Your bone marrow
The bone marrow produces most of the blood cells in the body and is vulnerable to damage by many of the chemotherapy drugs. Problems resulting from chemotherapy are also related to the specific type of blood cell affected.
* Red blood cells contain haemoglobin and carry oxygen around the body. When the number of red cells in your blood is reduced, anaemia caused by a lack of haemoglobin results. This can make you feel weak and tired and look very pale but is successfully treated by blood transfusions.
* White blood cells are essential for fighting infections. A low white cell count can result in an increased risk of infection so you may be given antibiotics during your treatment.
* Platelets help to clot the blood to prevent bleeding. If the number of platelets in your blood is low you will bruise easily and may bleed heavily from even minor cuts and grazes. This can be treated by a transfusion of platelets into your blood.
Once your treatment has begun, blood samples will be taken regularly to check that the number of these blood cells (the blood count) is normal before your next course of chemotherapy is given. Occasionally your treatment may be delayed if your bone marrow needs extra time to recover.
To reduce the problems associated with damage to your bone marrow:
* eat as healthy a diet as possible, including a wide variety of foods
* cut down your risk of infection; avoid people with coughs, colds and other infections. Avoid innoculations
* let your doctor know if you have any sign of bleeding or bruising.
* maintain high standards of personal hygiene.
* let your doctor know immediately if you develop a fever, that is a temperature over 38°C (101°F), or if you begin to feel unwell. You may need treatment with antibiotics. The time of greatest risk is 10-14 days after your chemotherapy. Don’t take medications to reduce fever without doctor’s advice
* take care to avoid injuries. For example, wear thick gloves when gardening.
* use electric razor instead of blades.
* rest whenever you feel tired.
The ability to replace damaged marrow using bone marrow transplants allows more intensive treatment to be used with a higher probability of achieving a cure in some cancers, such as leukaemia and some lymphomas in young people. These treatments are only available at specialist centres and many are still on a trial basis. These centres have produced their own information books which will be available to you if high dose treatment and transplantation is suggested.
Your bone marrow