
Sometimes, as cancer cells die, they release large amounts of the marker
that causes a temporary rise in the amount of marker in the blood.
Therefore, treatment changes are usually based on serial levels of the
markers rather than just one test. |
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