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When Cancer Keeps You Home

When you have cancer, it can sometimes feel like you went to bed one night and woke up on another planet.

At times when life feels out of control, most of us count on routines (like going to school or church) to make things seem normal. So it may seem like the last straw if the doctor tells you that your immune system isn't strong enough for you to go to school, the mall, or even a friend's house.

It's only natural that losing these routines — even for a short time — can sometimes leave people with a slew of emotions. You're not alone if you find yourself feeling angry, frustrated, depressed, or even jealous of siblings and friends.

For many people with cancer, having to stay home is only a temporary setback. Once your immune system recovers, you should be able to get back into your regular life. Until that happens, here's some advice on making the best of things.

What Is Neutropenia?

If you have cancer and have to stay home, chances are it's because you've developed something called neutropenia (pronounced: new-truh-pee-nee-uh). Neutropenia is when the body has very low levels of certain white blood cells called neutrophils. These cells are the body's main defense against infection.

When a germ enters the body, a healthy immune system springs into action, sending an army of neutrophils to the area to attack. Even more amazing, the next time those same germs enter the body, the neutrophils will "remember" them and try to head them off before they can cause any serious trouble.

People with cancer, though, often have fewer neutrophils patrolling the body. In some cases that's because the cancer itself damages the bone marrow, the spongy material inside the bones where all new blood cells — including neutrophils — are made. (This is especially common with cancers like leukemia and lymphoma.)

Other times it may be the cancer treatments themselves that are doing the damage. Both chemotherapy (cancer-fighting drugs) and radiation (high-energy X-rays) work by killing the fastest-growing cells in the body — both bad and good. That means that along with cancer cells, healthy blood cells, like neutrophils, often get destroyed too.

With fewer neutrophils, you are more prone to infection. Even things you'd normally be able to fight off without much trouble, like skin and ear infections, can become much more serious. That's why it's important to tell a parent or other adult right away if you have a fever, shaking or chills, or any mouth or skin sores. These can all be signs of infection.

Fortunately, doctors can use a blood test called an absolute neutrophil count (ANC) to judge how cautious you need to be about avoiding germs. When your neutrophil count falls below 1,000 cells per microliter of blood, your risk of infection increases somewhat; when it falls below 500 cells per microliter, the risk increases quite a bit more. If it stays below 100 for many days, the risk of serious infection becomes very high.

Sometimes doctors give people medications called growth factors to encourage the body to produce more neutrophils. But often it's safest just to remain home until your doctor says you can venture out again. Places like schools, locker rooms, and malls, where people are close together and germs spread easily, are just too risky. To your immune system, it would feel like standing at the edge of a forest fire with only a water gun for defense.

Making the Best of It

So what can you do to make the best of your time at home? Plenty — though a lot will depend on how you feel. Some days you may find that your cancer treatments really knock you out and all you want to do is sleep. Other days you'll probably have more energy. Listen to your body. And reach out to friends for support — even if the only shoulder they can give you is a virtual one.

Stay connected. Can you imagine what people used to do before texting, IM, Skype, and webcams? Ask friends to keep you in the loop. They can send photos of your team scoring. Or sneak a pic of that kid asleep in math class (your friends can always tell the teacher they are just trying to help you feel included!). Make up a funny quiz for friends to fill out each day and send back to you.

When it's the middle of the day and friends are in school, reach out to online friends in other time zones and play some games. You may even be able to have a friend over for a movie night if your doctor or nurse says it's OK.

On the subject of friends: Some people deal with illness better than others. Though it may hurt, try not to take it personally if some friends don't know what to say or if their talk about things that went on without you seems insensitive. Your true friends will know how to keep you included and treat you like the same person you've always been.

Get creative. Ask yourself: What do I never get a chance to do? Maybe you're an athlete who's always wondered if you have an artistic side. Perhaps you're a computer whiz who's always enjoyed creative writing. Now's the time to explore those other sides of yourself. Paint, draw, or make a scrapbook or a collage of your favorite photos. Build a model plane or ship, or design your own clothing or jewelry. Write poetry about the way you're feeling or keep a journal or blog about your experiences. Reading them back later on will remind you of how far you've come.

Redecorate. Ask your mom, dad, or siblings to help you turn your room into the cool and comfy space you've always wanted. Maybe you can turn a corner of it into a lounge or make your bed feel more like a funky sofa, with cozy pillows and a bolster. Choose colors that make you feel good, and keep your favorite music, books, and photos nearby to really make it your own.

Get outside. Even when a crowded place is off limits, fresh air usually isn't. Sit in the yard and read a book or a magazine, talk on the phone, listen to your iPod.

Feel better by doing good. One of the best ways to make yourself feel strong is to do something good — whatever that may mean to you. Ask your favorite charity if there's anything you can do to help out from home. Start a website about your experiences that may help others in the same position. Or just make a list of all the stuff you want to do when you're feeling better. Thinking beyond the here and now can make the time go faster and help you stay positive.

Talk it out. Feelings and worries can seem overwhelming if you hold them in, so find a way to let them out. It can especially help to get to know other teens who have cancer. Cancer support websites, most with chat areas or message boards, can make it easy to share what you're going through with others who understand.

Keep up with your schoolwork. Being at home gives you a chance to keep up with schoolwork if you feel well enough. You may be surprised at how much you actually want to do homework, so talk to your teachers and classmates about ways to stay involved.

Staying home may be hard at first, especially if your life was on full throttle before you got sick. But lots of people find that slowing down is not only good for the body, but also for the mind. So stay busy, keep your spirits up, and have confidence that, with a little help from the people you love, you'll get through this.

Reviewed by: Christopher N. Frantz, MD
Date reviewed: August 2011