Low white blood cell count

tmarmil0715

Hello everyone. My husband was diagnosed with tonsillar cancer with lymph node involvement in April. He had TORS surgery and a radical neck dissection, where they removed 44 lymph nodes, four of which were positive and one of those had extranodal extension of the cancer. He was prescribed 6 weeks of Cisplatin and 32 radiation treatments. They held the 6th dose of Cisplatin do to a platelet count of 79 and he started having ringing in his ears. He has three more radiation treatments left. His white blood cell count went from 3.1 to 1.7 this week. Absolute neutrophils are 0.9. I'm really questioning if he should have these last 3 radiation treatments, because doesn't the radiation lower your white blood cell count?

wbcgaruss

Welcome to the forum marm.

I didn't think radiation could affect blood cell count but I researched it and it will have an effect if it is over a very large area.

Radiation therapy. If you receive radiation therapy to large areas of your body and especially to the large bones that contain the most bone marrow, such as your pelvis, legs and torso, you might experience low levels of red and white blood cells.

But in the case of H&N treatment, the area covered is not that large so I believe the effect from radiation is minimal.

I had chemotherapy before my actual treatment started for a week at a time during my first cancer in the hospital for 5 days at a time I was hooked up to an IV pump and did 2 stretches of this. This was to shrink my throat tumor before they started my treatment regimen. Then I started 7 weeks of radiation of 35 treatments and chemotherapy at the beginning, middle, and at the end.

The only time I remember the cancer team I had worried about my blood counts was after and before the next chemotherapy treatment. They would always test my blood count before any chemotherapy treatments but never in relation to radiation. There was never any consideration nor mention of blood counts during radiation. I also had a second cancer in 2019/20 and had 30 follow-up radiation treatments for that and a blood count was never considered or mentioned nor was I given any blood tests.

So I don't think it applies to a localized area like the neck area just large areas and areas with large bones where it can affect your bone marrow.

One thing I do remember is I had an infected Parotid gland in my jaw at one point and a high fever and spent 7 days in the hospital on heavy antibiotics to fight the infection. That started on a Friday and that day I went to have my radiation done and the mask was hard to get on due to the swelling and it seemed to affect my breathing. So they skipped that on that day and I went from there to get my chemo and with my condition and fever they sent me to the hospital.

My point of all this is I was seen by a chemo doc in the hospital and he was asking me questions and found I had missed a radiation treatment and the fact that I may not be able to get any for a while as I was in the hospital and the radiation center was about 5 miles away. He was very distressed by this and emphasized how important not missing any radiation is and that I just shouldn't miss anymore and make up the one I missed by adding it to the end. He made arrangements starting The Monday after the weekend to have me transported by non-emergency transfer ambulance van every day from the hospital to the radiation center and back till I got discharged and returned home and would then go from there. There was no way he wanted me to miss any radiation treatments.

So I am understanding chemo has the biggest effect as far as H&N cases go and it is vital if at all possible not to miss any of your radiation treatments.

I would consult with your doctors on this as soon as possible and even possibly over the weekend as they usually have an on-call doc in the situation of cancer patients. See what they say.

Here is a great link about blood counts and cancer treatments.

https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-treatment/art-20046192

Wishing You the Best

Take care, God Bless-Russ

tmarmil0715

https://csn.cancer.org/discussion/comment/1697768#Comment_1697768

Thank you so much for the wonderful reply and taking your time to give me all of that information. I very much appreciate it.

wbcgaruss

So very glad I could offer some insight and for your appreciation.

Take care, God Bless-Russ

motorcycleguy

I was treated with 35 sessions of radiation, and 2 different chemo's.

My white blood cell count did drop. Before treatment, if was very high!

It took about a year, after treatment, before I was back in the acceptable range and it keeps slowly climbing.

Ironically enough, it was low, when Covid came out ... so I got the vax, as soon as it was available (luckily, I never got a case of it, that I knew of...)!!