Today we ll talk about How chemotherapy works How to prevent and manage side effects What to do if you get side effects What to expect when you come in for treatment New Patient Chemotherapy Class What you need to know A class for new patients having chemotherapy Last updated: September 1, 2017 Class video available online: http://bit.ly/smrcpchemoclass (weblink is case sensitive) 1 2 Your supportive care team How does chemotherapy work? Chemotherapy works by killing fast growing cells (cancer cells and healthy cells) Side effects happen because healthy cells are affected Time between treatments allow your healthy cells to recover We are here for you! Call 705-728-9090 x 43520 to meet with us. See flyer in your new patient package for more details, or visit www.rvh.on.ca 3 4
Possible side effects of chemotherapy Chemotherapy affects fast growing cells Low blood cell counts Fatigue (blood cells) Hair loss/changes Dry mouth Mouth sores Nausea Vomiting Diarrhea Constipation (Digestive system) Sexual health changes (reproductive system) When do side effects start? How long do they last? Side effects can happen any time during your treatment: immediately, or up to days afterwards They will slowly disappear when treatment is over and your healthy cells start to recover Remember: Each person reacts differently to chemotherapy You may not get these side effects 5 6 What to do when you have signs & symptoms: Call the symptom management phone service Symptom management phone service: what to expect Business hours Monday Friday 8:00 am 3:30 pm Cancer Centre Symptom Support (provided by the Simcoe Muskoka Regional Cancer Centre team) 705-728-9090 x79565 Leave a message After hours Monday Friday 6:00 pm 8:00 am Weekends and holidays 24 hours CAREpath (provided by Bayshore HealthCare Ltd) 1-877-681-3057 Have your Patient Info Sheet ready Cancer Centre Symptom Support 1. Leave a message 2. Triage clerk will call you back to get more info 3. A nurse will assess how you re feeling and help you with your symptoms 4. You may be asked to come to the Toxicity Assessment Clinic (Level 3, Cancer Centre) CAREpath 1. A nurse will assess how you re feeling and help you with your symptoms 2. You will need your Patient Info Sheet 7 8
What to do when you have signs & symptoms Low blood cell counts Use the My Health Diary Keeps track of how you re feeling Helps us understand your symptoms better Copies in Level 2 waiting room and www.rvh.on.ca Blood cell counts include: Red blood cells White blood cells Platelets Your blood cell counts will be checked before each chemo treatment The blood cell counts must be at a safe level for you to receive treatment If the counts are not at a safe level, we will delay your treatment until it is safe 9 10 Low white blood cell counts what to do If you get an infection what to do Goal: prevent infections Have a thermometer check your temperature when you feel unwell Wash your hands often Stay away from people who are not feeling well Keep skin clean and healthy Fever Temperature above 38.3ºC (100.9ºF) OR Above 38.0ºC (100.4ºF) for longer than an hour Call Cancer Centre Symptom Support or CAREpath Non-emergency issues: White patches/coating in mouth Unusual sweating Diarrhea Burning feeling when urinating Severe cough/sore throat Chills Call Cancer Centre Symptom Support or CAREpath 11 Go to nearest emergency if outside of phone hours Bring Fever Card You can also try: Walk-in clinic Your family doctor Nearest emergency 12
Fever Card Fatigue (feeling tired) Please note: You still have to wait your turn in the ED. You may be asked to wear a mask while waiting. You will receive this card on your first day of treatment. Important! Show this card each time you need to go to emergency You can go to the emergency department closest to your home and you can still use this card. 13 Most common side effect For help with fatigue: One-on-one help with dietitian call 705-728-9090 x43520 to sign up Watch video: http://www.reframehealthlab. com/cancer-fatigue/ Book in Level 2 waiting room and www.rvh.on.ca 14 Nausea and vomiting Tips on preventing nausea and vomiting Nausea and/or vomiting can happen after chemo treatment or a few days after. If your treatment is likely to cause nausea and/or vomiting, we will give you medications to prevent/control it. Book in Level 2 waiting room and www.rvh.on.ca Drinking tips Get enough fluids Try: water, decaf tea, juice, jello, soup, popsicle, Gatorade Drink small amounts more often If your anti-nausea medication isn t working, call 705-728-9090 x79565 (Symptom Line) Instead of: 1 big glass of water all at once Limit caffeine and alcohol Try: sips of water throughout the day 15 16
Tips on preventing nausea and vomiting Diarrhea and constipation Eating tips Eat small, frequent meals Instead of: a big meal Try: eating smaller amounts throughout the day Diarrhea watery/loose bowel movements Constipation - when your stools are hard/dry and difficult to pass Talk to us if you have any changes or problems with your bowel routine Books in Level 2 waiting room and www.rvh.on.ca Avoid sweet, fried or fatty foods Try to avoid odors that bother you Eat a light meal before your treatment 17 18 Oral health tips Hair loss See your dentist before starting chemo, if possible Tell your oncologist or nurse before you have any dental work Brush your teeth and gums with a soft toothbrush after every meal. Rinse toothbrush after use. Use salt and baking soda water rinse 4x per day + + 1 L of water 1 teaspoon salt 1 teaspoon baking soda Avoid commercial mouthwashes that contain alcohol 19 Hair loss can occur on all areas of the body. Your hair may thin or fall out completely depending upon what type of chemotherapy you are receiving Ladies and Gents: ask us about hair prosthesis services in your community Ladies: attend a Look Good Feel Better session Call 705-728-9090 x43309 to register 20
Let s talk about sex We re here to help! It s okay to have sex while on treatment Practice safe sex: avoid pregnancy Avoid all body fluid contact from your loved one on chemo for 48 hours E.g. urine, stool, blood, vomit, semen and vaginal fluid Use a condom (free condoms at the chemo clinic) 21 SHIC Clinic Private, confidential and professional support. Book an appointment: 705-728-9090 x43520 Group classes Call 705-728-9090 x43520 for upcoming sessions/register Books in waiting areas Ask Us About Sex! 22 What to bring for your chemo visit How to prepare for your treatment New Patient Package Patient Info Sheet Health Card Appointment Sheet List of medications List of questions for your Care Team My Health Diary Lunch/snacks Earphones No pets 23 24
What to tell us Changes to your medications Prescription medications Herbal medications Naturopathic remedies Over-the-counter medications Changes to/new allergies Any cancer-related symptoms Other hospital or emergency department (ED) visits (since we last saw you) The 2-day system at the Regional Cancer Centre (RVH) Video showing the 2-day system at RVH: http://bit.ly/smrcpchemotour1 Check-Up Day 1. If doing bloodwork at Cancer Centre, come 2 hours before doctor appt time 2. Register with a clerk on Level 2 Ask for a pager 3. Have bloodwork done 4. Complete symptom screening 5. Assessment by a nurse 6. See your oncologist Treatment Day 1. Come 15 mins before appt time 2. Register on Level 3 3. Receive your chemotherapy treatment Symptom screening kiosk 25 26 Symptom Screening When: at each visit with a care provider (e.g. doctor, nurse, social worker, dietician) Why? Helps us manage your care Track how you are feeling Help you with your symptoms early Using kiosk Using tablet Helpful tips from patients and caregivers We see it in your electronic chart. Speak to us if your symptoms are not getting addressed. 27 Brought to you by: 28
Helpful tips Need a ride? Canadian Cancer Society Wheels of Hope volunteer driver service $100 - $200 flat rate 1-800-263-6750 Buy multi-use parking pass at RVH 10-day pass $80 Visit the RVH parking office or a pay station Tired of driving? Stay at the Rotary House Cancer Lodge at RVH $15/night call 705-739-5662 or visit www.rvh.on.ca Save your receipts and keep a travel log for tax time. Thank you! Questions? 29 30 For more information: Online videos Supporting You Through Chemotherapy Class (27 mins) http://bit.ly/smrcpchemoclass Cancer Centre tour & 2-day system for chemo (6 mins) http://bit.ly/smrcpchemotour1 Tips from your fellow patients (5 mins) http://bit.ly/smrcpchemotips Other online resources: Simcoe Muskoka Regional Cancer Centre www.rvh.on.ca Canadian Cancer Society www.cancer.ca Cancer Information Services hotline, Peer Support, and list of Community Services 1-888-939-3333 31