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This information is about erythropoietin. It describes erythropoietin, how it is given and some of its possible side effects. It should ideally be read with our general information about your type of cancer|.
Erythropoietin is a protein that occurs naturally in the body. It can also be made as a medicine. These are sometimes called epoetins.
Erythropoietin stimulates the body to make red blood cells and so can be used as a treatment for anaemia. Anaemia means having too few red blood cells.
There are two types of erythropoietin that work in similar ways. These are:
One of the main side effects of chemotherapy| is a reduction in the numbers of new blood cells made by the body. White blood cells only live for a few days so their numbers are affected first. Red blood cells live much longer (about 120 days) so their numbers take longer to fall.
Towards the end of your treatment, particularly if you have had a lot of chemotherapy, your red blood cell count may fall. If you have too few red blood cells (anaemia), you will feel very tired| and may also be breathless|.
A blood transfusion is the most commonly used treatment for anaemia caused by cancer treatment. But, erythropoietin may be given as an alternative to a blood transfusion| in some situations.
The National Institute for Health and Clinical Excellence (NICE|) currently gives advice on which new treatments should be available on the NHS. NICE has approved erythropoietin as a possible treatment for some women with ovarian cancer| who have anaemia and are having treatment with platinum based chemotherapy|, such as carboplatin| or cisplatin|.
NICE has also approved erythropoietin for use in people with other types of cancer who have severe anaemia due to cancer treatment but who can't be given blood transfusions.
Erythropoietin is a colourless fluid in a small glass bottle or a pre-filled syringe.
Erythropoietin is usually given by an injection under the skin (subcutaneously), most often in the thigh or abdomen. You, or a person caring for you, can be taught how to give the injections so that you can continue the treatment at home. Alternatively you may be given the injections by a district nurse or GP practice nurse. You may also be given iron tablets or injections to help your body to make new red blood cells.
It can be given from once a day to once every three weeks, depending on the type of erythropoietin used and on advice from your doctor. The injections usually continue until one month after your chemotherapy course has finished or until you are no longer anaemic.
Erythropoietin should be stored in the fridge and protected from light. Follow any storage instructions given by your pharmacist.
When you're given erythropoietin injections, the amount of erythropoietin in your body increases greatly and becomes much higher than normal. This is why you may have side effects even though it's a naturally occurring substance.
Each person’s reaction to cancer treatment is different. Some people have very few side effects while others may experience more. The side effects described here won't affect everyone having this treatment.
We've outlined the most common side effects but haven't included those that are rare and therefore unlikely to affect you. If you notice any effects that aren't listed here, discuss them with your doctor or specialist nurse.
Some people have flu-like symptoms, such as feeling sick|, joint pains, weakness, dizziness and tiredness|. These are more likely to occur at the start of your treatment. Your doctor may prescribe a painkiller, such as paracetamol, to help with these symptoms.
Let your nurse or doctor know if you develop this side effect.
Your doctor will closely monitor your blood pressure while you're receiving erythropoietin. Let your doctor know if you take medication for high blood pressure.
If you have chest pain, suddenly feel short of breath or develop a painful swelling in your leg, this could be a sign of a blood clot. If you think you may have a blood clot , contact your doctor straight away.
Your skin may become red or tender in the area the injection is given. Giving the injection in a different place on your body each time may help.
You may develop a skin rash, which may be itchy.
It's important to let your doctor know straight away if you feel unwell or have any severe side effect, even if they're not mentioned above.
A number of trials| have looked at the benefits of using erythropoietin in the treatment of people with different types of cancer. The results from some of these trials have raised questions about its safety and have suggested that sometimes erythropoietin may cause the cancer to grow in size. These results are being reviewed by the drug safety authorities.
Although some people with cancer will benefit from having erythropoietin, its benefits and risks should be carefully considered for each individual person.
If you have any questions about this, it's important to talk them over with your doctor.
Not all types of erythropoietin are suitable for Jehovah's Witnesses. Your doctor or pharmacist can give you further advice about this.
This section has been compiled using information from a number of reliable sources including:
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