The Serious Side of Chemotherapy

Chemotherapy can sometimes lead to anemia, bleeding or infection. Here’s what you need to know to protect yourself and stay on schedule.

Anemia
If your red blood cell count dips too low, the result is anemia, which can lead to fatigue, dizziness, breathlessness, foggy thinking and intolerance of cold temperatures.
What you can do: Tell your doctor about your symptoms. A blood test will determine the next step: a medication or a transfusion.

Bleeding
A low platelet count (called thrombocytopenia) sometimes requires putting treatment on hold. Without adequate platelets, your blood can’t clot properly. Signs of trouble include easy bruising or nosebleeds, bleeding gums and/or small red or purple dots on your skin or mucous membranes.
What you can do: Report symptoms to your doctor. Protect yourself from bleeding by shaving with an electric razor and using a soft toothbrush.

Neutropenia
About half of all chemo patients develop neutropenia, a dangerous reduction in neutrophils, a type of white blood cell that destroys bacteria and viruses. With fewer neutrophils, your risk of infection increases—especially if you’re in the hospital when your fever starts, you’re 60 or older, you’re dehydrated or you’ve had a recent stem cell transplant. Neutropenia makes you vulnerable to infection, so it may cause you to postpone chemo sessions.
What you can do: Ask your doctor about colony-stimulating factor (CSF) medications, which can boost your white blood cell count. Margie Gelber, 56, was treated with these drugs. “They prevented the white count drop and kept me on schedule,” she says.

If you have any signs of neutropenia—fever, chills, sore throat—tell your doctor. You may receive a CSF medication during your first chemo cycle.