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Anemia

If the number of red blood cells in your body decreases, you can develop anemia. When anemia becomes severe, you have fewer blood cells to carry oxygen to your body’s cells and tissues so you may feel weak, fatigued, experience dizziness, shortness of breath and sometimes depression. If left untreated, anemia can interfere with treatment and strain the heart and lungs. Fortunately, there are treatments for anemia including blood transfusions or medications that encourage the growth of red blood cells, which supplies the body with oxygen. Treatment for anemia is determined by the cause and extent of the condition.

Symptoms to Report to Your Health Care Team

  • Shortness of breath
  • Feeling your heart pound or beat fast 
  • Confusion or difficulty concentrating
  • Dizziness or fainting
  • Feeling very tired or unable to perform your daily activities

Coping with Anemia

  • Get plenty of rest.
  • Ask your family and friends for help when your energy is low.
  • Eat a healthy diet and drink plenty of fluids. Ask your doctor or nurse about iron rich foods that are important for you to eat if you have anemia.
  • Stand up slowly. Anemia can cause you to feel dizzy when you rise quickly after lying or sitting.
  • Report worsening fatigue to your doctor.
  • Ask your doctor if you need medication or a transfusion to increase your red blood cells.

Infection

A low white blood cell count puts you at risk for infection, which is one of the most serious side effects of cancer treatment. Infection can lead to hospitalization, and may even be life threatening.

Recognizing Symptoms

Take your temperature daily or as your health care team recommends. Call your doctor or nurse immediately if you have a fever of 100.4° F (38° C) or higher. Fever is often one of the first symptoms of infection. If your immune system is weakened, a small infection can become a larger infection quickly if it goes untreated. Fever that occurs when your white blood cells are low (neutropenic fever) is considered an emergency and requires prompt medical attention.

How Infection Occurs

When you come in contact with different bacteria, viruses or other germs that don’t normally live inside your body, your immune system needs to fight them off. If your white blood cells are low it can be a sign that your immune system is unable to prevent these germs from growing inside the body, causing an infection. If you develop a bacterial infection, you will be treated with antibiotics. In some cases, hospitalization may be necessary.

Preventing Infection

  • The most effective way to avoid infection is to wash your hands frequently and thoroughly. Take at least 15 seconds to wash your hands with soap and warm water.
  • Wash your hands before cooking and eating and after using the bathroom, sneezing or coughing. Carry hand sanitizer when you are not at home.
  • Avoid people who are sick or who have just received a live vaccine (ex. a vaccine for chicken pox or polio). Stay away from large crowds. Avoid children who have received any live vaccines for 10-14 days.
  • If you cut yourself, clean the cut well and apply an antiseptic.
  • Wash fruits and vegetables well before eating.
  • Avoid touching or eating raw or undercooked meat, chicken, eggs and seafood.
  • Ask your doctor if you need medication to increase your white blood cells.
  • Ask your health care team about caring for pets during periods where your white blood cell count is low.

Call your health care team right away if you experience:

  • Fever
  • Chills, shaking
  • Shortness of breath, chest pain
  • Headache or stiff neck
  • Dizziness or fainting

Call your health care team if you experience:

  • Redness, swelling, rash or skin that is warm to touch, especially around a wound or catheter site
  • Cough or sore throat 
  • Mouth ulcers
  • Sinus pain or earache
  • Diarrhea or pain when you have a bowel movement
  • Bloody or cloudy urine, pain or a burning sensation during urination, frequent urination
  • Unusual vaginal discharge or itching

Bleeding

Platelets are blood cells that help control bleeding. If cancer treatment lowers the number of platelets in your body (thrombocytopenia), bleeding can occur. Low platelets can cause bruising, tiny red dots on your skin (petechiae) or bleeding from any part of your body.

Many medications, including aspirin, overthe-counter pain relievers and some herbal supplements, can also increase your risk of bleeding. Tell your doctor about any nonprescription medications you take. If your platelet counts become very low, you may need a platelet transfusion or a delay in your chemotherapy treatment to allow time for your blood counts to further recover.

Coping with Bleeding

  • Use a soft toothbrush, avoid toothpicks, ask your doctor about dental floss.
  • Blow your nose gently.
  • Use an electric shaver rather than a razor.
  • Try to avoid injury. Be careful when using sharp objects. Do not participate in contact sports.
  • Apply firm pressure to any cuts.
  • Do not use suppositories, enemas or rectal thermometers.
  • Avoid constipation. Ask your doctor or nurse if you should use a stool softener.
  • Ask your health care team about sexual intercourse if your platelets are low.

Call your health care team right away if you notice any of these symptoms:

  • Bruises, especially if you haven’t injured yourself
  • Tiny, red dots on your skin
  • Bleeding from your nose or around your gums
  • Headache or any change in your vision
  • Feeling very sleepy or confused 
  • Pink or red urine; bloody or black bowel movements
  • An extra-long or very heavy menstrual period or vaginal bleeding not caused by your period