Cancer Medical Care | Chemotherapy by-products | Leukopenia | Neutropenia

Cancer Medical Care | Chemotherapy by-products | Leukopenia | Neutropenia

Cancer medical care

Chemotherapy side effects

Leukopenia | Low White Blood Cells | Decreased White Blood Cells | Insufficient White Blood Cells 

1. Causes of white blood cell decline during cancer treatment

2. Symptoms of leukopenia

3. Problems that may be caused by leukopenia

4. Treatment of leukopenia

5. What should I do when the white blood cell drops?

6. Maintain the sanitation of the excretion system when the white blood cells fall

7. Attention should be paid to diet when the white blood cells are down

8. Please exercise moderately and regularly when the white blood cell drops

1. Causes of white blood cell decline during cancer treatment

After the patient received chemotherapy, radiotherapy, or resection, the internal organs were severely damaged; the hematopoietic system mainly included the liver, spleen, kidney, thymus, lymph nodes, bone marrow and other organs, all of which were affected by different degrees of injury. A certain degree of damage affects the inhibition of cell growth and metabolism in the normal body.

Because bone marrow is the main hematopoietic tissue. Therefore, after chemotherapy and radiotherapy, there is a certain degree of "myelosuppression", which causes the side effect of blood cell reduction.

Various factors make the degree of white blood cell decline vary greatly with time . Such as: types of chemotherapy drugs, drug dosages, patient bone marrow function, different sensitivity of hematopoietic cells to drugs, etc.

Usually it will reach a minimum within 7-14 days after the end of treatment, and then slowly rise again. Therefore, fever and infection most often occur between the 10th and 14th days.

 2. Symptoms of leukopenia

When the white blood cell is low, the patient will not feel any symptoms; unless the following symptoms of infection are related, please pay more attention.

  • Fever (over 38℃)
  • chill
  • Mouth sores
  • Cough, sore throat
  • Difficulty breathing
  • Abdominal or rectal pain
  • Sweating
  • diarrhea
  • Burning sensation during urination
  • Abnormal vaginal discharge or itching

 3. Problems that may be caused by leukopenia

  • Increased risk of infection
  • Common signs of infection in people with a healthy immune system may include fever, pus, pain, swelling, and redness. As the ANC decreases, many signs of infection may not appear when the infection starts. Because these signs seem to be caused by white blood cells resisting bacteria, and your white blood cells are not enough to produce these signs.
  • Your healthcare team may need to delay treatment or reduce the dose to prevent further leukopenia

 4. Treatment of leukopenia

Treatment may include the following items:

  • White blood cell growth hormone (G-CSF)

Mechanism of action: G-CSF is a cytokine that stimulates the bone marrow to produce more white blood cells. It drives the release of hematopoietic stem cells, mesenchymal stem cells, progenitor cells and VSELs in the bone marrow into the surrounding blood.

Side effects: cold-like symptoms often occur

1. Muscle and bone marrow pain: such as low back pain, back pain, chest pain, joint pain.

2. Fever, tiredness.

3. Redness or swelling of the skin.

4. Nausea and vomiting.

  • In some cases, antibiotics can be given to prevent infection.
  • Cancer treatment may be delayed, giving your body enough time to produce more white blood cells and restore ANC.

5. What should I do when the white blood cell drops?

  • The first thing to do is to avoid infection.
  • Try to avoid contact with colds and infectious diseases.
  • Wear a mask when you go to public places and crowded places.
  • Remember to wear protective gloves when planting flowers and plants, washing animals, and cleaning excrement.
  • Wash your hands frequently. Especially before eating or after going to the bathroom.
  • Do not squeeze or scratch pimples and pimples.
  • It is very important to maintain a balanced diet and adequate nutrition.
  • Maintain the integrity of skin and mucous membranes.
  • Most infections come from the normal flora of the skin, gastrointestinal tract and reproductive tract.
  • Do self oral examination daily. Pay special attention to whether there are erythema, ulcers or white puffy skin. Rinse your mouth with a non-irritating mouthwash from time to time.
  • Use a soft toothbrush to brush your teeth to avoid damaging your gums.
  • Try to use an electric razor. Do not use a razor to shave to avoid infection by scratching the skin.
  • Wash the shower with neutral soap. After washing, gently pat your skin dry with a bath towel. Do not rub the skin with the bath towel.
  • If your skin becomes dry and easily cracked, you can use lotions or oils to soften your skin.
  • When cutting your nails, be careful not to cut your skin.
  • Please use scissors, needles or knives carefully ; avoid injury and infection.

6. When the white blood cell drops, please keep the excretion system clean and hygienic

˙After each bowel movement, clean the anal area gently and thoroughly.

˙If there is inflammation or hemorrhoids in the anal area. Be sure to consult a doctor or nurse about the method of self-care.

˙Consult your physician before using enema or suppository. Avoid damage to the anal mucosa and cause infection.

˙Patients with urinary catheters should sterilize the urinary catheter at least twice a day.

˙ Female patients should wipe from front to back after urination, not back and forth.

˙During the menstrual period, the sanitary napkins should be replaced frequently to prevent infection.

˙Never receive any vaccination without the permission of the doctor.

˙If you have a fever, do not take fever-reducing medicine or any other medicine to lower your body temperature without the consent of the doctor.

˙During chemotherapy, if your white blood cell count has been declining; the doctor may suspend your next chemotherapy or lower the dose of the drug for a period of time.

˙The white blood cells are too low, the doctor may give "white blood cell growth stimulating factor" (G-CSF) to maintain your blood cell count. Prevent the white blood cells from continuing to fall down.

7. Attention should be paid to the diet when the white blood cell drops:

˙Eat a balanced diet. Because sufficient calories and protein can provide energy, it is beneficial to repair normal cells that have been injured.

 ˙Do not eat uncooked food; such as lettuce salad, sashimi, etc.

 ˙Avoid drinking cold beverages. 

 ˙If there are no special restrictions, drink plenty of water every day, at least more than 2,000 cc a day.

 ˙Eat cooked food; take more vitamins and phytochemicals.

 ˙Comprehensive brewing of rice noodles. Good digestion, easy absorption, less burden, comprehensive nutrition. 

 fruit juice. Non-chemically blended juices.

 ˙Foods that increase immunity, such as mushrooms (rich in polysaccharides), black fungus, coix seed, white fungus, lotus seeds, mulberry (juice), eight-treasure porridge.

 ˙Adverse reactions of bone marrow suppression occurred after radiotherapy and chemotherapy. Decline in red blood cells, low white blood cells, and insufficient platelets, in traditional Chinese medicine, are syndromes such as weakness of qi and blood, insufficient kidney yang, deficiency of liver and kidney yin...etc. In general, nourishing qi and nourishing blood are used. To nourish blood, the spleen and stomach must be strengthened first.

 ˙Patients with reduced white blood cells can choose Chinese medicines: Huangqi, Polygonatum, Spatholobus spatholobi, Chinese wolfberry, Ginseng, Chinese ginseng, red dates, ... and other medicines; Huangqi, Chinese wolfberry and red date drink.

 ˙Patients with thrombocytopenia can choose Chinese medicine: Angelica, jujube, cohosh, Ligustrum lucidum... and other medicines.

8. Please exercise moderately and regularly when the white blood cell drops

Exercise can promote bone marrow blood flow and maintain normal hematopoietic function.

The bone marrow in the bones is the main hematopoietic tool of the human body, which contains a large amount of red bone marrow that can produce many hematopoietic stem cells, and provide sufficient blood supply for the human body. If there is not enough blood to supply the bones , the bones will not get adequate nutrition, and a series of diseases will appear.

Quantitative and moderate exercise, especially aerobic exercise should be enhanced to increase the oxygen content of cells. Such as: walking slowly, jogging, yoga, lengthening breathing time.

Inhale evenly and slowly; hold your breath again; exhale slowly. From 20 seconds, slowly extend to 1 minute, or longer. It can increase the activity of hematopoietic stem cells and help enhance the hematopoietic function of bone marrow; at the same time, it can strengthen the strength of bones and make bones stronger and healthier.

If you have religious beliefs, you can chant silently; pray, confess

Christianity, Catholicism: Hallelujah, Hallelu Yah

Islam: Allahu akbar

Buddhism: Amitabha

No religious belief : I'm sorry, I love you, please forgive me, thank you

There are two main reasons leading to the decline of bone marrow hematopoietic function: 

The first is the lack of exercise and the weakening of the hematopoietic ability of cells. Without moderate and regular exercise, it is useless to eat more nutrients; if a factory imports a lot of raw materials and does not have normal production operations , it will not be able to produce products. It just hoards a lot of raw materials. Exercise produces blood circulation, which can effectively produce excellent red blood cells, white blood cells, and platelets 

The second is malnutrition; lack of hematopoietic raw materials. Deficiency: protein, iron, vitamin C, vitamin B complex, folic acid, amino acids, trace elements, vitamins, ... and many other nutrients. Need to develop good eating habits. 

Protein is not big fish or big meat; after chemotherapy, certain parts of the gastrointestinal tract are damaged. Therefore, the work and burden of the gastrointestinal tract must be reduced. Therefore, food is easy to digest and easy to absorb. Such as: soy milk, tofu, plant milk, brewed comprehensive cereal flour, ... and so on.

Exercise for at least 30 minutes each time and at least 3 to 5 days a week. However, strenuous exercise, staying up late and overwork should be avoided, and adequate rest should be taken to avoid the consumption of a lot of physical strength and nutrients. If the anemia is too severe, it is not suitable for exercise.

When changing postures, such as getting up from a chair or getting up, it is advisable to slow down. You can sit on the edge of the bed for 5-10 minutes, and it is best to be accompanied by someone to avoid falling down due to dizziness and fainting.

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