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General Information
When To Seek Medical Attention Other Information Taking Care Of Yourself Common Chemotherapy Side Effects Cancer Resources Arrange for a friend or relative to drive you to and from the clinic on the day of your first treatment. Once you know how well you tolerate the treatment, you can decide whether it is necessary to continue to have a driver. Please do NOT wear any strong scents such as perfumes or after-shaves. Strong smells can cause nausea in some people receiving chemotherapy. Please silence your cell phone while in the infusion room and use a quiet voice while talking in the infusion area. Usually we have space for you to bring one person into the infusion room, although some days can be crowded and we may ask that person to wait in the waiting room. You are welcome to bring snacks and drinks into the infusion room. Please avoid bringing foods with strong scents. You may also bring a portable music device with head phones, tablet or a computer into the infusion room. Wireless access and outlets are usually available. If you are scheduled to see your dentist, be sure to inform your dentist that you are receiving chemotherapy. Consult with your doctor or nurse before having any dental procedures. You should have a thermometer available at home so that you can check your temperature if you are not feeling well. Call the Office Immediately or Seek Medical Attention if... ...you have signs or symptoms of infection including fever over 100.4 degrees F, shaking chills, burning or pain with urination, cough with mucous that has color. ...you have constipation that lasts more than 3 days and is not relieved by laxatives. ... you are unable to keep down food or liquids due to vomiting, and your prescription anti-nausea pills aren't helping. ...you have bleeding that doesn't stop, or excessive bruising. ...you have severe sudden headache, change in balance, or sudden change in vision. ... you have any unusual symptom that began after chemotherapy. Ask your doctor or nurse before using aspirin, ibuprofen (Advil), or naproxen (Aleve, Naprosyn). These medications may affect your platelets, which are important for blood clotting. Check your medications before your visit and let us know if you need a prescription refill. Please be sure to write down the name and dose of the medications that you are taking. If you are using alternative therapies including high doses of vitamins or minerals, herbal preparations, or special diets, please inform your doctor or nurse. You have a primary oncologist in our office who will order your chemotherapy and see you at office visits. You may also see the nurse practitioner or another physician as part of your care. If you have questions or concerns between 9am and 5pm on Monday through Friday you may call (415) 885-8641 and talk to the nurse directly. The nurses are usually available during the day to answer your questions, but you may reach the nurses' answering machine. You may leave a message if you do not require immediate assistance, and they will call you back as soon as they are able. Call the main number if you require immediate assistance from the office. If you call after hours, call the main office number: (415) 885-8600. You will speak to the answering service, and the doctor should call you back within 30 minutes. If you do not hear from the doctor within 30 minutes, call again. The doctor is available 24 hours a day via our answering service for emergencies. Taking Care of Yourself Mouth Care: Sensitive tissues in the mouth and lips can become irritated after receiving chemotherapy. During your treatment you should continue to practice regular oral care with a soft toothbrush and any commercial toothpaste. Do not use mouth washes with alcohol as this can be irritating to the mucous membranes. After meals and at bed time, rinse your mouth with a salt and soda rinse (1 teaspoon salt and 1 teaspoon baking soda in 500 milliliters, or ½ quart, of warm water). Keep your lips moist with a mild lip balm such as Chapstick or Vaseline. Skin Care: Avoid sun-burns and use sunscreen with a minimum SPF of 15. Wear a hat or wig to protect your head, and use long sleeved clothing if you plan to be outside during mid-day. Dry skin can occur and you may use a lotion such as Vaseline Intensive Care, Lubriderm, Cetaphil or aloe vera containing lotions. Avoiding perfumed or scented lotions may be helpful if you are feeling nauseous. Fluids: Unless you are told otherwise, drink 2 to 3 liters of fluids for the first 3 or 4 days after treatment. In addition to water, teas, juices, milk, broth, sport drinks (Gatoraid) can all be helpful, and may be diluted with water if the taste is too strong. Consider making popsicles out of your favorite drinks. Alcohol: Alcohol may increase your chances of becoming nauseated if consumed within a few days after receiving chemotherapy. Heavy drinking is strongly discouraged as it may delay recovery of your blood counts and may cause liver damage. One glass of wine or beer is usually acceptable, but not until several days after your treatment. Consult your doctor or nurse if you plan to drink alcohol during treatment. Sleep, Rest, Fatigue, and Exercise: You may feel more tired than usual while receiving chemotherapy. Be in control of your fatigue-- don't let it control you! Try to go to bed and wake up at the same time each day. Plan your day, and save your energy for the most important things. Rest frequently throughout the day if you feel tired, but you may need to limit napping so that you are able to sleep at night. In most cases, light exercise is ok, but learn to listen to your body. Rest when needed, and adjust your level of activity to how you feel. Ask your doctor or nurse if you are considering exercising. Food Suggestions: The Day of Chemotherapy: Eat a regular breakfast or lunch on the day of chemotherapy. If you have a late morning or afternoon appointment, eat a snack before your treatment. Avoid fried or greasy foods. Preventing Nausea: Sometimes patients have less nausea if they are not hungry. Eating frequent small meals may be helpful. Avoid greasy, fatty or fried foods. Avoid spicy foods, red meat, and foods with strong odors, especially if you are cooking. Some easy Snacks:
Common Chemotherapy Side Effects Low Blood Counts: Your blood counts will be checked regularly during
treatment. These results are important because they help us determine if it
is safe to give you your next treatment, and if you are at risk for
infection or bleeding.
Nausea and Vomiting: We are often able to control nausea and vomiting with the anti-nausea medications that we have to offer. You may be more at risk for nausea several hours after receiving chemotherapy and it may last for a few days afterwards. Eat frequent small meals on small plates. Take your anti-nausea medications as instructed by your doctor or nurse. Call us if your medications are not working! Taste Changes: It is not uncommon for food and drinks to taste differently while receiving chemotherapy. If you have a metallic taste in your mouth after chemotherapy, avoid using metal utensils for eating. Use herbs and mild spices to enhance flavor if foods have an unpleasant taste. Diarrhea: You should contact the nurses if you are having diarrhea, especially if associated with abdominal pain or cramps. We may recommend that you try Imodium AD (loperamide) tablets. You may follow the directions on the box unless told otherwise. Be sure to drink plenty of fluids. Constipation: Constipation is common among chemotherapy patients. It is important to maintain a regular bowel regimen. Drinking plenty of fluids, eating foods with fiber, and maintaining some activity can help you keep regular bowel habits. Warm prune juice may be helpful, and a stool softener such as docusate sodium (generic for Colace) may be needed. We may also recommend an over the counter laxative such as senna or Senokot. Mouth Sores: Painful blisters on the lips and in the mouth can occur with some chemotherapies, usually a couple of weeks after starting treatment. Sometimes a bacterial or fungal infection can occur, so you should notify your doctor or nurse if your mouth is very sore, red, or covered with a white film. Consider using the salt and soda mouth rinse described under the Mouth Care section on the previous page. Hair Loss: Some chemotherapy drugs affect hair cells. This can lead to thinning of the hair or total hair loss, which usually takes place 2 to 3 weeks after your first dose of chemotherapy. Almost always, the hair will grow back after you finish chemotherapy. Covering the head with a cap, scarf, wig or hairpiece may be helpful. Sexuality: It is not uncommon to have a decrease in sexual desire during treatment. Share your feelings with your partner. You may find that hugging and cuddling is important. If you experience sexual concerns or problems, talk to your nurse or doctor. Fertility: Ask your doctor or nurse before starting chemotherapy about sperm
banking, egg banking, or ovarian protection options if you are considering
having children after your treatment. Chemotherapy drugs may lead to
permanent sterility and inability to have children. Please discuss this with
your doctor or nurse immediately if you have concerns!
Birth Control: Chemotherapy drugs may cause birth defects in babies who are conceived during treatment. Women and men receiving chemotherapy may still be able to reproduce, and contraception should be practiced regularly during treatment. Condoms may be most effective in preventing exposure to your partner, and are an effective measure for preventing pregnancy. Oral contraceptives may be an option for some female patients. Please consult with your doctor or nurse for more information. If you are a lactating mother receiving chemotherapy, you should stop breastfeeding. In addition to side effects, treatments can affect your personal life and relationships. Talk with your health care team. There are people and programs available to help you and your family cope with living with cancer. Ask about support groups or resource centers that are available in your area. Participating in your treatment begins by asking questions. Your health care team is there for you, to help you understand what to expect from your chemotherapy, and what you can do to help yourself. National Cancer Institute (NCI) American Cancer Society (ACS) People Living With Cancer (PLWC) Clinical Trials |
