Cancer-Related Anemia: Care Instructions

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What is anemia?

Anemia is a low level of red blood cells. Red blood cells carry oxygen from your lungs to the rest of your body. Cancer or cancer treatment is stopping your body from making enough red blood cells, which means that your body tissues are getting less oxygen. This can make you feel weak and tired.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What do you need to know about getting red blood cells?

Your doctor may have prescribed a transfusion of packed red blood cells. These are red blood cells that have been taken from blood donated by someone else. Getting extra red blood cells can help your blood carry more oxygen to the tissues of your body. This can help you feel stronger.

Your health care team will make sure that the packed red blood cells, also called PRBCs, are the right match for your blood type.

What do you need to know about epoetin and darbepoetin?

Your doctor may have prescribed epoetin or darbepoetin because these medicines may help your body make red blood cells. It usually takes several weeks before the medicine starts to work.

The medicine is given as an injection under the skin. If you miss a dose, take it as soon as you can, unless it is almost time for your next dose. If it is almost time for your next dose, then skip the missed dose and get back on your regular schedule.

Do not take two doses of the medicine at once. Do not freeze the medicine. Store it in the refrigerator. Do not shake the bottle before you prepare the shot.

What do you need to know about iron pills?

Your body needs iron to make red blood cells. Epoetin and darbepoetin will not work as well if you do not get enough iron. For this reason, your doctor may tell you to take iron pills as well as certain vitamins that help the iron work better. Take these exactly as directed. Do not take more iron than your doctor tells you to. Too much iron can cause serious health problems.

You will have regular blood tests to make sure that your blood counts are getting better.

Iron pills may cause heartburn, nausea, diarrhea, constipation, or cramps. If you have any of these problems, try taking one less iron pill each day. Let your doctor know about your side effects and that you are not taking as much iron.

Iron pills can change the colour of your bowel movements to black or dark grey. This is harmless, but let your doctor know if you see this colour change. Internal bleeding can also cause dark stools, so your doctor may want to test the stool to be sure that there is no blood in it.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have symptoms of a heart attack. These may include:
    • Chest pain or pressure, or a strange feeling in the chest.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
    • Light-headedness or sudden weakness.
    • A fast or irregular heartbeat.
    After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.
  • You have a seizure. (This is very rare.)

Epoetin and darbepoetin can cause side effects. Call your doctor or nurse call line now or seek immediate medical care if:

  • You have flu-like symptoms and a fever.
  • You have swelling of the face, fingers, ankles, feet, or lower legs, or you are gaining weight and do not know why.
  • You have diarrhea, dizziness, nausea, or vomiting.
  • You feel very tired and have low energy, muscle pain, loss of strength, or numbness or tingling.
  • You have signs of a blood clot, such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if you have any problems.

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