Health Center
What is Chemotherapy?
Chemotherapy refers to medications or drugs used to treat cancer. Cancer cells are different than normal cells. They grow in an uncontrolled manner and divide more often. Chemotherapy interrupts the cancer cells ability to grow and multiply. Unfortunately, it affects normal cells as well. Those cells that divide more often are impacted. The normal cells affected include the digestive system, bone marrow, reproductive system, and hair follicles.
There are many different types of chemotherapy. Depending on the type
of drug used, the dosage of the drug and the individual's response to the
drug determine the side effect that may occur. The type of drug will determine
treatment length and frequency to be given. It could take minutes or hours
for the drug to be administered. Chemotherapy can be given by mouth (in
pill form), injection into a muscle, or intravenously (through a needle
in a vein). Some chemotherapy regimens require hospitalization. Others can
be given in the doctor's office. Most of the side effects will disappear
after the chemotherapy treatments are completed. However this may vary depending
upon the person, their overall health and the types of drugs they receive.
Ask your doctor or nurse for specific information regarding the specific
drugs you are taking.
The following information is provided to help you better understand and manage the common side effects of chemotherapy.
Chemotherapy can affect you physically as well as emotionally. The uncertainties can be stressful. Treatments are available to alleviate the symptoms associated with cancer and cancer therapy. Be sure to ask your oncologist or nurse any questions you may have. They are your main source of information. They can help you prevent, lessen and cope with some of the side effects that may occur.
Special Precautions
1. Medications: Inform your doctor of any medications or vitamins that you take.
2. Aspirin and Non-Steroidal Anti-Inflammatory Drugs: While you are receiving
chemotherapy, it is advised that you not take aspirin or aspirin containing
medications. These drugs affect platelet function, thereby increasing the risk for
bleeding. This includes Advil, Ibuprofen, Motrin and Alka Seltzer.
3. Cough Syrups: Those that contain Guaifenesin (such as Robitussin) should be
avoided since this ingredient also affects platelet function and increases the risk
for bleeding.
4. Dental or Surgical Procedures: Check with your oncologist before any dental or
surgical procedures are planned.
5. Fever: If you develop either a temperature above 101 degrees or shaking chills at any time
during chemotherapy, you may be at risk of infection. If this occurs, call your physician immediately!
6. Drinking Fluids: It is important to drink 6-8 glasses of fluid every day while you are on chemotherapy.
7. Sun: Avoid exposure to sunlight. Use sunscreen and a hat while outdoors.
8. Alcohol: Avoid drinking alcohol.
9. Sushi: Avoid eating uncooked fish.
10. Redness or Pain at Injection Site: If you notice redness or pain at the injection site, notify your doctor or nurse.
11. Allergies: Inform your doctor of any allergies.
Managing Common Side Effects of Chemotherapy
1. White Blood Cells protect the body by fighting infection. When they are low, a person is more at risk for developing a serious infection.
A. Notify your oncologist if you have a fever over 101, shaking chills, sweating, cough, sore throat, burning sensation during urination, or redness and/or swelling around a wound or IV site.
B. Good hygiene is important. Wash your hands often especially before eating or after using the bathroom.
C. Resist infections by avoiding people who have colds, flu, or contagious illnesses.
D. Prevent breaks in your skin. Use an electric razor and protective gloves while gardening or cooking.
E. Avoid contact with pet excrement.
F. If your white blood cell count is low, avoid contact with crowds, fresh flowers, and eating uncooked fruits and vegetables.
2. Red Blood Cells carry oxygen to the body. When red blood cells are decreased, the tissues in the body are deprived of oxygen they need to function.
A. Notify your oncologist if you have any of the following symptoms: shortness of breath, chest pain, dizziness, headache, palpitations or excessive fatigue.
B. Get plenty of rest.
C. Eat nutritious foods (include green leafy vegetables, liver, and red meat if your diet allows).
D. If anemic, it is important to minimize your energy expenditure. Ask for assistance from others,
plan activities to conserve your energy, and take frequent rest periods.
3. Platelets are involved with the clotting of blood. If your platelets are low, you may bruise or bleed more easily.
A. Notify your oncologist if you notice any unusual bleeding or bruising.
B. Avoid activities that could result in injury.
C. Avoid suppositories and enemas.
D. Be careful not to blow your nose forcefully.
E. Avoid aspirin, aspirin containing medications, anticoagulants, and nonsteroidal anti-inflammatory drugs.
G. Use an electric razor for shaving.
H. Avoid restrictive clothing.
I. Use protective gloves while gardening, cooking and ironing.
J. Avoid constipation by using stool softeners if needed.
K. Avoid using dental floss.
L. Clean your mouth gently and use a soft toothbrush.
M. Avoid cutting your nails too close.
N. Avoid straining and heavy exercise.
4. Nausea and Vomiting
A. Take your anti-nausea medication as prescribed by your doctor.
B. Drink clear liquids such as Gatorade, apple juice, or ginger ale.
C. Eat 6 small meals throughout the day.
D. If the smell of cooking makes you feel sick, avoid cooking (ask others to cook). Foods that are cool or chilled have fewer aromas.
E. Avoid spicy, citrus, caffeine, chocolate, and fried or greasy foods.
F. Eat dry and bland foods such as toast and crackers.
G. Try eating Popsicles.
H. Eat a light meal before your chemotherapy treatment.
I. Rest after eating. Avoid lying flat for 2 hours after a meal.
J. Call your doctor if you do not drink or eat for 24 hours.
5. Poor Appetite
A. Small portions are more appealing
B. Eat small frequent meals. Plan to eat every 2-3 hours.
C. Add calories to food by adding butter, salad dressing, or sauces to food. Peanut butter and crackers or cheese and crackers make a good snack.
D. Add food supplements such as Boost, Sustacal, Ensure or Scandia to your diet. (Add a scoop of ice cream to the supplement for extra calories.
E. A walk before meals or light exercise might increase your appetite.
F. Experiment with different seasonings, flavors or textures of food.
G. Warm foods can stimulate the sense of smell that can increase your appetite.
H. A pleasant atmosphere will make meals more enjoyable.
I. Consult with a dietician. They may have suggestions and recipes to stimulate your appetite.
6. Sore Mouth
A. Gargle: Use either 1 tsp. baking soda in 8 oz. of tepid water, or
use 1/2 tsp. salt in 8 oz. of tepid water. Mouthwashes also may be used.
B. Avoid commercial mouthwashes that contain alcohol.
C. Use a toothbrush with soft bristles.
D. Avoid flossing between your teeth.
E. Do mouth care after eating and every 4 hours while awake.
F. Drink fluids frequently.
G. Avoid spicy foods, citrus fruits, juices, or scratchy foods (such as toast, popcorn, chips, and pretzels).
H. Foods and drinks that are very warm can irritate your mouth.
I. Cool soothing liquids and foods like Jell-O, ice cream, pudding, or non acidic juices can make your mouth feel better when it is irritated.
J. Keep your lips moistened with petroleum jelly or lip balm.
K. Avoid drinking alcohol and smoking.
L. Using a straw to drink liquids will make swallowing easier.
M. If your mouth becomes sore, you notice white patches or ulcers, your gums bleed, or if you have difficulty swallowing, call your doctor.
7. Diarrhea
A. Keep track of the number of stools you have in a day and note whether they are loose or formed.
B. Use anti-diarrhea medication as prescribed by your doctor.
C. Eat a low fiber, high calorie and high protein diet.
D. Avoid fresh fruits and raw vegetables. Cooked or canned vegetables or fruits are encouraged.
E. Avoid whole grains such as whole wheat, bran, seeds and nuts.
F. Avoid spicy, fatty, fried, and citrus foods.
G. Avoid milk products.
H. Avoid alcohol and caffeinated drinks.
I. Avoid carbonated beverages. Drink them only after they have lost their fizz.
J. Increase your fluid intake (Gatorade is recommended).
K. Foods should not be too hot or too cold.
L. Foods such as rice, bananas, applesauce, mashed potatoes, eggs, yogurt, pasta and toast are encouraged.
M. Eat foods or liquids that contain salt or potassium. These minerals are lost when you have diarrhea.
N. Call your doctor if diarrhea is not controlled by anti-diarrhea medication.
8. Constipation
A. Drink 6-8 glasses of fluid per day.
B. Exercise regularly.
C. Foods high in roughage (fiber) are encouraged. Fresh fruits and vegetables, whole grain breads and cereals, bran, and dried fruits are examples of high fiber foods.
D. Hard stool may result from binding foods such as cheese, rice and meat.
E. Daily stool softeners and peristaltic stimulators (such as Pericolace) are recommended.
F. Drink 4 oz. of warm prune juice or lemon water every morning.
G. If constipation persists despite the above recommendations, call your doctor.
9. Hair Loss
A. Arrange for a wig before you lose your hair. Your hairdresser or wig
specialist can match your hair more easily.
B. Ask your oncologist for a wig prescription. Some insurance companies cover the cost of the wig.
C. Wear a nightcap during sleep to help trap the hair that falls out.
D. A short haircut prior to your hair falling out will make hair loss less noticeable.
E. When hair loss is at its greatest, you may find shaving your head is best.
F. Avoid hair dyes and body waves because the chemicals may irritate your scalp.
G. Avoid hair dryers, curling irons, direct sunlight and heat.
H. Scarves, hats, wigs and turbans are recommended. Hair extensions or fringes are available that can be sewn or velcroed in hats. (They look like your own hair)
10. Fatigue
A. Increase your rest and nap times as needed.
B. Eat nutritious meals and drink a lot of fluid.
C. Plan your activities when you have the most energy.
D. Take short walks or do light exercise.
E. If unable to do your normal exercise routine, do a shorter or easier version of the activities you enjoy.
F. Notify your doctor if fatigue is excessive.
G. Ask your family and friends to assist you with some of your needs.
11. Sexuality: Cancer treatments may affect sexual function. Changes may result from the cancer itself, the treatment and their side effects, or from changes in appearance, which may affect ones self-concept. Anxiety can result, leading to further changes in sexual patterns.
A. Sharing your feelings and concerns with your partner is the most important intervention.
B. Support groups as well as private therapists are available for sexual counseling.
C. Should you have questions or concerns consult your doctor or nurse.
12. Emotions/Feelings of Well-being
A. Share your feelings and concerns with family, friends and/or your health care worker. Most people feel better after they "get things out in the open".
B. Keep a journal. Writing things down often helps to clarify your thoughts.
C. Adequate sleep is necessary.
D. Exercise helps relieve stress and tension.
E. Listen to soft music.
F. Joining a support group or talking to a therapist can be beneficial.
Remember: Take life one day at a time Do something nice for yourself every day!