Preparing For Chemotherapy


You’ve met with your medical oncologist (a doctor specialising in cancer treatment with medication), you’re aware of the risks and benefits of chemotherapy (using anti-cancer drugs to destroy cancer cells) and you’ve decided to go for it. You might be wondering, what happens now? 


Firstly, it would be helpful to know that with progress in cancer treatments, there are now many types of chemotherapy. The two most commonly administered form of chemotherapy are:


Intravenously (into a vein)

The most common way to administer intravenous chemotherapy is through a cannula which consists of a small needle and plastic tube. The cannula is inserted into a vein either on the back of your hand or lower arm. The diluted chemotherapy drugs are slowly injected into the vein. The cannula is usually inserted in a vein on the arm on the opposite side to where you had surgery, as this may help reduce the risk of lymphedema. The cannula is removed at the end of the chemotherapy session. 


Orally (by mouth as tablets or capsules)

Oral chemotherapy is given in liquid or pill form that you swallow. You don’t have to receive any injections and you can complete your treatment at home. Though this form of chemotherapy is more convenient, it is also more expensive and patients have to be extra responsible to ensure they complete the course. 


This article focuses on how to prepare for intravenous (IV) chemotherapy. If you’re feeling anxious about your first IV chemotherapy treatment, know that it is perfectly normal to feel the way you do. Having a full understanding of what happens during a chemotherapy session will help allay your worries and concerns. 


What to Expect?

Before a Chemotherapy Session 

    Most chemotherapy sessions are given in repeating cycles ranging from 2 to 6 weeks. The length of a cycle depends on the treatment you are being given. The number of treatment doses scheduled within each cycle also varies depending on the drugs you will be given. [1]


    On your first day of your IV chemotherapy, you might want to have a friend or family member accompany you, for support and to help you remember information. You will meet with the oncology nurse or other medical professionals who will be administering the treatment. The nurse or medical personnel will carry out a short physical exam to check your blood pressure, pulse, breathing and temperature. Your height and weight will be measured to ensure that the right doses of chemotherapy are given and a blood sample will be taken. An IV tube will be put in your arm. Your medical oncologist will check your health and review the blood test results before he or she orders the chemotherapy. 


    Prior to your first IV chemotherapy session, you may have minor surgery to have a port inserted. This is so that the nurse does not have to look for a vein to insert the IV for every treatment. A port is usually a round metal or plastic disk that the IV is put in during treatment. [2]


    During a Chemotherapy Session 

      The chemotherapy may be administered as an injection into a vein which takes a few minutes, or through a drip or pump (intravenous infusion) which may take anything from 30 minutes to several days. If you’re having continuous infusion, it may take weeks or months. [3]


      After a Chemotherapy Session 

        Once your chemotherapy session is complete, the nurse will remove the IV and check your blood pressure, pulse, breathing and temperature again. Your medical oncologist or nurse will discuss again with you on the side-effects that you may experience and provide medication as well as advice on how to manage the side-effects.  


        Planning Ahead


        Chemotherapy drugs are very strong and you may experience some side-effects which can affect your normal day-to-day life which can make it hard to get things done. Here’s a checklist to help plan ahead to make your chemotherapy treatment days as stress-free as possible:


        Organise your information 

        Have all your medical information in a portable folder so that you can have the necessary information right at your fingertips when you need them.


        Clear your schedule 

        Depending on the type of chemotherapy treatment you are receiving, a chemotherapy session can take anything from a few minutes to several days. Prior to the session, there’s going to be a lot of waiting around in the hospital for blood tests results and such. Make sure you clear your schedule for the day or the next few days to allow yourself ample time for the session and some time to rest after.


        Plan your trip there and back

        You will not know how your body will react to the chemotherapy, so it would be a good idea to arrange for a friend or family member to drive you to and from treatment, at least for the first time.


        Arrange for help with meals and child care

        Following a chemotherapy session, you may feel some of the side-effects kick in such as nausea and vomiting. Being in such an uncomfortable state, you may not have the ability to prepare meals for yourself or your family, or take care of your children, especially if they are very young. Make special arrangements for child care and to have food pre-prepared or delivered to alleviate any added stress.


        Visit the dentist

        Some chemotherapy drugs can cause sores in the mouth and throat. It would be a good idea to visit the dentist prior to a chemotherapy session and get some advice on how to care for your teeth and gums during treatment. Good oral hygiene is also a key part of treatment, so be sure to brush your teeth and cleanse your mouth with mouth-wash after each meal.


        Plan ahead to avoid germs

        Having chemotherapy can negatively impact your immune system making you more susceptible to infection. After chemotherapy, avoid people who are ill. Arrange for a cleaning service to do all your housework and avoid handling dog waste or cleaning litter boxes, bird cages and fish tanks. You might also want to adopt a no-handshakes no-kiss policy to further limit your risk of exposure.


        Stock up on healthy groceries

        Set up a healthy meal plan to boost nutrition.


        Consider shopping for wigs or head coverings

        One of the side-effects of chemotherapy is hair loss. You may lose your hair slowly or even overnight. Cutting your hair short before chemotherapy will minimise the shock of losing your hair, if you do. You may also want to think about whether you want to wear a wig or head covering like a hat or scarf until your hair grows back. Or you might prefer not to wear anything at all. Different people prefer to wear different things or nothing at all for different reasons. Feel free to choose what you feel comfortable with at the time. Can-Care offers a wide range of comfortable head wear and chic wigs to suit any style and need.


        Explore support programs

        Common side-effects of chemotherapy include hair-loss, brittle nails and dry skin. For many women, these physical changes can sometimes take a toll on their self-esteem and self-image. Learn how to manage the psychological and physical side-effects of chemotherapy through the Look Good Feel Better Programa global cancer support program conducted by Can-Care. Through the empowering 3-hour style and beauty workshop, you will learn about skin care, nail care, styling techniques with wigs, turbans and scarves, as well as beauty tips from make-up professionals on how to make your skin glow again. Based on the Look Good Feel Better 2016/2017 global participant survey, women in cancer treatment who completed the program experienced a 78 percent surge in self-esteem and self-confidence, and 96 percent of these women said the program helped improve their self-image. 

        On the Day

          Dress comfortably

          You may be in the treatment area for an extended period of time, so it is important to be comfortable. Dress in loose comfortable clothing which provides easy access to your central line, PICC (peripherally inserted central catheter) or port. 


          Bring a snack

          Unless directed by your medical team or nurse, it is important to maintain proper nutrition and keep hydrated during your treatment. As some treatment suites are open, which means there may be other patients undergoing treatment the same time as you are, you might want to pack snacks which are not heavy smelling such as nuts, whole grain crackers, granola bars and fruit.


          Keep yourself entertained 

          During your treatment, ease your mind and keep yourself occupied with books, music to elevate your mood, or your favourite crafts.  


          After you have completed your first chemotherapy treatment, you may feel tired, emotional, overwhelmed or ecstatic. It’s difficult to know exactly how you will feel and what to expect until you’re experiencing it yourself. Whatever emotions you may be feeling, don’t be afraid to share it with a friend, family member or professional counsellor to help you cope. Can-Care has a team of counsellors who are specially trained in providing professional support to cancer patients in managing their emotions. 


          At home, get adequate rest, eat well and stay hydrated. Look out for any side-effects you may experience to report back to your medical oncologist or health care provider who will be able to provide tips and medication to help alleviate them. 


          Citations:

          1-2) What to Expect When Having Chemotherapy(https://www.cancer.net/navigating-cancer-care/how-cancer-treated/chemotherapy/what-expect-when-having-chemotherapy) 

          3) About Chemotherapy Into Your Vein (Intravenous)(http://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/chemotherapy/how-you-have/into-your-vein/about)



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