Safety and Low Blood Counts

Your blood is made up of many components including red blood cells, white blood cells and platelets. These cells help your body function normally. Cancer and its treatments can affect the components of your blood and can cause potentially unsafe changes to the different cells in your blood. In this blog we will talk about the main components of your blood, their function and what to do (or not do) when these counts are lower than normal.

Red Blood Cells: The job of red blood cells (RBC) is to carry oxygen to the organs in your body. Hemoglobin is a protein in these red blood cells. You may hear your care team discuss your hemoglobin levels, which is one part of your RBC. When your RBC count is low, sometimes called anemia, you may feel more tired than usual, your skin may be more pale, you may feel dizzy and you may feel short of breath. Treatment for anemia may include a transfusion of RBC and medications that stimulate RBC production. Ways to keep yourself safe if your RBC level is low:

• Take it easy. Listen to your body and rest when you need to. If you become dizzy or feel short of breath you should call your provider.
• Avoid situations that could cause bleeding.
• Eat a balanced diet. Foods rich in iron (dark, leafy greens, sweet potatoes, meat, fish and beans) can help you to increase your hemoglobin in some cases.
• Stay hydrated by drinking plenty of water and non-alcoholic drinks.

White Blood Cells: White blood cells are part of the immune system and work to fight germs and keep you from getting sick. There are four types of white blood cells, each working differently to protect you from infection. Some cancers and some cancer treatments can lower your white blood cell counts and make you more prone to getting sick. You will want to talk to your provider about if your cancer or treatments will affect your white blood cell count, and if so, what your levels are. Treatment for a low white blood cell count can include medications to help your WBC increase. Your care team may also recommend taking a break from treatment. Ways to prevent infection when your white blood cell counts are low include:

• Wash your hands before activities such as eating or touching your face. Wash your hands after touching objects such as trashcans, being in a public space, couching/sneezing, using the bathroom, or touching animals.
• Do not spend time in crowds or with someone who is known to be sick/have an active infection. 
• Use a soft bristled tooth brush and brush your teeth twice a day.
• Ask your provider before getting any vaccinations. Often it will be suggested that you get a yearly flu shot.
• If you have any signs of infection such as a fever, redness or swelling of the skin, cough, runny nose, frequency or urgency with urination, call your provider right away.

Platelets: Platelets help the blood to clot. Some cancers and some treatments used in cancer can lower your platelet count. A low platelet count makes you more prone to bleeding and not being able to stop it. To treat a low platelet count you may be given a transfusion of platelets, steroids, or you may need to take a break from treatment. To prevent bleeding you can:

• Avoid contact sports or putting yourself in situations where you could be hurt and start to bleed. When in a car you should always wear a seatbelt.
• If you need to shave you should use an electric razor.
• Ask your provider if it is ok to floss your teeth. You should use a soft bristled toothbrush when brushing your teeth.
• Be gentle when coughing and blowing your nose to avoid bleeding.
• If you feel constipated, check with your provider about what you should do to avoid straining to have a bowel movement. It may be suggested that you take an oral stool softener.
• Check with your pharmacist or provider before taking any anti-inflammatory medications such as aspirin, Motrin® or Aleve®.
• If you do start to bleed and it is not stopping, contact your provider right away for instructions as to what you should or should not do.

Often during treatment for cancer your blood counts will be monitored frequently. It is important to take certain safety precautions while these counts are low. Following these tips will help you get through the periods of time that your counts are low. And don’t forget to ask your team if you have any concerns about your blood counts.

Karen practiced as an acute care nurse on a medical-oncology unit at the Hospital of the University of Pennsylvania for several years. She joined OncoLink as an Educational Content Specialist in 2014. In her blog she shares stories about her personal experiences with cancer, both on the floor and in her personal life.