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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