Chemotherapy

CANCER CHEMOTHERAPY FACTS

Facts:

• Chemotherapy is a term used to describe the treatment of cancer with drugs.
• Chemotherapy can be given orally, by injection into a vein or an artery, below the skin, into a muscle, into the fluid surrounding the spinal cord and brain, or into the space surrounding your lungs.
• Cancer cells usually grow more rapidly than normal cells and chemotherapy works by interfering with the growth and reproduction of these cells. Unfortunately, some normal cells also grow rapidly and can be killed by chemotherapy. These normal cells include those found in the bone marrow, mouth, stomach, intestines, hair follicles, and reproductive cells (sperm and egg).
• Some of the side effects from chemotherapy are the direct result of the anti-cancer drugs on these cells. It is important to remember that chemotherapy produces side-effects in some, but not all patients. Each anti-cancer drug can produce different side effects and these may not be the same in all patients. At times certain odors and environments, i.e., coming in to the clinic may trigger nausea. It is important to remember that most side effects can be managed and severe side effects are uncommon.

The following points can help protect you from complications:

• Notify your physician if you have a fever above 100.5 degrees F.
• Notify your physician if you have any unusual bruising or bleeding.
• Notify your physician if you have any unusual dizziness, lightheadedness, shortness of breath, excessive fatigue.
• Notify your physician if you have persistent nausea, vomiting, diarrhea, or constipation lasting more than 48 hours after treatment.
• Notify your physician if you have persistent mouth sores, ulceration, or painful swallowing. Check with your physician before having any dental procedures performed.
• Avoid people with obvious illnesses (colds, coughs, flu, etc.).
• Do not hold or change diapers of children for 6 weeks after the child has received oral polio vaccine (given as drops).
• Remember, if you feel tired, take frequent rest periods before and following chemotherapy appointments.

• Eat small meals frequently throughout the day. For example, eat 6 small meals a day instead of 3 large ones.
• Eat slowly and chew food well.
• Try to eat protein at every meal. Protein helps you keep up strength during treatment. Good sources of protein include chicken, turkey, soy foods, beans, fish, cheese, eggs, and milk.
• Drink small amounts of liquid frequently throughout the day.
• However, do not drink a lot with meals. This can cause bloating.
• Drink at least eight 8-ounce glasses of fluid every day. Good fluids are: water, non-acidic fruit juices (apple, cranberry juice), milk, soups, gelatin, yogurt, and popsicles. Try to limit your caffeine intake as it can further dehydrate you

Hair Loss:

• Some chemotherapy drugs may cause temporary hair thinning or hair loss. Check with your doctor or nurse to see if your chemotherapy causes hair changes.

Preventing Infection:

• Avoid large crowds and people with contagious illnesses (colds or flu) when your blood counts are low.
• Keep body clean by bathing daily.
• Wash your hands frequently throughout the day, and always after using the bathroom.

 Preventing Nausea

• Many patients are given medications to prevent nausea. It is very important that you take this medication as directed. Talk to your nurse if you have any questions.
• Eat food at room temperature or cooler.
• Try to eat food that does not have a strong smell. Cold food often smells less.
• Do not eat fatty or fried foods.
• Do not eat spicy or acidic foods.

Sun

• Try to stay out of the sun. Chemotherapy can make your skin sensitive. If you do go out in the sun, use a sunscreen with at least a 30 SPF. Swimming or sweating removes sunscreen, so remember to reapply every 2 hours.
• Wear protective clothing, such as a wide brim hat. Protect your scalp and ears.

Sexual Activity/Fertility

• Maintaining sexual relationships is important to your well-being. However, both men and women still need to use a reliable method of birth control while receiving chemotherapy.
• Menstrual periods may become irregular or stop during your treatment, but that does not indicate you are safe from becoming pregnant.
• Using a condom for several days following your chemo treatment is suggested to protect your partner from exposure to chemotherapy through bodily fluids.
• Chemotherapy may also affect your fertility temporarily or permanently. If you have concerns, talk with your doctor or nurse about this before starting your treatments.

Fatigue

• Pace yourself. Prioritize activities and take rest periods during the day.
• Stay active. Try to keep moving, and exercise if you can.

Mouth Care

• Brush after meals and at bedtime with a soft toothbrush.
• Floss as usual but be gentle! Talk to your doctor or nurse about flossing if your platelets are low or if your gums bleed easily.
• Rinse your mouth with warm salt water or baking soda and water after meals and frequently throughout the day. Use 1 /2 teaspoon salt or baking soda in an 8-ounce glass of water.
• Use other mouth care solutions as prescribed or directed.
• Do not use any mouth care products that contain alcohol.
• Keep lips moist with lip balm.
• If you have dry mouth, use artificial saliva, or spray your mouth with water.
• Do not wear dentures if your mouth is irritated. Remove and brush dentures after every meal.
• Check with your doctor or nurse before having dental work.

Medications for Nausea and Vomiting

These medications are used to prevent and treat nausea (upset stomach) and vomiting. You will often take several of these medications. Your nurse will explain your personal anti-nausea treatment plan. Remember, only take the medicines that have been checked off or circled for you.

• Emend (Aprepitant): Helps prevent nausea (upset stomach) and vomiting.
• You will take your first dose of Emend in the hospital, right before your first chemotherapy treatment.
• Take Emend once a day, in the morning, for the next 2 days.
• Emend is always used with other anti-nausea medications.
• Zofran (Ondansetron): Helps prevent nausea (upset stomach) and vomiting. After each chemotherapy treatment, you will take this medication for two to three days.
• Your nurse will give you your first dose of Zofran right before your first chemotherapy appointment.
• Your nurse will tell you when you need to take your next dose at home.
• You must continue taking Zofran for _____ days, even if you feel fine.
• This drug may cause constipation. If this occurs, ask your nurse about taking a stool softener.
• Zofran may cause headaches.
• Decadron (Dexamethasone): Has many uses. These instructions are only for use to prevent nausea.
• Your nurse will give you your first dose of Decadron in the hospital, right before your first chemotherapy treatment.
• Continue taking Decadron for 2-4 days after your treatment. You will take it either once or twice a day.
• Take Decadron with food.
• Decadron may cause trouble sleeping and flushed cheeks. These are normal side effects.
• When you stop taking Decadron, you may become very tired. This is also normal.
• Ativan (Lorazepam):
• Helps treat nausea, anxiety, or trouble sleeping.Take Ativan every 4-6 hours, only as needed.
• Ativan will make you sleepy. Do not drive or do anything that requires concentration while you are on Ativan.
• You may take Ativan even if you have already taken Zofran and Compazine that day.
• Compazine (Prochlorperazine):
• Helps treat nausea. This medication is often prescribed along with Zofran and Ativan.
• Take if needed, every 6 hours for mild nausea.
• You can take this medicine in between our Zofran doses, or after you finish your 2-3 days of Zofran.

Remember:

• Take all medications as directed by your nurse.
• Call your nurse if you still have nausea or vomiting 24 hours after taking your medication.
• Tell your treatment team if you have trouble paying for your medications. Some medicines are expensive.