Tuesday, December 6, 2011

Chemotherapy and Lab Testing

During a patient's chemotherapy treatments routine blood draws for lab testing are important. Chemotherapy drugs can affect your blood cell counts and organs of your body .  This can be monitored through the results of the lab test that are ordered.  A Complete Blood Count is very important as to monitor low white cell counts, platelet counts, red cell counts and low hemoglobin. When a CBC is ordered before a next chemo treatment they are looking for changes in all blood counts. The nurse will look at the ANC which stand for the Absolute Neutrophil Count.

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).

Some other blood tests that the physician may order during cycles of chemotherapy are a Complete Metabolic Panel and a Magnesium level.
A typical CMP-16 will specifically measure the levels of Glucose, Waste Products ( Blood Urea Nitrogen, Creatinine, Uric Acid, & the Glom Filtration Rate), Electrolytes (Sodium & Potassium Chloride), Minerals (Calcium & Phosphorus), Blood Fats (Cholesterol & Triglycerides), Proteins (Albumin, Globulin, & Total Protein), Enzymes (Total Bilirubin, Alkaline Phosphatase, GGTP, LDH, & SGOT (AST)).
cThe glucose checks your pancreas function.  Blood Urea Nitrogen and creatinine levels relate to kidney function.  Protein levels are important in liver and kidney damage.  Finally bilirubin and the enzyme testing is very important in determining liver damage. Magnesium is another electrolyte.  The magnesium can be low during chemo and may cause kidney damage. 

It is vitally important that you have your pre-chemotherapy  lab testing done the day before your chemo appointment.  When you do not have the labs performed then they have to order the tests stat and then wait and hour or two to begin your infusion.  As a result, this makes your nurse behind in her infusion schedule and other patients have to wait.

If you are experience weakness, shortness of breath, bleeding or muscle pain before your next blood draw for your chemotherapy then you need to contact the oncologist.

For more information :  http://www.labtestsonline.org ; http://www.medicineworld.org/cancer


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