Chemotherapy Questions and Concerns: General information about what to expect

Transcription

1 Chemotherapy Questions and Concerns: General information about what to expect Princess Margaret For patients who will get chemotherapy and their families Class Overview: What is chemotherapy Side effects and how to manage them Tips to help you cope What to expect during your treatment Please visit the UHN Patient Education website for more health information: University Health Network. All rights reserved. This information is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medical condition. A single copy of these materials may be reprinted for non-commercial personal use only. Authors: Systemic Therapy Team Revised: 09/2016 Form: D-3373

2 Your PMH Healthcare Team Oncologists (Doctors) (Radiation, Surgical, Medical) Registered Nurses (Chemotherapy, Case Manager, Advance Practice, Clinical Trials) Pharmacists Psychosocial Oncology Social workers Psychiatrists Psychologists Palliative Care Staff Dietitians Pain Control Specialists Radiation Therapists Physiotherapists Occupational Therapists Spiritual Care Providers Volunteers including transport services Community Care Access Staff Clerks/ Receptionists Medication Reimbursement Specialist Patient Education Specialists 2

3 What is Cancer? Normal cells grow and divide in a controlled way. Normal Cell Division Cell Suicide or Apoptosis Cancer cells are abnormal cells that continue to grow without control. Cancer Cell Division Abnormal cell Abnormal cell UHN Patient Education Uncontrolled growth UHN Patient Education What is Chemotherapy? Chemotherapy destroys cancer cells, but it also affects normal cells Normal cells most commonly affected are blood cells, cells in the gut, mouth and hair follicles Damage to normal cells is the reason for many of the side effects 3

4 Common Side Effects Low blood counts White blood cells (WBC) Platelets Red blood cells (RBC) Nausea and vomiting Diarrhea and constipation Mouth sores Fatigue Hair loss/skin and nail changes When to Expect Common Side Effects Remember: Not everyone will experience all of these side effects or any of them. Speak to your nurse for more information. 4

5 Blood Counts You have 3 kinds of blood cells: White Blood Cells: help fight infection Platelets: help form blood clots Red Blood Cells: carry oxygen to your tissues Know the Signs of Infection Fever of more than 38 C or F Chills/sweating Loose bowel movements Burning or frequent urination Severe cough, sore throat or mouth sores An open area that appears red or swollen If you experience any of these symptoms, call your doctor or go to your nearest emergency department right away. 5

6 Low Platelet Count Platelets help form blood clots Use a soft tooth brush Use an electric razor Do not take the following without speaking to your doctor, nurse or pharmacist: Aspirin or ibuprofen (like Advil, Motrin) Any new medications (including herbal or traditional) See page 6 of your Managing the Side Effects of Chemotherapy booklet. If you have any unusual bleeding call your doctor or go to your local emergency department right away. Low Red Blood Cells (RBC) Count RBC carry oxygen to your tissues Low RBC count can make you feel tired Save your energy: pace yourself, take naps Eat a well-balanced diet See page 8 of your Managing the Side Effects of Chemotherapy booklet. If you experience the following symptoms call your doctor or go to your local emergency department right away: dizzy short of breath headaches or ringing in ears 6

7 Nausea and Vomiting Can happen before, during and after treatment Take your anti-nausea and antivomiting medication as prescribed If it does happen, tell your nurse at your next visit See page 11 of your Managing the Side Effects of Chemotherapy booklet. If for 24 hours after your treatment you can t: stop vomiting keep liquids down Call your doctor or go to your local emergency department Diarrhea and Constipation Diarrhea Rest and drink lots of fluids Avoid natural laxatives such as prunes, rhubarb and papaya. Constipation Stay active and drink lots of fluids Eat more high fibre foods (whole grain breads, fruit and vegetables) See page 13 and 15 of your Managing the Side Effects of Chemotherapy booklet. 7

8 Mouth Sores (Mucositis) Some chemotherapy can cause sores in the mouth or throat Symptoms may include: Soreness Redness White patches in mouth/tongue Fever Dryness Tell your nurse if you have mouth sores. See page 16 of your Managing the Side Effects of Chemotherapy booklet. Hair Loss Caused by some, not all chemotherapy Can occur anywhere on the body(eye brows, face, pubic area) Visit the wig salon on the 3rd floor at PMH (see information package) See page 19 of your Managing the Side Effects of Chemotherapy booklet. 8

9 Skin and Nail Changes Skin may become red, dry, itchy or flaky Finger and toe nails may become darker, yellow, brittle or cracked Tell you nurse if you notice any changes See page 20 of your Managing the Side Effects of Chemotherapy booklet. Fatigue Feeling tired or a lack of energy that does not go away with sleep or rest Most common side effect of chemotherapy Pace yourself, know your limits See page 9 of your Managing the Side Effects of Chemotherapy booklet. 9

10 Intimacy and Sexuality Sexual activity may be continued during treatment If you or your partner is able to become pregnant, you must use birth control. Your desire for intimacy and sexuality may be affected by physical and emotional changes See page 20 of your Managing the Side Effects of Chemotherapy booklet Reproductive Changes Chemotherapy can cause fertility changes in both men and women. Couples or individuals may want to discuss sperm or embryo banking prior to treatment See page 23 of your Managing the Side Effects of Chemotherapy booklet 10

11 Coping with Emotions: for Patients and Family You may feel some or all of these emotions: anger sadness fear anxiety sense of loneliness helplessness Emotions are normal and a natural part of living; we all have our own ways of coping Remember: you are a person not just a cancer patient or a person caring for a loved one with cancer See page 23 of your Managing the Side Effects of Chemotherapy booklet Family Members and Caregivers: How You Can Help Go with your lovedone to their appointments Keep surfaces clean Wash your hands Make quick/easy meals Tell a joke and laugh Listen and be supportive Allow for silence, encourage relaxation 11

12 Hospital Appointments You will have two kinds of appointments related to your chemotherapy: Doctor visits Treatment visits Prepare for your Treatment Appointment You need to have your blood work done 1-2 days before your chemotherapy Check your patient itinerary to know when you should have your blood work done. This will be given to you before you leave the clinic. You can have your blood work done at Princess Margaret or at a community lab. Why do you need blood work before every chemotherapy appointment: You need blood work before every chemotherapy appointment to make sure it is safe for you to have chemotherapy If your blood counts are too high or too low, it may not be safe for you to get your treatment. 12

13 What to Expect: Doctor Visit During this visit you may: Go to the blood lab for blood work Be examined by your doctor Get a prescription (if needed) for chemotherapy and return appointment Have appointments before or after your clinic visit, such as: blood test diagnostic tests (X ray) treatment (chemo or radiation) What to Expect: Treatment Visit During this is visit you will: Check-in to the Chemotherapy Unit front desk Wait for chart to be clear, drug to be made by pharmacy, and then receive treatment 13

14 What to Expect: How Your Drugs are Prepared Blood Work Order Processing Pharmacy Treatment Time What to Bring: First Day of Chemotherapy Your health card (OHIP card) Private insurance information All your medications Book, ipod, laptop (wireless internet) 1 Family member/ friend Snacks / food $ for parking 14

15 Remember Ask questions Keep a journal and write down questions to ask your doctor, nurse or pharmacist. Do not worry about remembering it all Bring someone with you to your appointments to be a second set of ears and to take notes The development of patient education resources is supported by the Princess Margaret Cancer Foundation. 15