This page has information about the tests you may need before and during a course of chemotherapy. There is information about
Before your first treatment you will have blood tests, X-rays or scans. These help your doctor decide what treatment you need. They may also compare the results with future tests to find out how well your treatment is working.
You will have your weight and height checked, as the dose of the drugs you need is based on your size. Other tests depend on the chemotherapy you are having and may include
- Lung, heart, liver and kidney tests
- Hearing tests
- Blood clotting tests
- Dental checks
If you are a man and the chemotherapy is likely to make you infertile, you may be able to bank sperm before your treatment begins.
Before each treatment cycle
You have a full blood count before each cycle of treatment. This may be a couple of days before treatment, or on the day. If your blood counts are low, your treatment may be delayed. You will have another blood test, usually a week later. The blood counts need to be normal before you can have treatment.
All chemotherapy doses are prepared specially for each patient. So, if you have your blood test on the day, you may have to wait while the hospital pharmacy prepares your drugs. You may find it helpful to have something with you to pass the time.
Before your first treatment you will have blood tests, X-rays or scans. These tests give your doctor information about the treatment you need. They can also give your doctor a picture to compare with future tests to see how your treatment is working. The dose of chemotherapy you have is based on your height and weight, so your height and weight is checked. Your doctor will also examine you.
Chemotherapy drugs can stop your bone marrow producing enough red blood cells, white blood cells and platelets. So before your treatment starts you need to have a blood test to check your normal levels of these different types of blood cell. You may have other blood tests, depending on the type of cancer or leukaemia that you have.
It often helps to make a list of questions. You may also want to take a relative or friend with you when you go to have tests to remind you of your questions. When you're feeling worried, it's easy to forget what you planned to ask your doctor.
You may have some of the following tests.
Tests to check your lungs
Some chemotherapy drugs can affect the way your lungs work. If you are going to have any of these drugs your doctor will suggest you have a lung function test before you start your chemotherapy. Lung function tests measure how much air your lungs can hold and how well you are taking in oxygen.
Tests to check your heart
Some chemotherapy drugs can cause damage to the muscles of the heart. This damage may change the rhythm of your heartbeat. In most people this change will go back to normal after the chemotherapy treatment has ended. But if you are going to have one of these drugs, you need to have your heart checked before you start treatment.
Your doctor may ask you to have a recording of the electrical activity of your heart. This test is called an electrocardiogram (ECG). An ECG tells your doctor how well your heart is working. You may also have a heart ultrasound. This test is called an echocardiogram. Sometimes the name for this test is shortened to an ECHO. An ECHO checks the force that your heart is pumping with. This force is called cardiac ejection fraction. Both of these tests are painless.
Tests to check your liver
Some chemotherapy drugs can damage the liver, so you may have blood tests to check how well your liver is working. Many drugs are broken down by the liver, so the liver needs to be working well to get rid of the chemotherapy.
Tests to check your kidneys
Some chemotherapy drugs can damage your kidneys. So you may have blood tests or need to collect your urine so that it can be tested. The kidneys also get rid of the chemotherapy drugs when they have been broken down in the body, so they need to be working well.
HIV and Hepatitis tests
Your blood may be tested for HIV and hepatitis. Your doctors will explain this to you and you will need to sign a consent form to say that you agree to your blood being tested.
You may need other tests depending on the type of chemotherapy you are having and the side effects it may cause. For example if you are having a drug that can affect your hearing you may have a hearing test before you start treatment (audiogram).
If you are taking warfarin to stop blood clots you may need to have more regular checks to make sure you are taking the correct dose. And if you are taking steroids as part of your chemotherapy and you have diabetes you will need to keep a closer check as it can interfere with your blood sugar control.
If there is time before you start treatment your doctor may suggest you see your dentist. Having any dental treatment while you are having chemotherapy can be more complicated because you may be at increased risk of developing infections.
If you are a man and the chemotherapy is likely to make you infertile, you may be offered the chance to bank sperm before your treatment begins.
When you go to the hospital or clinic, the first thing you will have each time is a blood test. In some centres you have this the day before your treatment. It is important that your chemotherapy nurse checks your red blood cells (RBC), white blood cell (WBC) and platelet count before you have your next treatment. If your RBC is too low you may need a blood transfusion. If either your WBC or your platelet count is too low, having more treatment could push them down to a dangerous level.
You will also have blood tests to check how well your kidneys and liver are working. If they aren't working as well as they should you might have more side effects from the chemotherapy.
After your blood has been taken, you will have to wait for the result to come back. If it is okay, you will then need to wait for your chemotherapy to be prepared. Or you may go back the next day to have the chemotherapy.
All chemotherapy drugs are prepared specially for each patient, so you may have to wait while the hospital pharmacy prepares your drugs. This takes time. You may find it helpful to take something with you to pass the time.
To reduce the amount of time you have to wait it may be possible to have the blood tests the day before you are due your treatment. This could either be at the hospital or at your GP's surgery. Ask your chemotherapy nurse about this, if you think it would make things easier for you.
If your blood counts are too low, then unfortunately your treatment will have to be delayed. You will have another appointment to come back and have another blood test. This is usually about a week later. If the tests to check your liver and kidneys show that there have been changes in how well they are working you may need the dose of your treatment changed. Sometimes people may need a different treatment, but this is rare.
There is information about the individual drugs and combination chemotherapy treatments in the cancer drugs section. If you would like more information, contact one of the cancer information organisations. They often have free factsheets and booklets which they can send to you.
You can also contact our cancer information nurses. They would be happy to help.
Remember – every patient is different. So each person's treatment plan is different too.
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