Medical Oncologist
Understanding your blood tests
Which Blood Tests Are — Repeated Every Month and Why
Every month — or before every treatment cycle — your oncology team draws blood and checks the same panel of tests. These results decide whether your next dose goes ahead safely, and they often catch problems weeks before you feel anything.
Medically reviewed by Dr. T. Raghavender Reddy, Medical Oncologist, MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · Last reviewed August 2026
- Go or no-go check — Your blood results decide whether treatment runs on schedule that day or needs to be adjusted.
- Early warning system — Changes in blood values often appear weeks before any symptom develops.
- Monitoring your body, not just the tumour — These tests show how your liver, kidneys, and bone marrow are coping with treatment.
- Trends matter more than single results — Your team reads the pattern across multiple cycles, not just the most recent number.
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Before each treatment cycle, your oncology team checks a set of blood tests — usually a complete blood count, liver function, and kidney function. These confirm your body is ready to receive the next dose safely. They also catch side effects before you feel them, which is why they are repeated even when you feel well.
What does each test on your blood report actually check?
| Test | What it measures | Why it matters during treatment |
|---|---|---|
| Complete Blood Count (CBC) | Red cells, white cells, and platelets in one panel | Shows whether your bone marrow is keeping up with treatment |
| Liver Function Tests (LFT) | Enzymes and proteins that reflect how the liver is working | Many treatments are processed by the liver; a rising level may prompt a dose review |
| Kidney Function Tests (KFT) | Creatinine and urea — waste products the kidneys filter out | If the kidneys are under strain, drugs can build up to harmful levels |
| Random Blood Sugar (RBS) | The amount of glucose circulating in your blood | Steroids and some treatments raise blood sugar, which needs its own management |
| Tumour Markers (where applicable) | Proteins produced by certain tumour types, such as CA-125 or CEA | Used to track treatment response over time, not to diagnose |
What should you do when you go for your monthly blood draw?
- Drink water before going, unless your team has told you to fast — hydration makes the draw easier.
- Bring all your previous blood reports so your team can compare trends, not just the latest single number.
- Tell the nurse or phlebotomist if you have a port, PICC line, or Hickman line before they look for a vein.
- Write down any new symptoms — unusual tiredness, bruising, swelling — so you can report them when results are discussed.
- Ask what number to call if a result comes back flagged before your next scheduled appointment.
Why does your team need these results before every treatment cycle?
These results act as a go or no-go check before your next dose. If a critical value is too low or too high, treatment may be delayed or the dose adjusted — not as a setback, but to protect you.
Catching a problem in a blood result means acting before you develop a fever, begin bleeding, or feel your kidneys under strain. That is the reason the same tests are repeated cycle after cycle.
Your team is also building a picture of how your body responds over time. One result matters less than the trend across several cycles.
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Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
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Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
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Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
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Radiation Oncologist
Radiation Oncologist
Hematologist
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Dr. Mohammed Imran
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Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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What do the terms on your blood report mean?
- Haemoglobin (Hb)
- The protein in red blood cells that carries oxygen around your body. Low haemoglobin is the reason many patients feel deeply tired or short of breath during treatment.
- Absolute Neutrophil Count (ANC)
- The number of neutrophils — white cells that fight bacterial infection. This is the value your team watches most closely before each chemotherapy cycle.
- Platelets
- Cells that help your blood clot after a cut or injury. A low platelet count means you bruise more easily and bleed longer than usual.
- ALT and AST
- Enzymes released when liver cells are under stress. A rising level tells your team the liver may need protection before the next dose.
- Creatinine
- A waste product produced by muscles and cleared by the kidneys. A rising creatinine suggests the kidneys are not filtering as efficiently as they should.
- Bilirubin
- A yellow substance produced when red cells break down, normally cleared by the liver. A high level can cause yellowing of the skin and eyes, known as jaundice.
What happens if one of your results comes back outside the normal range?
Reports flag values with H (high) or L (low) against the laboratory's reference range. That range is set for healthy adults — it is not specific to people on cancer treatment.
A flagged result does not mean a crisis. Your team interprets every number in context: what treatment you are on, what your personal baseline has been, and what is happening clinically.
If you receive your report before speaking to your team, call the number on your treatment card and read the flagged values out. Your team will tell you whether to come in the same day or whether it can wait.
Questions patients ask about their blood tests
Can I eat or drink before a blood test?
Most blood tests during cancer treatment do not require fasting. Drinking water is encouraged — it keeps your veins easier to find. The exception is if your team has specifically asked you to fast, or if a fasting glucose panel is included in the request. When in doubt, call your team the day before rather than assuming and then being turned away or rescheduled.
My haemoglobin is low. Do I need a transfusion?
A low haemoglobin is common during treatment and does not automatically mean a transfusion is needed. Your team will decide based on how low the value is, the trend over time, and whether you have symptoms such as breathlessness or chest pain alongside it. Mention any symptoms at your next contact rather than waiting for your next scheduled appointment.
What is the 'nadir' my team keeps mentioning?
The nadir is the point at which your blood counts are at their lowest after a chemotherapy dose — usually in the middle of the gap between cycles. It is the period when your risk of infection is highest. Your team times your blood test around the nadir so they can see what your lowest point was before deciding whether the next cycle can proceed.
Why does the report show a reference range if it is not meant for me?
The reference range is the spread of values seen in healthy adults of your age and sex. It is printed because it is the laboratory standard. Your oncologist will apply their own thresholds — often different from the printed range — based on your specific treatment protocol and your personal baseline. Treat the reference range as a starting point for a conversation, not as a verdict on your health.
Can I have the blood drawn at any laboratory near my home?
Your team may accept results from an accredited external laboratory for routine panels, particularly if travelling to the centre is difficult. Some tests — such as those drawn through a port or line — need to be done where the device can be safely accessed. Check with your team before going to an outside laboratory so that results reach them on time and in the format they need.
What happens if my counts are too low and treatment has to be delayed?
Your oncologist may delay the next cycle, reduce the dose, or add a supportive medicine that helps your bone marrow recover faster. A delay is not a sign that treatment is failing — it is a safety measure. Starting the next cycle too early with low counts increases the risk of a serious infection, which causes a longer and more disruptive delay than waiting an extra week.
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Common questions
Frequently asked questions
What is a CBC and why is it done before every cycle?
The CBC, or complete blood count, measures your red cells, white cells, and platelets in a single panel. Before each cycle it tells your team whether your bone marrow has recovered enough for the next dose to be given safely. If any of the three counts is too low, treatment may be delayed or the dose adjusted. It is the single most important routine test during chemotherapy.
Why does my team keep checking my kidney and liver function?
Chemotherapy and many targeted agents are processed and cleared by the liver and kidneys. If either organ is under strain, the drug can accumulate to a harmful level or cause additional damage. Liver and kidney function tests give your team an early warning — often weeks before you would feel any symptom — so they can adjust the dose or timing before a serious problem develops.
My white cell count is low. Am I at risk of infection?
A low white cell count, and in particular a low absolute neutrophil count, does increase your risk of bacterial infection. Your team will tell you the level and what precautions to take. Common guidance during a low count includes avoiding crowded places, washing hands frequently, and seeking immediate care if you develop a fever. Do not wait to see whether a fever settles on its own — fever with a low white count needs same-day assessment.
Can I take my usual medicines on the day of a blood test?
In most cases, yes. The exception is if you are taking a medicine whose dose is adjusted based on the test result — for example, a blood thinner monitored by INR. Tell your team what you have taken and ask specifically whether any regular medicine should be timed differently around the test. Do not stop or delay a regular medicine on the assumption that you should be fasting.
How do I read a flagged result if my doctor is not immediately available?
Look at the values marked H or L and note the units alongside them. Do not compare your numbers against internet sources or another patient's results — the relevant threshold depends on your treatment protocol and your own baseline. Call your team's helpline number and read the flagged values aloud. They will tell you whether to come in the same day or wait until your next scheduled appointment.
Will blood tests always be monthly, or does the frequency change over time?
The frequency depends on where you are in treatment. During active chemotherapy, tests are done before every cycle, which may be every two, three, or four weeks. During oral targeted therapy or maintenance treatment, monthly testing is common. During follow-up after treatment ends, the interval usually lengthens gradually. Your team will tell you the schedule and adjust it if your situation changes.