WBC regularly too low
Hi,
My mom has breast cancer and has been receiving chemo for the last 3 months or so. They're meant to make a decision this month whether the chemo is enough or whether she'll need to have her breast removed.
Unfortunately her White Blood Count is regularly too low and as a result she has had to delay the chemo a number of times - today the same story. I've asked her why she's not getting any treatment to bring her WBC up, but her doctor keeps telling her just to stay at home and wait another week for chemo.
Can someone tell me more about white blood cell booster (CSF) drugs or what should be done in this case? Is the chemo less likely to succeed if there are regular delays of a week like these?
Long story following, but there is a point to it. My mom has dedicated her life to helping underpriviledged kids in South Africa. She's got at least one building named after her, she's won numerous woman of the year awards throughout her life, she used to be the acting national director of Child Welfare South Africa and she even sat at Nelson Mandela's table at charity functions years ago. So when she retired, she started a charity of 4 foster homes for kids affected by HIV/AIDS in a poor community in our home town. When I urged her in 2009 to get medical aid, she said it's more important for the money to be spent helping improve the conditions for the kids, so she refused to get medical aid. I hate myself for not sending the money to her from here!! Unfortunately South Africa doesn't have much of a government sponsored health system like here in Australia where I now live, so if you get a serious condition like cancer without private medical aid, you've got problems. She's nou stuck with a government doctor who, as far as I can tell, doesn't particularly want to treat an old white woman. Point is, I'm not convinced that she's getting the best advice from her doctor.
Any advice would be appreciated. Is there any reason why CSF drugs may not be the right thing for her? What would determine that? How are they administered? My mom said something about her having to inject herself in the stomach multiple times per day and she couldn't see herself doing that. Is that true, is that how you administer CSF?
many thanks,
Dirk
Hi JustD
I think your assumptions are correct about the doctor there. I was diagnosed with triple negative breast cancer in 2009 and went thru chemo & radiation after a lumpectomy.
There are shots that can be administered 24 hrs after your chemo treatment. The cheaper of the two, Neupogen, requires numerous shots given once a day. It took 5 of these to get my white blood count up again after my first chemo. With Neulasta, it only took one shot, the day after. However, this drug is extremely expensive (close to $4,000/shot). But I was able to get it for less than $50 if I gave the shot to myself.
Like your mom, I was a bit 'nervous' about administering it to myself. But it's really not that big of a deal. It's nothing more than a little pin prick and it is injected into the fat of your stomach. You merely pinch a hunk of your skin and poke the very tiny needle in and push the syringe. (Everything is already pre-measured in the needle). AND it's only done once a day---not multiple times. With Neulasta it would only be the one shot each time she had the chemo. With Neupogen, it would be one shot per day for 3-5 days.
I'm not a doctor but have read a lot about the various treatments. From what I have read, chemo is more effective if you can stay on schedule. That's not saying that her treatments wouldn't still be successful.
How many more treatments does she have to go? What is her stage? How large was her tumor, any node invasion?? Is this chemo being done to shrink her tumor?
I KNOW IT SOUNDS CRAZY, BUT LENTILS AND SPINACH EATEN EVERYDAY SEEMS TO KEEP THE WBC HIIGH. I HAD A FRIEND WHO WOULD EAT A BOWL OF LENTILS EVERYTIME HER WBC WAS TOO LOW FOR CHEMO AND SHE WAS ALWAYS ABLE TO RECEIVE IT THE NEXT DAY. WHILE GOING THRU CHEMO I ATE LENTILS AND SPINACH EVERYDAY AND NEVER MISSED ONE TREATMENT. IT CAN'T HURT TO TRY. GOOD LUCK.
Hi JustD, I agree with Echo. In addition, has your Mother asked for a second opinion? The stage, type and lymph invovlement is important to know. The neulasta is what I had after each chemo. The deal with that is that you need to get the chemo first, then they give you the neulasta. If you haven't already done so, you need to have your Mother get all the copies of her pathology reports. You need to know more about type and stage before you can make decisions on treatment.
BTW. It isn't unusual to have to skip treatments because of the white blood count being too low. But, it is better if you can keep on schedule for your body and mind.
My husband had some problems with low white blood count and he was given NEUPOGEN injections (see here http://www.neupogen.com/pi.html for informations)between rounds of chemo to up his white cell blood count, this medecine make the bone marrow produce the white cells.
I certainly hope that this can be done for your mother too, it would help get proper treatment
good luck! Jacline
Hi daysi I was able to get the Neulasta cheaper because of my drug prescription plan. I picked it up at my local drug store. If I had the cancer place administer it to me, my cost would have been higher as they charged close to $150 just for the nurse to give you the shot (that didn't include the cost of the drug).
Most people don't know about this---they think that you have to get it thru the place where you are having your chemo. I was lucky enough for one of the nurses told me about it. I would suggest that you contact your prescription insurer and inquire about it. Not everyone will have the same coverage as I did---it all depends on who you have your prescription coverage with. I was told that some women (who had the nurses administer it to them at the center) had to pay $800-$1,000/shot. Again, due to the type of coverage I had, along with me picking it up myself at the drug store and administering the shot myself, I was able to get it much cheaper because then the insurance company didn't have to pay the higher fee to the cancer center.
This is one of those situations when YOU have to be the advocate and do all the research on. Make the calls---inquire about what is possible.
Also, I don't know if this had anything to do with it, but for the 1st chemo round I had the Neupogen and had to have 5 shots for it to work. Although those shots are expensive too, they are still much less. Perhaps the insurance felt it would be cheaper in the long run for me to get the Neulasta?
Good luck---hope you're able to get the Neulasta as it does work so much better!
You should try finding information at the drug company who sells this product to get financial help, if you cannot afford the medication as my husband had Neupogen shot, there was a program called "Victory" sponsored by the drug company, here in Canada, maybe you could have similar help where you are? The shots were 200$ each and a nurse came at home to give them to him for 3 days, and it cost us nothing! Jacline
Hi, thanks for all the replies and sorry I've taken so long to reply.
My mother was able to get chemo this past Wednesday and now she only has one more treatment left in March, then they will decide whether they need to operate to remove her breast. She has already had an operation to remove some of the cancer from her lymph nodes, where it was first discovered.
It's very difficult because I'm in Australia and my mom in South Africa and she doesn't want to "rock the boat" with the doctor. Bur my sister is there so I will ask her to find out about Neupogen. There doesn't seem to be much information about it in South Africa on the Internet.
regards,
Dirk
Dirk
Do you know your mom's stage, tumor size, etc?
I'm a little confused as to why they removed her lymph nodes but are still deciding whether to remove the tumor in her breast. I can understand them trying to shrink it (if it was large) before doing the surgery, but it sounds like the only surgery that would be scheduled would be to remove her entire breast if the chemo didn't work. What about removing the tumor by only doing a lumpectomy? They are going to remove the tumor, right??? I'm hoping they aren't just trying to shrink it and then leave it there to grow again.
Is there any chance that your mother could go to Australia to get medical care there as it doesn't sound like Africa is up on the latest treatments?
Sounds like she's going to need you to do a lot of research for her. Remember that KNOWLEDGE IS POWER and that you have to be your own advocate when it comes to your health. If that means being pushy, questioning things and demanding tests, then so be it.
Please keep us informed on her progress. May she find strength and hope on her new 'journey'.
im going for kemo now for breast cancer, i have to eat alot of mixed greens fried in bacon greese, with bacon in it.
My Mom has been undergoing chemo treatments for the past two years for ovarian cancer. When her white blood counts gets too low(this happens a lot)to receive treatment, she also take the neupogen shots. The are very costly if your insurance doesn't cover it, but they work great.
Best of Wishes for you and your Mom. It's hard but stay strong!
