Delayed Chemo - what effects does this have? Advice welcome

[Be-Positive]

Hi All,

So today I took my mum for her 2nd cycle appointment for her 2nd line treatment with Carbo/Caylex, however they took her bloods today and said she cannot have chemo Thursday because her neutrophils are too low. We took mum to the local hospital around a week or so ago as she had been feeling very fatigued and everything was going black when she stood up, they checked her bloods but said everything was ok. This hosppital is not where she has treatment so not sure if they checked it properly or raised it as low when they should of.

Mum is now having a blood transfusion Friday instead of chemo Thursday, we then need to go back again next week to see if she is ok to have the next cycle.

My questions are, does delaying the chemo have an impact on the treatment? Also if they know she has had to have blood transfusions on her 1st line treatment why have they not checked it properly in time for the next cycle.

If they know someone usually needs a transfusion shouldn't they automatically book her in for a blood check in time to sort it for the next cycle?

I have asked these questions to the Onc nurse but they take a while to come back so thought I would ask you lovely ladies ad you have first hand experience and lots of useful knowledge that I always use when asking questions back to the hospital.

[Lily-Anne]

I have chemo on a Friday so bloods on Tuesday oncology on Wednesday to prepare for chemo on Friday. However I was told there is no guarantee of a pattern with each dose and definitely not with each cycle. So that's possibly the reasoning behind it

LA

[Hidden]

I dont think delaying treatment has an effect on the outcome of a treatment, chemo is cumulative so it does stay in your body for some time after completion or so I am led to believe. I hope your Mum will pick up after her transfusions, I understand that these are always beneficial. She is having a tough old time of it but sometimes our white cells let us down with a bang. When getting last chemo her bloods were probably okay so they went ahead. These things do happen it is a nuisance because you get geared up for treatment and then you are sent away, I understand your concern

[Lyndy]

Hiya

I think that a week delay is not thought to be significant...it is pretty normal to get bumped at least once during chemo. When I had low neutrophils they offered me injections to take at home which supported my immune system-it really helped me avoid becoming neutropenia..may be ask if your Mum could have them? Hope she feels better soon xx

[Whippit]

Dear Be-Positive

Your Mum is a lucky lady to have a daughter with her and on the ball. I hope I might be able to help a little and reassure you. It can take an age for the CNS to get back to us and every minute seems an hour.

Each time your Mum has chemo it will have an effect on her bloods and generally it is hoped by the time of her next chemo treatment it will have recovered enough to have more chemo. They can't predict what levels the bloods will be which is why they test a day or two in advance and it's also why they don't assume your Mum will need blood transfusions for 2nd line just because she needed some for first line.

You also asked whether delaying chemo has an impact on treatment. I don't think any of us like having our chemo delayed but it's not an exact science and the established patterns are just works in general. There is no way of knowing in advance yet what treatment would look like if customised to an individual patients. Perhaps a way of thinking about bloods is that it would be dangerous for your Mum to have chemo if her bloods are not what they should be so it is the safest and best option.

I hope your mum's getting on well with her treatment, and I hope someone's also keeping an eye on you. It's a tough role being a carer and I'm not sure our carers really get the support they should have.

Hope this is helpful. xx Annie

[Be-Positive in reply to Whippit]

Hi Annie,

Thank you.. the whole things feels so surreal. I was looking through old photos at the weekend and it really hit me how much everything has changed. This time around I feel stronger about it all but certainly struggle some days watching her suffer and her life destroyed right now. It is so hard not being able to do anything to help it go away.

I am praying she can get through these next 5 chemos ok and enjoy the rest of the summer.

If all goes to plan she will be off treatment for July and we have booked a holiday for September. The Onc said delaying treatment a week shouldn't have an impact, however mum has been really sick these past two days so worried it has started growing again during the gap. Not sure tho. Have to wait and see the outcome this week.

Thanks for coming back to me take care of yourself too xxxxx

[Btte]

Hi just wanted to say I have had 3 rounds of chemo over the last 3 1/2 years and we talk on this site about it being on a merry go round, I certainly relate to that expression . I have like your mum had low white cells and delayed chemo I have had the injections to boost them and got back on the merry go round. It's the red blood cells that sometimes hit rock bottom that's when we need the blood transfusion, but things can change overnight I had been xmatched for a transfusion my bloods were done again and I didn't need it. For me it's very much taking it one day at a time and here I am feeling better than I have for a very long time the cancer is back I have been on watch and wait to try and go a year before more treatment . Love to you both . Bridie xx

[Be-Positive in reply to Btte]

Hi Bridie,

Thanks for coming back to me. I would love for mum to get a year or close to a year without needing treatment. This time around she has been much worse, she has had really bad aftigue so cannot leave the house often like she did on the last round. She isnt having any good days at all at the mo.

Mum had chemo 5 weeks ago now but she has been being sick for the past 2 days. She is back for her blood app today after the transfusion so fingers crossed she is ok for chemo this thursday!

I hope you enjoy your time for as long as possible off of treatment xxx