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Handling an Emergency During Breast Cancer Treatment

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Updated July 23, 2010

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

How Should I Respond to Urgent Symptoms?:

Recognizing an emergency during breast cancer treatment can help you cope with the situation.  Stay calm, write down the symptoms, and use your emergency phone list.  Be ready to describe the problem and its severity as well as events that may have preceded the start of symptoms.  Not all patients with breast cancer will develop an emergency situation, but its good to know which symptoms are urgent and which can wait overnight.  Here are some symptoms to watch for and ways you can respond.

Fever and Infection:

Problem: Fever of 100.5F or higher that does not respond to an analgesic.
Reason: If your immune system is low (neutropenia) you may have an infection that your body can't fight on its own. Antiobiotic medicines may be needed to combat the infection and bring down the fever.
Action: Call your doctor right away (day or night) and start drinking plenty of fluids.
Not Urgent: If the fever is just two degrees higher than the person's normal temperature, monitor the problem and try a fever reducer such as Advil (ibuprofen) or Tylenol (acetaminophen).

Allergic Reactions:

Problem: Symptoms of an allergic reaction - face, throat or tongue swelling, difficulty breathing, rapid heartbeat, confusion, convulsions, a change in the difficulty with urination and bowel movements.
Reason: Allergic symptoms sometimes progress rapidly and can become dangerous.
Action: Call 911, describe the symptoms and explain that the patient is being treated for cancer.

Pain Related to Cancer or Treatment:

Problem: Persistent pain that interferes with movement, sleep or appetite. Pain that does not respond to proper medication.
Reason: Severe pain may signal physical changes caused by the cancer, from a bone fracture or break, or a need for more effective pain medication.
Action: Call your doctor or nurse if pain increases between doses of prescribed pain medication. If severe pain occurs, call your doctor or nurse or call 911 to describe the problem and ask for help.

Feeling Wiped Out and Fragile:

Problem: Difficulty breathing, fingernails turning blue, extreme weakness and fatigue, cuts or sores that are actively bleeding.
Reason: You may have a low platelet count (thrombocytopenia) caused by chemotherapy.
Action: If you have at least three of these symptoms, call your doctor right away. You may need a platelet transfusion.
Not Urgent: Keep track of your symptoms if you bruise easily, have nosebleeds or bleeding gums, and have persistent headaches. Report these to your doctor by phone and ask for help.

Stuck With Needles:

Problem: Needle sticks (near chemo port or at shot sites) become tender, swollen, red or painful. Needle sticks may begin to drain fluid or pus or may develop blisters.
Reason: Shot sites can become infected, or nearby skin can have a drug reaction.
Action: Call your doctor or nurse if the problem persists or worsens. You may need to visit your clinic for treatment, or you might be able to apply a home treatment.
Not Urgent: Try alternating a cool compress with a warm compress on the affected area and monitor the site. If it responds well, continue compresses for about 20 minutes.

Deep Fatigue and Weakness:

Problem: Severe and frequent dizziness, loss of balance, falls, mental confusion, shortness of breath, or unconsciousness.
Reason: Cancer treatments may cause low levels of oxygen or red blood cells (anemia).
Action: Call 911 if someone is unconscious and you can't rouse them. If the person is conscious, but has other symptoms of anemia, call your doctor or nurse for help. Shots to boost red blood cell counts may be given to alleviate the problem.
Not Urgent: Anemia can also cause ringing ears, pounding head, and fatigue. Get lots of rest, stay hydrated, eat well, and call your clinic if symptoms persist or get worse.

Sources:

Caring for the Patient With Cancer at Home: Chemotherapy. American Cancer Society. Last Revised: 11/12/2009.

Home Care Guide for Cancer. American College of Physicians, Peter S. Houts, Editor. Softcover book. Last Modified: November 1, 2001.

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