More ways to help manage low red blood counts

Managing Low Red Blood Counts: Page 2

By , Caring.com senior editor
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When to ask a cancer patient's doctor to treat extreme fatigue due to anemia

If the person's hemoglobin level drops below eight, or if he's so fatigued that he's not getting up and about very much, talk to the doctor about more aggressive treatment. There are two possible treatment options for low RBC: growth factors and transfusions.

Growth factors. These hormones, made by the kidneys, stimulate the bone marrow to produce more red blood cells. Low red blood cell count can be treated with injections of erythropoietin (EPO), also called epoetin and darbepoetin (brand names Procrit, Aranesp).

Growth factors can cause side effects, including high blood pressure, blood clots, rashes, and flu-like symptoms, so the doctor may hesitate to prescribe them. Unfortunately, growth factors have recently been linked to long-term health concerns, including kidney failure and shorter survival times for certain advanced cancers. So the patient, his doctor, and you will need to weigh the short-term benefit of helping him have more energy against this risk of rare side effects.

If your friend or relative does take Procrit or Aranesp, you can expect him to feel significantly better in four to six weeks, maybe even sooner. Iron has been found to help growth factors work better, so if the doctor prescribes growth factor injections, be sure to talk to her about iron supplementation as well.

Transfusions. If the doctor doesn't think growth factors will work, or if the patient has taken them and had trouble with side effects, or if the doctor wants treatment to take effect immediately, she can recommend a transfusion. (Transfusions are less common now than they were in the past because growth factors are usually tried first.) The advantage of a transfusion is that it will make the person you're caring for feel better right away.

Transfusions can also help with types of cancer, such as leukemia, that affect the body's ability to produce red blood cells. There are few side effects to having a transfusion, now that blood products are carefully screened. However, because plasma is a foreign substance that's introduced into the patient's body, his doctor will monitor him carefully to make sure he doesn't have a reaction.

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