Chemotherapy treatment education

Patient and family educational resource for chemotherapy treatments.

1. CHEMOTHERAPYCHEMOTHERAPY AND AND
YOUYOU
Lions Gate HospitalLions Gate Hospital
The Dr. Paul Klimo Medical The Dr. Paul Klimo Medical
Oncology ClinicOncology Clinic

2. TODAY WE WILL FOCUS ON:TODAY WE WILL FOCUS ON:
Chemotherapy side effects Chemotherapy side effects
What to expectWhat to expect
How to manageHow to manage
When to callWhen to call

3. WHAT IS CHEMOTHERAPY?WHAT IS CHEMOTHERAPY?
The use of drugs to destroy The use of drugs to destroy
or control the growth of or control the growth of
cancer cellscancer cells
May use one drug or a May use one drug or a
combinationcombination

4. HOW IS CHEMOTHERAPY HOW IS CHEMOTHERAPY
GIVEN?GIVEN?
Intravenous (into a vein)Intravenous (into a vein)
Oral ( by mouth)Oral ( by mouth)
Other routesOther routes

5. IS CHEMOTHERAPY PAINFUL?IS CHEMOTHERAPY PAINFUL?
NO!NO!
If you feel burning, or notice redness or If you feel burning, or notice redness or
swelling in the area of the needle, tell your swelling in the area of the needle, tell your
nurse immediatelynurse immediately
If you feel pain, or notice redness or If you feel pain, or notice redness or
swelling after you are at home, phone the swelling after you are at home, phone the
Telephone Triage NurseTelephone Triage Nurse

6. CAN I TAKE OTHER CAN I TAKE OTHER
MEDICATIONS WHILE MEDICATIONS WHILE
I AM ON CHEMOTHERAPY?I AM ON CHEMOTHERAPY?
Check with your cancer doctor Check with your cancer doctor
(oncologist) or clinic nurse before starting (oncologist) or clinic nurse before starting
any new medications.any new medications.

7. CHEMOTHERAPY CHEMOTHERAPY
SIDE EFFECTSSIDE EFFECTS

8. NORMAL CELLS AFFECTED BY NORMAL CELLS AFFECTED BY
CHEMOTHERAPYCHEMOTHERAPY
Bone marrow (red blood cells, white Bone marrow (red blood cells, white
blood cells and platelets)blood cells and platelets)
Lining of the mouth, throat, stomach, Lining of the mouth, throat, stomach,
intestinesintestines
Peripheral nerves (nerve endings)Peripheral nerves (nerve endings)
Reproductive systemReproductive system
Hair folliclesHair follicles

9. WHITE BLOOD CELLSWHITE BLOOD CELLS
(the cells that fight infection)(the cells that fight infection)
White blood cells may be decreased White blood cells may be decreased
following your chemotherapyfollowing your chemotherapy
Neutrophils, a type of white blood cell, Neutrophils, a type of white blood cell,
fight bacterial infection fight bacterial infection

10. SIGNS OF INFECTIONSIGNS OF INFECTION
Temperature of 38°C (100.4°F) or higherTemperature of 38°C (100.4°F) or higher
Areas of redness or tendernessAreas of redness or tenderness
Chills, shakesChills, shakes
Sore throat/ mouth soresSore throat/ mouth sores
Productive coughProductive cough
Itching or burning in genital areaItching or burning in genital area
Pain/ burning/ frequent urge to urinatePain/ burning/ frequent urge to urinate

11. TO PREVENT INFECTIONS :TO PREVENT INFECTIONS :
WASH YOUR HANDS!WASH YOUR HANDS!

12. FEVERS AFTER FEVERS AFTER
CHEMOTHERAPYCHEMOTHERAPY
Remember you are at risk for infection Remember you are at risk for infection
after your chemotherapy treatment after your chemotherapy treatment
Take your temperature every 4 hours if Take your temperature every 4 hours if
you are not feeling wellyou are not feeling well

13. FEVERSFEVERS
If you have a fever, If you have a fever, 38°C38°C or higher or higher
( 100.4°F or higher), phone the ( 100.4°F or higher), phone the
Chemotherapy Clinician immediately.Chemotherapy Clinician immediately.
If you have a fever after 4 p.m. or during the If you have a fever after 4 p.m. or during the
weekend, go to the nearest Emergency weekend, go to the nearest Emergency
Department.Department.
 DO NOT TAKE ACETAMINOPHEN DO NOT TAKE ACETAMINOPHEN
(Tylenol(Tylenol™)™) for your fever until you have for your fever until you have
completed the above.completed the above.

14. RED BLOOD CELLSRED BLOOD CELLS
(HEMOGLOBIN)(HEMOGLOBIN)
Feel tiredFeel tired
Feel short of breath with activityFeel short of breath with activity
Have a headacheHave a headache
Have no symptomsHave no symptoms
If your red blood cell count is low you If your red blood cell count is low you
may:may:

15. PLATELETSPLATELETS
(the cells that help the blood to clot)(the cells that help the blood to clot)
Bruises or small purple spots on your Bruises or small purple spots on your
body body
Nose bleedsNose bleeds
Bleeding gumsBleeding gums
Blood in your urine or stoolBlood in your urine or stool

If your platelet count is low you may If your platelet count is low you may
notice:notice:

16. TO PREVENT BLEEDINGTO PREVENT BLEEDING
Use a soft toothbrushUse a soft toothbrush
Blow your nose gentlyBlow your nose gently
Use the bowel routine recommended Use the bowel routine recommended
to prevent constipationto prevent constipation
Talk to your oncologist about blood Talk to your oncologist about blood
thinners and aspirin-thinners and aspirin-based drugsbased drugs

17. PAIN MANAGEMENTPAIN MANAGEMENT
Do not use ASA (aspirin) or ASA based drugs Do not use ASA (aspirin) or ASA based drugs
for pain – discuss use of ASA drugs with for pain – discuss use of ASA drugs with
oncologist ( daily heart/stroke prevention)oncologist ( daily heart/stroke prevention)
Talk to your oncologist about pain relief Talk to your oncologist about pain relief
optionsoptions
Ibuprofen (advil) is okay to use occasionally Ibuprofen (advil) is okay to use occasionally

18. BLOOD WORK PRIOR TO BLOOD WORK PRIOR TO
CHEMOTHERAPYCHEMOTHERAPY
Blood work should be done within 2 days Blood work should be done within 2 days
of each chemotherapy treatment of each chemotherapy treatment
If you live out of town, blood work may be If you live out of town, blood work may be
arranged in your home communityarranged in your home community

19. CHEMOTHERAPY DELAYSCHEMOTHERAPY DELAYS
Chemotherapy may be delayed if:Chemotherapy may be delayed if:
Blood counts are too lowBlood counts are too low
You have other side effectsYou have other side effects
If blood work is not done prior to If blood work is not done prior to
treatmenttreatment

20. NAUSEA AND VOMITINGNAUSEA AND VOMITING
Nausea is Nausea is notnot a side effect of a side effect of
every drugevery drug
It may be immediate or delayedIt may be immediate or delayed
Fill your prescription at your local Fill your prescription at your local
pharmacypharmacy

21. MANAGING NAUSEA AND MANAGING NAUSEA AND
VOMITINGVOMITING
Take anti-nausea pills as directed !!Take anti-nausea pills as directed !!
Eat frequent, small meals (6-8 times a Eat frequent, small meals (6-8 times a
day)day)
Eat bland foodEat bland food
Drink 8-10 glasses of fluids dailyDrink 8-10 glasses of fluids daily

22. LOSS OF APPETITE (ANOREXIA)LOSS OF APPETITE (ANOREXIA)
Taste and smell may be changed by Taste and smell may be changed by
chemotherapychemotherapy
Eat small meals often (6-8 meals a day)Eat small meals often (6-8 meals a day)
Eat food high in protein and caloriesEat food high in protein and calories
Consult dietitian if neededConsult dietitian if needed

23. MOUTH PROBLEMS:MOUTH PROBLEMS:
Dental workDental work
Let your dentist know you are receiving Let your dentist know you are receiving
chemotherapychemotherapy
Discuss any dental work that needs to be Discuss any dental work that needs to be
done with your clinic nurse or doctordone with your clinic nurse or doctor
Get regular dental cleaningGet regular dental cleaning

24. MOUTH PROBLEMS:MOUTH PROBLEMS:
Sore MouthSore Mouth
If you have tender gums or a sore mouth, If you have tender gums or a sore mouth,
look at your mouth in the mirrorlook at your mouth in the mirror
Rinse your mouth with baking soda and Rinse your mouth with baking soda and
water / or salt and warm water after eating water / or salt and warm water after eating
and as often as you can (every 2-4 hours)and as often as you can (every 2-4 hours)
Use a soft toothbrushUse a soft toothbrush
Do Do notnot use over the counter use over the counter
mouthwash!mouthwash!

25. DIARRHEADIARRHEA
Drink fluids slowly Drink fluids slowly
Eat small, frequent mealsEat small, frequent meals
Eat bland foodEat bland food
StopStop dairy products if diarrhea dairy products if diarrhea
developsdevelops
Take medications as prescribedTake medications as prescribed
Call if diarrhea lasts longer than Call if diarrhea lasts longer than
24 hours24 hours

26. CONSTIPATIONCONSTIPATION
Follow suggestions in the constipationFollow suggestions in the constipation
booklet. The nurse will be able to give you booklet. The nurse will be able to give you
a handouta handout
Speak to the nurse or oncologist in clinicSpeak to the nurse or oncologist in clinic
Call if no bowel movement in three days Call if no bowel movement in three days
Increase fluids, fiber and fruits and Increase fluids, fiber and fruits and
vegetablesvegetables

27. FATIGUEFATIGUE
Plan regular bedtime and Plan regular bedtime and
wakeup timeswakeup times
Pace yourselfPace yourself
Delegate responsibilitiesDelegate responsibilities
Plan a regular exercise Plan a regular exercise
programprogram
Inform your Physician/nurse at Inform your Physician/nurse at
your next appointmentyour next appointment

28. REPRODUCTIVE SYSTEM REPRODUCTIVE SYSTEM
CHANGESCHANGES
Changes may be temporary or permanentChanges may be temporary or permanent
WomenWomen
May or may not menstruateMay or may not menstruate
May experience symptoms of May experience symptoms of
menopausemenopause
MenMen
May have decreased sperm countMay have decreased sperm count

29. HAIR LOSSHAIR LOSS
May have total hair loss, May have total hair loss,
thinning or no loss at allthinning or no loss at all
 Depends on the Depends on the
chemotherapy drugchemotherapy drug
Usually occurs within 3 weeks Usually occurs within 3 weeks
after your first treatmentafter your first treatment

30. SKIN – MUSCLE – NERVE SKIN – MUSCLE – NERVE
CHANGESCHANGES
SkinSkin
use sunscreen SPF 30use sunscreen SPF 30
wear a hat and keep covered outdoorswear a hat and keep covered outdoors
MuscleMuscle
muscle weaknessmuscle weakness
NerveNerve
numbness or tingling in your numbness or tingling in your
hands or feet, ringing in the earshands or feet, ringing in the ears

31. TIMING OF COMMON TIMING OF COMMON
CHEMOTHERAPY SIDE EFFECTSCHEMOTHERAPY SIDE EFFECTS
FatigueFatigue
NeutropeniaNeutropenia
Chemo 5 10 15 20 25
Days
Nausea/ Nausea/
VomitingVomiting Mouth SoresMouth Sores Hair LossHair Loss

32. When to Contact the When to Contact the
LGH Oncology ClinicLGH Oncology Clinic
Fever of 38º C/ 100.4 º FFever of 38º C/ 100.4 º F
Chills, shakingChills, shaking
Mouth sores and/or pain on swallowingMouth sores and/or pain on swallowing
Severe constipation or diarrheaSevere constipation or diarrhea
Abnormal bleedingAbnormal bleeding
Bruising or small purple or red spotsBruising or small purple or red spots
Unrelieved shortness of breathUnrelieved shortness of breath
Marked pain or soreness at injection siteMarked pain or soreness at injection site
Any new rashes or lumpsAny new rashes or lumps
Any unusual strong or new painAny unusual strong or new pain

33. CONTACT NUMBERSCONTACT NUMBERS
LGH Main Desk:LGH Main Desk: 604-984-5753604-984-5753
Nurse ClinicianNurse Clinician604-984-5831604-984-5831
PharmacistPharmacist 604-988-3131 ext 4488604-988-3131 ext 4488
Social WorkerSocial Worker 604-984-3709604-984-3709
DietitianDietitian 604-988-3131 ext 4719604-988-3131 ext 4719
NS CommunityNS Community 604-986-7111604-986-7111

34. APPOINTMENTSAPPOINTMENTS
If you If you cannotcannot attend your chemotherapy attend your chemotherapy
appointment as scheduled, call the appointment as scheduled, call the
LGH Oncology Clinic Booking Office LGH Oncology Clinic Booking Office
604-984-5753604-984-5753

35. FLU VACCINEFLU VACCINE
Flu vaccines are recommended for cancer Flu vaccines are recommended for cancer
patients and their familiespatients and their families
Vaccinations are offered October to Vaccinations are offered October to
December by your family physician or December by your family physician or
local public health cliniclocal public health clinic
Discuss the timing of your vaccine with Discuss the timing of your vaccine with
your clinic nurse or oncologistyour clinic nurse or oncologist

36. DOCTORS RESPONSIBLE DOCTORS RESPONSIBLE
FOR YOUR CAREFOR YOUR CARE
Your oncologist (cancer doctor) is Your oncologist (cancer doctor) is
responsible for your responsible for your cancercancer treatment treatment
Your family doctor is responsible for all Your family doctor is responsible for all
non-cancernon-cancer related health problem related health problem

37. INFECTIOUS DISEASESINFECTIOUS DISEASES
You You MUSTMUST call the Telephone Triage call the Telephone Triage
Nurse Nurse beforebefore your next visit if you think your next visit if you think
you have been exposed, or have been you have been exposed, or have been
diagnosed with an infectious diseasediagnosed with an infectious disease

38. Living with CancerLiving with Cancer
Support Services available at LGH Oncology Support Services available at LGH Oncology
Clinic:Clinic:
PharmacyPharmacy
Social WorkSocial Work
CounsellingCounselling
Pastoral CarePastoral Care
DietaryDietary
Symptom Management/Drug Reimbursement Symptom Management/Drug Reimbursement
NurseNurse

39. Chemotherapy is a hazardous wasteChemotherapy is a hazardous waste
Chemotherapy takes 48 hours to clear your Chemotherapy takes 48 hours to clear your
bodybody
Chemotherapy is excreted in your urine, Chemotherapy is excreted in your urine,
stool, vomit, sperm, and vaginal fluidsstool, vomit, sperm, and vaginal fluids
Please take precautions to protect your Please take precautions to protect your
family members.family members.

40. AcknowledgmentAcknowledgment
The Lions Gate Hospital Oncology Clinic thanks the Cross Cancer The Lions Gate Hospital Oncology Clinic thanks the Cross Cancer
Institute for permitting reproduction of this presentation for Institute for permitting reproduction of this presentation for
teaching purposes.teaching purposes.
This power point presentation is available on our This power point presentation is available on our
website atwebsite at
www.coastalpalliativecare.cawww.coastalpalliativecare.ca