|
This
section is an excerpt of an excellent booklet called "Choices:
Living with cancer, dying with dignity." Molly Sower Sugarman
wrote this booklet in honor of her husband, Matthew, who died
of prostate cancer in 1999. The Rotary Clubs of District 5190,
generously funded the publication of this brochure. Molly and
the Rotary Club have given permission to reprint this section.
You can obtain a complete copy of the brochure by sending an
e-mail request to Molly at
mssugarman@gmail.com
or by reading the copy at the
PSA-Rising
website. |
INTRODUCTION
If
cancer affects your bone marrow, the marrow will produce fewer and fewer
of the blood cells essential to your well being.
Too
few red blood cells causes fatigue and breathlessness. The bone marrow
produces red blood cells, which carry oxygen. With too few red blood
cells, your body does not have enough oxygen. Giving you oxygen may
not be a solution. It is not lack of oxygen intake that is causing the
problem; it is lack of cells to carry the oxygen.
Low
white-cell counts increase your risk of infection. Too few platelets
reduces the ability of blood to clot.
Low
blood counts may be caused by treatment, such as radiation. The effects
on your bone marrow may wear off over time and the cell counts may go
up again. Low blood counts may also result when cancer destroys the
cell-making capacity of the bone marrow or when the cancer kills blood
cells faster than the marrow can make new ones.
If
the cancer has destroyed the bone marrow’s ability to produce blood
cells, palliative measures are available to help maintain your quality
of life but these measures will not cure the problem.
PALLIATIVE
MEASURES
If
blood counts are low due to treatments, such as radiation, medication
may "jump start" the bone marrow. Usually the medicine is
given in a series of injections. You may be able to give the injections
yourself. If this is successful, the blood counts will rise and the
symptoms—breathlessness and fatigue—may lessen.
Eventually,
the toxic effect of the cancer on all body systems may increase, making
fatigue and breathlessness unavoidable. You may be less able to perform
daily tasks simply because you don’t have the energy.
Blood
transfusions can increase the number of red blood cells available to
carry oxygen. Your doctor can test your blood on a regular basis and,
if the cell counts are low, order the transfusion of whatever amount
of blood he or she feels will reduce your fatigue.
Because
the bone marrow is not replenishing the red cells naturally, this outside
replenishment may be ordered repeatedly, on a monthly or more frequent
basis, as needed. When blood transfusions are required frequently, you
may want to consider whether the time spent traveling to the medical
center and getting the treatment is worth the benefit received. This
is one of the many choices you have to make between treatment and quality
of life.
Ask
your doctor about options to minimize the effects of low blood counts
or what help hospice care might offer.
LIFESTYLE
CONSIDERATIONS
Techniques
for dealing with the fatigue and the breathlessness of low red blood
counts are discuss in the section "Fatigue."
White
blood cells cannot be transfused. Because of the increased risk of infection
when white counts are low, your doctor may suggest immunizations for
flu and pneumonia, or avoiding people who have contagious diseases.
You will want to pay attention to health alerts aimed at people with
reduced immune systems. Report any fever to your doctor for early antibiotic
therapy, if needed.
Low
platelet counts may cause problems with clotting and reduce the body’s
ability to stop bleeding, even from minor cuts and scrapes, such as
those that occur while shaving. Tell your doctor about any sign of bleeding,
such as a nosebleed or blood in your urine or stool.
You
may bruise more easily. If this happens, you may want to talk to your
doctor about medicines, food or herbs that increase the clotting ability
of blood.
Molly
Sower Sugarman
