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CHEMOTHERAPY FAQ's
What chemotherapy will I receive today?
Your doctor recommends what kind of chemotherapy you will receive during each visit, in addition to your diagnosis, your doctor considers how far along your cancer is in its development, the expected behavior of the cancer, and where the cancer originated. Your doctor also takes into account several other factors including your age, any other medical problems you may have, and any potential side effects from the treatment.
How is my chemotherapy scheduled?
Your schedule is determined by the specific treatment ordered by your physician. Depending on how you are doing you may have to be seen weekly or perhaps even daily for a period if your blood counts are low.
Why am I so tired?
Most people who receive chemotherapy experience fatigue. Your daily activities should be planned according to how you feel. We suggest that you take rest periods throughout the day; as often as you feel necessary. Your nurse can suggest other rips to combat fatigue. There are several things that you can do to help yourself recover from this condition.
- Take naps during the day and sleep more at night
- Maintain your usual lifestyle activities, as much as possible, but pace activities according to your energy level. Plan on doing your most important activities first or when you feel your best .
- Mild exercise such as walking, playing golf, swimming or stretching may actually increase your feelings of energy. Heavy exercise, however, generally should be avoided.
- Eat a well balanced diet. Good nutrition will help with your energy level.
- Additional protein will help normal cells to repair themselves.
- Ask family member and friends to pitch in with daily duties and obligations.
Will my chemotherapy make me sick?
This too often depends on the specific chemotherapy you receive. It may not occur at all or may occur soon after treatment and may last 24-48 hours. A number of very effective medications called anti-emetics or anti-nausea drugs are now available to help lessen or prevent nausea and vomiting. These medications may be given to you intravenously during your chemotherapy, or you may be given a prescription medication to take at home. There are also several things that you can do to complement those treatment strategies.
- Eat several small meals throughout the day rather than a few large ones.
- Stay away from fatty, sweet or fried foods.
- Eat foods cold or at room temperature.
- Eat dry foods like cereal toast or crackers in the morning.
- Wear loose fitting, comfortable clothing.
- Always be sure to tell your doctor or nurse if you are experiencing nausea and or vomiting.
Will I have the same nurse each time I visit the Infusion Center?
You may not have the same nurse at each visit. We have assembled a team of highly qualified oncology nurses who are all equally capable of caring for you. All of our nurses receive continuing education and clinical development to provide you with quality, safe, and up-to-date care.
What tests will you do?
Your doctor determines what kinds of tests are needed. If you are receiving chemotherapy, you may have blood work anywhere from 1 to 7 days before your first day of treatment. This blood work will include a CBC (complete blood count), chemistry profile, and any necessary cancer markers. Blood samples for a CBC will he collected seven to fourteen days following your chemotherapy. It is important to be aware of possible symptoms of reduced red blood cell (RBC), white blood cell (WBC) or platelet (PLT) production. Be sure to report any of the following:
• Fever (over 100 degrees), congestion or a cold,
• A rash, blister, easily bruised skin, any signs of bleeding, an infected cut, or itching or burning in the genital area,
• Worsening weakness, fatigue or shortness of breath, lightheadedness or chest pain.
What is Neutropenia?
Low white blood cell count (neutropenia)
Because chemotherapy kills both cancerous cells and other normal cells that grow at a fast rate, white blood cells (WBC) we often destroyed along with the cancerous cells resulting in a condition of low WBC’s in the circulating blood called neutropenia.
Because white blood cells play an important role in preventing infection, any time your white blood cell count drops you are at higher risk of getting an infection. What's more, as these cells also help to fight off infections once they are in the body, it is harder to get over an infection when your white counts are low, therefore, you must do everything that you can to decrease the chance that you will develop an infection while you are receiving chemotherapy.
What can I do to prevent infections?
It is important to realize that there is nothing that YOU can do to prevent neutropenia / low white blood cell count that is caused by chemotherapy. There are medications that your doctor may prescribe to try to prevent this. However, there are several things that you can do to prevent infections when your white blood cells ale low and you are at high risk.
Know what to look for. The signs and symptoms of infection include the following:
- fevers, chills of sweats
- cough, mucous production, shortness of breath, or painful breathing
- soreness or swelling in your mouth, ulcers or white patches in your mouth, or a change in the color of your gums
- pain or burning with urination or an odor to your urine
- change in the odor, character, or frequency of your stool, especially diarrhea
- redness, pain or swelling in any area of your skin
- redness, pain, or swelling in the area surrounding any in-dwelling catheter or port
- pus or drainage from any open cut or sore or from any in-dwelling catheter or port
Maintain excellent personal hygiene
- wash your hands frequently, especially before eating and after using the bathroom
- use antiseptic mouthwashes (that contain no alcohol) daily
- when menstruating, use sanitary napkins rather than tampons, which may promote infection in neutropenic patients
- strictly follow the instructions given to you by your nurse about care for your in-dwelling catheter or port
Avoid situations that will increase your chance of getting an infection
- stay away from people with colds or other infections and avoid crowds as much as possible
- consider using an electric shaver rather than a razor when shaving to prevent cuts and breaks in the skin
- use a soft toothbrush that won't hurt your gums
- do not take vaccinations unless they have been approved by your oncologist
- wear sunscreen with a sun protection factor (SPF) of at least 15 and avoid getting sunburned
- protect your hands from cuts and burns.
- reschedule any dental work until your white blood cell counts improve
- wash all fruits and vegetables thoroughly and eliminate uncooked foods from your diet, including:
- cold soups, made from fresh fruits or vegetables
- raw meats or fish salads
- natural cheeses
- uncooked eggs
- sushi and sashimi
What is Anemia?
Low red blood cell count (anemia)
Red blood cells carry oxygen throughout your body. When there are too few red blood cells, you have anemia. Your body tissues don't get enough oxygen to do their work, and you could feel very weak, tired or even experience dizziness, chills or shortness of breath. However, not fatigue is caused by anemia. The stress of chemotherapy or radiation therapy can also make you very tired and fatigued. If your counts are severely low, you may need a blood transfusion to boost your RBC count.
What is Thrombocytopenia?
Low platelet count (thrombocytopenia)
Platelet (PLT) cells are the types of blood cells that help form blood clots. Platelet cells are made in the bone marrow and can be found in both the bone marrow and the circulating blood. Patients with certain types of cancer and those patients receiving chemotherapy or radiation may experience a reduction in the number of platelets in the circulating blood called thrombocytopenia. This condition may increase your risk of bruising and bleeding once your platelet count drops below 50,000 uL.
What can I do to prevent bleeding?
Although there is no real protection from certain types of cancer, chemotherapy or radiation therapy from causing a drop in your platelet counts, there are precautions you can take to help limit the extent of the condition.
- notify your physician immediately of any bleeding from your mouth, nose, vagina, rectum and urethra or for any prolonged bleeding from minor cuts or scratches.
- report any significant bruises and avoid activities with potential for injury
- use an electric razor for shaving
- brush with a soft-bristle toothbrush and avoid using dental floss
- avoid medications, without the advice of your physician, that may increase your risk of bleeding, which include:
- aspirin and aspirin-containing products
- Ibuprofen (Advil, Motrin etc.) and other non-steroidal anti-inflammatory drugs (NSAIDS)
- certain herbal products
Be sure to consult with your nurse, pharmacist or physician prior to taking any prescription or non-prescription medication, vitamins or herbal preparations during the course of your cancer therapy.
Will I lose my hair because of my treatment?
Hair loss occurs with some, but not all, chemotherapy drugs. The amount of hair loss varies from a slight thinning to complete baldness, affecting the scalp, eyelashes and eyebrows, legs, armpits, and pubic area. The loss may be gradual or sudden. Sometimes, all body hair may be lost. Keep in mind that hair loss is always temporary. Many people find that their hair starts growing back while they are still receiving chemotherapy. If you wish to purchase a wig, your nurse can provide you with a list of local suppliers. It is recommended that this be done prior to complete hair loss so that your wig can be matched to your natural hair.
Although hair loss (alopecia) is often difficult to deal with, it's comforting to know that the hair will grow back, often thicker than before. Hair loss can occur on all parts of the body, not just the head. Usually hair loss will occur 2 to 3 weeks after chemotherapy or radiation therapy treatment begins. Once it starts, this loss will continue over a period of days to weeks. Re-growth can begin as soon as 6 to 8 weeks after treatments are completed.
Can I color or perm my hair during treatment?
We do not recommend using a chemical process on your hair, but it is your decision. You may experience hair loss during your therapy depending on the drugs you receive.
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