Frequently Asked Questions (FAQs)
Blood is composed of both a liquid part, called plasma, and solid portion, called blood cells. Blood cells are made in the bone marrow, which is the soft, spongy center found in most bones of the body. The different cells are manufactured upon demand from the body, and are then released into the bloodstream to do their jobs.
There are three kinds of blood cells: white cells, red cells and platelets. There are several different kinds of white cells, and their role in the body is to protect it from different infections and other harmful substances. Red blood cells carry oxygen throughout the body, nourishing cells and helping to provide energy to the body. Platelets, the smallest of the cells, help prevent bleeding.
Anemia is a condition where there is a reduced number of red blood cells. This can be due to either decreased or ineffective production, or a shortened life span. Anemias can either be inherited or acquired as part of some disease.
The complete blood count (CBC) is an automated test that gives a large amount of useful information about all three blood cells. It can often provide clues to many illnesses, including non-hematologic ones, and can also give proper direction to the physician as to what kind of treatment may be necessary.
Prevention of bleeding is a complex interaction of platelets, the inner lining of veins and capillaries and proteins called coagulation factors. Bleeding can be caused by a reduced number or function of the platelets and coagulation proteins and can be inherited or acquired. Blood tests that measure the number and quality of the platelets and proteins can usually predict the risk and severity of bleeding and can provide insight into how to treat it.
Thrombophilia is a condition where a patient is at increased risk for abnormal clotting that can obstruct normal blood flow. These diverse disorders can result in painful swelling in different areas of the body – most commonly the legs or arms – or respiratory distress and chest pain from clots that are thrown off into the lungs.
The first appointment with your physician may be a long one. So, it helps to have the paperwork filled out prior to coming into the office. You should also have a list of all medications you are taking; this includes both over-the-counter, herbal and prescription drugs. Any physician you see for other reasons should also be noted in your paperwork. All pertinent medical records, pathology reports and radiology reports should be faxed from your other physician’s office or brought by you.
We always encourage supportive friends and families to accompany you to your visit. There will frequently be a lot of information discussed with you on the first visit and it is helpful to have another person present to write things down or think of other questions related to your care. Of course, we will discuss things with you until it is completely understood by you whether you come alone or with your family.
No. If you are being referred for abnormal laboratory values, it is important to have those records available to us during the visit. We draw all labs on site and have instant results on your white blood cell count, hemoglobin and platelets. Other lab work may take 1 day or longer for results.
Chemotherapy is a type of medication used to treat cancer. It is usually given as an intravenous injection but can occasionally be given as a pill. There are many different types of chemotherapeutic drugs used in even more combinations. Your physician will choose the one or a combination that is right for you.
Both of our offices have dedicated infusion centers located within the office itself. Our highly qualified chemotherapy nurses are specially certified and extensively trained to give you the best care while you are receiving chemotherapy.
You should continue with your same routine unless told otherwise by your physician. It is usually recommended to eat at least a light breakfast or lunch. Take your regular medications unless told otherwise. You may also need to take anti-nausea medications or steroids prior to your treatment as directed by your physician.
Yes. We usually request that another person drive you home after your first treatment, since you may be especially tired from the chemotherapy or the premedications given to prevent nausea. That person may sit with you throughout the treatment or can leave and come back when you are finished.
The duration of your treatment will very depending on your type of cancer and the chemotherapy drugs you are receiving. Your physician or nurse will give you an estimate on the time you will be sitting, but it may be longer than anticipated. You are encouraged to bring a book, magazine, knitting, headset or other activity. You may also want to bring a snack or lunch if your treatment is a long one.
Your doctor and nurse will discuss this with you in great detail at your visit. Many people receive different regimens, even if they have the same type of cancer, so a side effect that you heard about from a friend may not apply to you.
Not necessarily. Many regimens given today do not have alopecia (hair loss) as a side effect so you will need to discuss this with your doctor. If you do have hair loss, it usually occurs 2-3 weeks after the start of your first treatment. It doesn’t all fall out at once; you will start to notice more hair in clumps on your pillow, clothes, in the shower, or when you brush your hair. Some people prefer to shave it off at that point while others let it fall out. It usually grows back once your chemo treatment is fully completed or changed to a different regimen.
There are several symptoms that may require hospitalization after you have received chemotherapy. You should call if you have:
-fever above 101*F
-nausea, vomiting, inability to eat for 2 days or more
-chest pain, shortness of breath
-sores in your mouth
-severe diarrhea, lightheadedness or dizziness
-other Of course, we would hope to prevent hospitalizations from severe symptoms so we do encourage a phone call early on. If you are not sure whether or not to call, it is best to err on the side of caution and call your doctor. We would much rather have you call and be given advice on how to manage your symptoms rather than waiting until your symptoms have progressed.
We do everything we can to prevent nausea and vomiting. Some regimens however do produce more nausea more than others. You may be given prescriptions prior to your first treatment to prevent nausea. It is best to have them filled and at your home so they can be immediately available to you when you need them. They work best when taken at the first sign of nausea rather than after you have begun vomiting.
Although you may not become nauseous, your appetite may be decreased for the duration of your treatment. Even if you are overweight, you should not lose weight during your treatment course unless it is done in a nutritious way. You may not feel like eating a normal meal, but you still need the same amount of calories and protein as you did prior to beginning treatment. This is even more important if you have lost a lot of weight before your diagnosis. Protein supplemented drinks are a healthy way to improve your calorie and protein intake when taken in addition to a meal (not as a substitute!). There are many brands available, even ones specifically designed for diabetics or patients who are lactose intolerant.
It is always best to discuss this with your doctor. But, for an extensive list of side effects caused by chemotherapy, the website of People Living With Cancer www.plwc.org has fantastic, comprehensive and reliable information.
The transfusions need to be given in the hospital.
Can I take alternative therapy or herbal medications in addition to chemotherapy to boost my immune system or help improve my chances?
While we always encourage patients to do everything they can to fight cancer, many alternative agents are unproven in their effectiveness at what they claim to do. Furthermore, they may interact with your chemotherapy in ways that are not anticipated by your doctor and could even be harmful. It is best to check with your doctor before taking any new medication, herbal remedy or alternative treatments (such as acupuncture)