I had a blood test Thursday morning at the Queen’s Cancer Center at Kuakini. Instead of searching for an elusive vein in my hand or arm—a process that has left my arms feeling like pin cushions lately—the blood was drawn through the port installed earlier in my chest. It’s the same two-way port used for chemotherapy infusions, accessible only by registered nurses with special training. So instead of just having blood drawn at one of the many available Diagnostic Laboratories locations, such as the one just a few blocks from home, I went across town where Nurse Pattie was able to use the port for access.

Afterward, I met briefly with my oncologist. Everything appeared on track for my next chemotherapy session on Friday.

Then came the 3:10 p.m. phone call. Chemo was cancelled and postponed until next Friday. The morning lab results showed my white blood cell count was simply too low to proceed.

Chemotherapy works by slowing or stopping fast-growing cancer cells, but it also impacts the immune system by reducing infection-fighting white blood cells. As the Mayo Clinic notes, low counts significantly raise the risk of infection, often forcing doctors to delay treatments or adjust dosages until the body has time to rebuild its defenses.

Given the numbers, my oncologist called off this week’s treatment.

It also means that I need to take special precautions to avoid infections. Stay away from groups, or people who might be sick. Wash hands frequently, even here at home. For us, that appears to require staying out of restaurants for a while, and being sure to wear a mask on any other outings.

And my oncologist also noted another option for moving forward: shifting the schedule.

The original plan was two consecutive weeks of chemotherapy followed by a week off. Switching to a treatment every two weeks would give my white blood cell count more time to recover between rounds.

There’s a lot of trial and error at this stage of cancer treatment, it seems.