Stopping Treatment due to low blood counts

Hi WarriorS1,

It's fairly common that blood counts are impacted by chemo.  I never had this issue, but it's likely that it could happen with subsequent treatments.  Exercise does help with this.  My naturopath told me that eating sesame seeds helps with platlet counts.  If your white blood cell count continues to drop between treatments, you might want to talk to your doctor about receving a Neulasta or Neupagen injection after yout chemo.  These both keep your white blood cell counts up. 

Good luck

Good morning fellow “Warrior”

I know you were surprised to hear the words “Ovarian Cancer”, as were so many of us.  Unfortunately, there are no “warning shots” across the bow that alert us to “incoming and oncoming fire!”  But meeting the enemy eyeball to eyeball is the best strategy!

Indeed you have to be “engaged” in a constant stage of “warfare” to confront this enemy we know as Ovarian cancer.  Thank you for writing on your “about me” page.  This gives us some idea of the battle you’re in.  With metastasis to your large and small intestine, you do have to keep watch day and night.  Part of my Cytoreductive surgery (not curative but preventative in nature) large amounts of my intestines were removed.  Since my surgery in July of 2013, irregularity has been a constant problem, but I’m still alive to grapple with it.  I thank God I’m still here, because I could have died anytime along the way.  And believe me, there are days when one wonders, “Is this the problem that will take me away?”  Being a realist and a deep faith in God have kept me sane.  My oncologist is quick to try to help when I have a “new unexplainable pain” in some “new place.”

And you are so right, keeping a positive attitude, makes you feel better as well as those around you.  But there are those days when we become upset over a persistent side effect.  Fortunately we don’t stay in that frame of mind for long.  For instance, I’ve had a sharp piercing pain in my left lung area since yesterday afternoon.  The pain was intermittent so I thought that with time it would pass.  It did not, and so this morning I called my oncologist.  He has already gotten back with me.  He has called in an order for a chest x-ray to see if I have excessive fluid buildup around my lungs yet again.  And so today, I will make a trip to my local hospital which is close by and have that done.  I will not be surprised if it is another excessive fluid buildup, another chest drainage may be ordered.  I have had two previously.  That’s the kind of communication I have with my medical team, and that’s what gives me confidence that help is only a phone call away. 

From reading regularly on this site, I see that this is not always the case for my sisters.  So close communication with your doctors is truly a plus.  You never know what will happen on what day.  That’s the nature of this enemy.  But we don’t “surrender” and wallow in self-pity.  So keep close touch with your doctor at all times.  

And as for “missing” your treatment regimen because of  a low white blood cell count, that is to be expected from time to time.  Since the first of the year, I have had to miss two treatments.  However, the delay was only for a week each time.

Recently, I developed a swelling and redness and heat on my left hand and forearm.  I was due to have a Carbo/Paclitaxel (Taxol) treatment the next day.  But I called up and asked my nurse if I could come in the following day instead because I had this problem with my arm.  She said, “How soon can you get here?”  By afternoon, I was back in my doctor’s office.  I’m so glad I went.  It was “Cellulitis”.  The nurse had said, “red-hot & swollen” are not side effects of your chemo.”  My upcoming chemo was cancelled and I was put on an antibiotic until it cleared up.  My oncologist said that “skipping one week” wouldn’t hurt.  Most recently I had to delay one treatment by a week due to low WBC.  So this is common and happens to us cancer patients from time to time. 

Also I can sympathize with the nasty wound saga. I developed an infection after my Cytoreductive Surgery. My wound broke open and I had to wear a wound vac for months on end.  The doctors said the wound would have to close up from the inside out.  The wound vac keeps the area suctioned of fluids that would keep the area from closing up.  So I had to wear the monitor 24/7.  Actually my surgery was in July of 2013 and my open incision did not close up completely till March of 2014.  My incision began between my breast and continued down in a straight line to the pubic area.  And when it broke open, it started immediately above my waist line and continued all the way down.  That was quite an ordeal, but I'm alive to tell about it and can readily sympathize with others who have similar experiences.  

I began my 4^th series of Carboplatin/Paclitaxel (Taxol) treatments December 28, 2017.  PET/CT scan indicated tumors were building up in my stomach and I couldn’t eat but a few bites without feeling “full”.  If I tried to force the food in, nausea set in.  That’s the nature of this battle.  You never know where & when the enemy will attack.  Thankfully, my CA-125 count is coming down. 

So as of this date, April 9, 2018, I still have two more chemo sessions.  They are intended to give me some further extension of life but with some quality.  So far the treatments give me about 10 months of “feeling somewhat normal” before another problem crops up somewhere. 

Incidentally, previously my doctor would have me return the next day for hydration and a Neulasta injection to help my immune cells build up more quickly.  But now, Neulasta has come out with a small device that is filled with the medication.   (Actually the first reference below indicates that this lady posted her remarks about the injection device way back in 2015.  However, it is new to me.)

It’s a small injection device, about 2 inches in length and a width of about ½ inch.  Mine is attached to my stomach.  The nurse affixes it and the injection is scheduled to dispense the med inside in 24 hours.  There is a small green signal on the device that blinks.  When the injection is finished, the light no longer blinks and an indicator shows the little device to be “empty.”  It saves a trip to the doctor’s office.  I will say that the first injection that I ever had to build up my white blood cells was “Neupogen.”  It gave me severe bone pain to the point that I had to go to the ER and get a shot for pain.  So from then on, I said, “Don’t give me that again.  Fortunately, “Neulasta” does the same thing, it just acts in a little bit slower time frame.  So if I were you, I would ask about that, the next time you have a treatment.

Okay, keep up the fight, and know that missing a treatment from time to time due to low white blood count is “normal”.  Carbo/Taxol has served me well, and I hope it will do the same for you.

Loretta (Peritoneal Carcinomatosis/Ovarian Cancer Stage IV) since November of 2012)

P.S.  Here are some references which I have found to be helpful. 

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1.      https://www.youtube.com/watch?v=O6_be_A0tb4

Here is how the device works.

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2.      https://www.youtube.com/watch?v=TsQJkF9yIYU

Here is a lady showing how her Neulasta injection device works. 

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3.      https://www.youtube.com/watch?v=wsOGyNwqQrc

How Neulasta works.

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4.      http://www.chemocare.com/

“…Drug Information

Find the latest information about chemotherapy drugs including how they work, their potential side effects, and self care tips while on these therapies.”

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5.      http://www.chemocare.com/chemotherapy/drug-info/carboplatin.aspx

6.      http://chemocare.com/chemotherapy/drug-info/Paclitaxel.aspx

______________End of references_______________

WarriorS1 said:

Thanks azgrandma

I stopped treatment at the end of Cycle 3 for 2 weeks and my blood counts came back up.  The oncology team now has me on a shot 22-72 hours after each chemo treatment called Neulata.  This medication make the white blood cells increase.  I had a lot of pain the 1st shot even though I took the Claritin and Tylenol as directed.  My calves actually cramped so bad my toes were turning under.  My wife was able to massage my calves to get the cramping to stop.  But I had pain for about 3 days. I did gradually decrease over this time.

Oncology team now has me taking Prednisone series 12 hours after the shot since I am not able to take pain medication due to severe allergies.  Will also increase my exercise to see if that will help.

So far I am handing the treatments ok.  Only real side effect I have to work through is the fatigue and I find the more active I am the less it really bothers me and I do sleep better at night from being active.

Thanks again for your encouraging words and I am so very happy that all is well with you.

WarriorS1

Sorry to hear you get side effect on Neulata.  My WBC also went way down after the 2nd chemo session (from 6.4 to 2.7).  I tried the following food that increase B4 (banana, orange, apple, strawbarry, whole wheat, honey, cloves, spinish, tomato, bell pepper) and in the 3rd session the WBC went back to normal (>4.0), I did not reply to you at that time because I want to see if it maintains this way, or it is just a timing thing.  Now I am in 5th session and the WBC is still normal, all I do is keep eating those things.  I agree with you the more excersie you do, the less side effect you get.  I did lots of exercise (walk a few hours a day) and I get no side effect so far, not even fatigue.

Best wishes!

Palor