Together We Can -- Newsletter of the Joan Karnell Cancer Center

Summer 2003

Bloodless Medicine
A Survivor's Story
The Joy of Life
Improving the Lives of Women
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Bloodless Medicine

Once an obscure specialty, bloodless medicine, a service that offers alternatives to blood transfusions, is quickly becoming the latest trend at many hospitals and health systems around the country. The worldwide blood shortage and patients' fears about the transfer of diseases like AIDS, SARS and West Nile virus have no doubt contributed to this increased interest in bloodless medicine.

While bloodless care can be used in the treatment of several different diseases and surgeries, cancer patients can particularly benefit. “Cancer treatments, both chemotherapy and radiation, frequently cause anemia,” says Patricia Ford, MD, medical director of the Center for Bloodless Medicine and Surgery at Pennsylvania Hospital. “In cancer patients, anemia can also be caused by significant blood loss or poor nutrition. The disease itself can cause anemia too, if it infiltrates the bone marrow.”

Jehovah's Witnesses
The Center for Bloodless Medicine and Surgery offers an option not only for cancer patients who are fearful of receiving blood transfusions but also for those who avoid them as part of their religious beliefs. For Jehovah's Witnesses, whose interpretation of the Bible forbids them to receive blood transfusions, bloodless medicine means these patients will not have to choose between their health and their faith.

“We have several coordinators who work with Jehovah's Witnesses that talk to patients about their wishes and then communicate those wishes to the rest of the staff,” says Barbara Mathews, RN, OCN, nurse manager. The coordinators are in close contact with the Jehovah's Witness community so that they are aware of what medicines or procedures are and are not permitted. Further, they have been trained to educate patients on all of their bloodless medicine alternatives. As Dr. Ford notes,“We take special care to make certain that a patient's decision is honored.”

Bloodless Treatment
After meeting with a coordinator and completing a comprehensive history, physical exam, and complete blood count (CBC), Dr. Ford will review your treatment options.“Our goal is to optimize a patient's hemoglobin level to as high a point as possible prior to treatment or surgery,” says Dr. Ford. This is achieved through precise monitoring and measurement of your red blood cell levels.

Treatment may include anything from iron to erythropoietin, a molecule that causes your bone marrow to produce more red blood cells. (If you require surgery, other key bloodless treatments include the use of surgical tools that cut and seal blood vessels and drugs that reduce blood loss during surgery.) “The same techniques are used for cancer patients who are undergoing chemotherapy as those who are undergoing radiation,” says Dr. Ford.

“By restoring and building up red blood cell levels, the patient benefit is two-fold. Patients can continue to receive their chemotherapy or radiation on time and we can enhance their quality of life, helping to reduce symptoms like extreme fatigue and shortness of breath.” Further, by reducing anemia, another potential complication to cancer treatment and therapy is removed.

When to Begin
Optimally, it's ideal to start your bloodless care three to four weeks prior to beginning surgery or treatment but the Center can help at any point that anemia may be a problem. “We like to have as much time as possible to achieve an ideal hemoglobin level but if that's not possible, we can still help patients who would rather not receive blood transfusions,” says Dr. Ford. Typically, cancer patients are monitored before, during and after treatment to ensure hemoglobin remain at a safe level.

To learn more about how bloodless medicine may be beneficial to your cancer care and treatment, call 1-800-789-PENN (7366). You can also request an appointment online.


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Need an appointment? Request one online 24 hours/day, 7 days/week or call 800-789-PENN (7366) to speak to a referral counselor.

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