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Blood Counts

Lena Rose
Posts: 73
Joined: Apr 2010

My husband was recently diagnosed with stage 3 base of tongue HPV cancer. His course of treatment is 1 day each week chemo (cisplatin and erbutux) and 5 days radiation for 7 weeks. He just finished his 2nd round of chemo. I'm concerned about his blood counts since his white, red and platelet counts went down considerably in one week and he still has 5 chemo sessions to go. His oncologist didn't seem concerned. Any suggestions as to how to get his blood counts up? He's been eating well but I'm sure that's not going to last. Thanks for helping us on this journey that we never wanted to go on.

Skiffin16's picture
Skiffin16
Posts: 8053
Joined: Sep 2009

Lena, do they take blood and do lab work each time you have the chemo? If it was like mine I have every one of my labs and CBC sheets. I have the first before I started treatment, one for each of the three week cycles when I had the heavy chemo (cisplaten, taxotere and 5FU), and one for each of the seven weeks that I was getting carboplaten with the daily radiation. Also one for each three month post lab and scan to the very last one a month or so ago when everything finally came back into normal ranges.

If your counts become too low, or low enough that your chemo doctor won't let you take chemo for that round.

I never was that low, but my counts all dropped significantly (at least to me). I'll have to dig them out tomorrow, but these are the numbers from the top of my head.

When I started everything was in the normal ranges.

Platelets were at 202, they dropped all the way down to 92 if I remember correctly.
RBC were in the 4.5 range, got down less than 2.0
WBC were in the 4.5 range, got down less than 2.0

Those are just a few they look at, neutrophil
GFR (kidney filtration)

There are about 40 different items that they look at and monitor.

I know my potassium dropped low enough that she prescribed a precription and I had to take that for 10 days to build it back up.

But nothing ever got to the point she stopped treatment.

Now at about every 12 weeks I was going in for a CT and blood work, I have all of those sheets also. Anyways the last was about a month ago, being right at about 10 months post treatment. My blood has finally come back with everything in normal ranges once again.

The WBC and RBC took the longest to come back, they had been hovering just below low normal for several tests, each being a little higher than before, but still lower than low normal.

Now everything has come back in and she has moved my blood works and scans to a six month schedule.

Hope this gives you a little insight.

Also, if you haven't been getting the CBC sheets, request them each time. I'm sure they won't have a problem. I didn't really think of it, a nurse suggested it at the chemo center and it sounded like a good idea. I like seeing the effects and how I am responding to the chemo.

Also, when I was getting the heavy doses of chemo, not the once a week carboplaten. When I was on the three weeks cycles first, fourth and seventh weeks I received the chemo, on the following Mondays they gave ma a shot of Neulasta. It helps build and regenerate the blood cells in the bone marrow (from my understanding). It will give you flu like sysmptons for a day or so, ache in bones and back. It's also around $4,000 - $6,000 for each injection.

John

Fire34
Posts: 350
Joined: Feb 2010

Lena
I was like John and given my lab sheets at each chemo visit. I cant remember all my numbers off the top of my head though.
They were concerned more about RBC, hemoglobin & WBC counts. They(U of Chicago) had a protocol that if hemoglobin dropped below 9.5 they transfused you. I had seven units during my treatment. My RBC and hemoglobin has been messed up for quite a while but protocol was protocol.
My WBC was always high and never dropped to the nuetropenic state, I was on antibiotics for that for most of my treatment also. Also Like John my potassium was low and was given that IV again during most of my treament.
How is your husbands energy level? I dont know your feelings about transfusions but that might be something to consider or ask about. Best Wishes & Prayers
Dave

ratface's picture
ratface
Posts: 1231
Joined: Aug 2009

Blood counts come back quick and it's not a setback to postpone a chemo. Thats exactly why they monitor them so close. On my second 21 day regime of cisplatin my counts were low and I was sent home on a Friday after sitting in the chemo chair. I was devastated. Thought, Oh my God I can't even make it through the treatment! By Monday they were back to levels acceaptable for the chemo. Give it a couple of days and don't fret too much. Hang in there!

Skiffin16's picture
Skiffin16
Posts: 8053
Joined: Sep 2009

I was a little off on my lows, here's some dates and numbers;

2/6/2009 Before Chemo
RBC 4.85
WBC 6.3
Pla 202

After 1st Chemo (but had the Neulasta which kicked my WBC up)
2/27/2009
RBC 4.73
WBC 12.0
Pla 96

Week after everything chemo, chemo/rads
7/1/2009
RBC 4.1
WBC 2.0
Pla 88

Nine months post
3/3/2010
RBC 4.62
WBC 4.5
Pla 162

Hope this gives you something to compare to although I'm sure everyone has different counts even under the normal ranges.

John

Lena Rose
Posts: 73
Joined: Apr 2010

Thanks everyone. I do get a copy of my husband's blood counts every week. I'll try not to worry too much over them. He just had 2 chemo treatments-I don't know how he's going to get through 5 more chemos and 24 more rads! I guess I just have to focus on one day at a time.

Skiffin16's picture
Skiffin16
Posts: 8053
Joined: Sep 2009

That's how you get through it, you just do it....ever watch the movie "Groundhog's Day", that's what it's like. The same thing everyday, you do whatever you have to to keep on going.

I drove myself to all of my rads, other than chemo day. It gets boring, but you just go, you do it, go home rest, and do it again the next day.

They won't let him get too low, they'll monitor his blood before each chemo...

John

Clearblue
Posts: 188
Joined: Apr 2010

Is anyone out there willing to give me a clear "bloodcounts for dummies" checklist or refer me to a site which might present this in a clear uncomplicated way.

Were on erbitux only, two infusions to date. So far one blood count taken.

Clear.

sweetblood22's picture
sweetblood22
Posts: 3230
Joined: Jan 2010

Fanconi Anemia: Guidelines for Diagnosis and Management, in this one there is a chapter on HNC:
http://www.fanconi.org/pubs/Guidelines.htm

http://www.fanconi.org/pubs/books/Guidelines%20for%20Diagnosis%20and%20Management.pdf

Chapter 13
Head and Neck Squamous Cell
Carcinoma in Fanconi Anemia
Patients

blood counts, 340; post-transplant, 193-194, 226, 232; to monitor bone marrow failure, 52, 54-56, 63, 65, 188

this one is the handbook:

http://www.fanconi.org/pubs/FamilyHandbook.htm
http://www.fanconi.org/pubs/books/FAHandbook3.pdf

Both Dr. Kutler and Dr. Auerbach told me to make sure that they do a cbc twice a week, and monitor my counts. The doctors will know what to look for.

These are good handbooks and guidebooks to read on the latest on FA. The info in there can be kind of scary, but remember that you want to get and read as much info as possible to get educated. I know at least one or both of these documents addresses different areas about blood counts i think. It has been a while since I have read them though. I believe it may even address erbitux, which I think is cetuximab in one of the hand books. At any rate they are full of info that you can use.

If for some reason those links do not work, (i copied them from my favorites) that is the website that Theresa Kennedy on the other thread was talking about.

i
Posts: 1
Joined: May 2010

Hi. My husband had tonsil cancer.squameous cells. he has been cancer free for five years now. His treatment included radiation, erbutux, and cisplatin. The treatment was horrific. Rash from head to waist. He had every sideffect. It was horrible. But it was worth it. He didn't give up. He is here. Good luck. I hope the rash isn't too bad.

Skiffin16's picture
Skiffin16
Posts: 8053
Joined: Sep 2009

Congrats on your husband's success...always great to hear of a long time survivor.

Lena Rose
Posts: 73
Joined: Apr 2010

I love to hear success stories. Only 8 more days of treatment!

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