Chemotherapy drugs are designed to attack and kill the fast growing cancer cells, hence it is not surprising to note that these drugs are associated with significant side effects. The side effects of chemotherapy depend on the type of drugs, dose of the chemotherapy, and the length of treatment. Patient may get temporary side effects, which might include fatigue, nausea, vomiting, loss of appetite, and mouth soars.
Warning signs of infection
What you can do to minimize risk of infection during chemotherapy?
Hair loss is more common with AC as compared to CMF. A menstruating woman may undergo cessation of menstrual cycles during the chemotherapy. This may be temporary but in many cases can be permanent. Older women may have more problems with menstrual cycles compared to younger women. Older women may develop bone loss and osteoporosis during chemotherapy.
Since chemotherapy attacks the fast growing cells, the normal tissues with high growth rate suffer the major brunt of attack of the chemotherapy drugs. These include the fast growing cells of the bone marrow, oral mucus membrane and lining of the stomach and intestine. This may subsequently lead to low blood counts, mouth soars, diarrhea, and abdominal upset. White blood cells are the guardian defense system of your body, and when the white cell count decrease due to the chemotherapy; you may be at great risk of an infection. Also when your body defense system is low due to low white cell count, once you get an infection it could be overwhelming.
Physicians usually calculate the absolute neutrophil count (ANC) from your regular blood count to determine the risk of infection. ANC is calculated by multiplying the total white cell count by the percentage of neutrophils and then dividing by 100. For example if your total white cell count is 4,000 and neutrophil percentage is 50 then your ANC is 2000 x 50 divided by 100 and equals 1000. If your white cell count is 8000 but neutrophil percentage is 25 then the ANC is again 1000. If your ANC is 500 to 1000 you have slightly increased risk of getting infections. If ANC is 300 to 500 you are at moderate risk of getting infections. If the ANC is less than 300 then you are at high risk of getting infections. Infection can come from out side or from your own body (example gut).
You may also experience drop in the platelet count from chemotherapy. If the platelets drops markedly you may be at risk of bleeding. Sometimes you may get platelet transfusions to prevent bleeding if the platelet count is too low. Your red cells or hemoglobin may also be affected with chemotherapy leading to anemia. This may cause tiredness and fatigue. There are medications available to treat anemia caused by chemotherapy. These drugs are erythropoietin alpha (Procrit) and darbepoetin (aranesp).
Many of the temporary side effects of chemotherapy can be treated effectively. Unlike olden days, now there are excellent drugs available for preventing and controlling nausea and vomiting. These drugs are called 5-HT antagonists. Dolasetron (Anzamet), Ondansetron, Granisetron (Kytril) are examples. The menstrual cycle may become irregular or stop altogether during the chemotherapy. Sometimes the periods may come back when the chemotherapy is completed, but in many cases it may never come back. Older a woman is when she receives chemotherapy; the more likely it is that she will become infertile or menopausal as a result of chemotherapy.
Adriamycin (Doxorubicin) is an effective drug against breast cancer and is one of the most commonly used chemotherapy agents in the treatment of breast cancer, however it may sometimes cause damage to the heart muscle. Most of the time this occurs with larger doses that are currently not used in oncology practice, but some patients may develop heart muscle problems even with the standard doses of doxorubicin. Your physician will recognize this problem early and may discontinue administration of this drug. If this problem is suspected you may get echocardiogram or a nuclear medicine test to assess the pumping capacity of the heart. With the stopping of adriamycin the heart muscle problem may improve, but in rare cases the damage may be permanent. Chemotherapy may also result in a condition called chemo brain. This condition is associated with slight decrease in mental and may include difficulty in concentration and decreased memory. One in five hundred women who received chemotherapy may develop acute leukemia as a complication of chemotherapy. This may occur years or decades after the chemotherapy. Everything in life has to be viewed with a cost benefit analysis. When we think about these potentially bad side effects of chemotherapy you should also think about thousands and thousands of women who are living today thanks to the chemotherapy beneficial effects. This would give you the strength and courage to go through the chemotherapy. There is no doubt that benefits of chemotherapy far exceed the risk of serious but rare complications.
If your ANC is less than 300 you are at high risk from infection. ANC is also used to determine if you are ready for the next cycle of chemotherapy. If your ANC is less than 1500 your physician may hold further chemotherapy until it comes above this level. Because you are at great risk from infection when your ANC is low if you ever develop a fever any time during the course of your chemotherapy, it is absolutely essential to make sure that your ANC is within acceptable range. If your ANC is low and you are having a fever, you may have to be admitted to the hospital form administration of iv antibiotics. There are drugs known as white cell growth factors that can be used to improve the ANC, if drops very low. The other components of the blood namely platelets and red blood.