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BLK Cancer Centre >> Treatment Offered >> Chemotherapy

Chemotherapy

What is Chemotherapy?

The word Chemotherapy simply means "drug treatment." The treatment is carried out with one or more drugs that kill cancer cells or make them less active.

Chemotherapy can be given with a single drug or in combination of multiple drugs, depending on the type of cancer being treated. The aim of the treatment will depend on the type of cancer you have and how advanced it is.

 

How does Chemotherapy work?

Healthy body cells divide and reproduce in an orderly and controlled manner; however in cancer cells, this process occurs without proper control.

The Chemotherapy drugs enter the blood stream and travel around the body. Chemotherapy works by interfering with processes inside the cells, damaging them so that they cannot divide and grow properly and therefore leading the cancer cells to die. Chemotherapy can also affect healthy cells which are dividing and growing quickly and it is because of this that people can experience side effects. These side effects are usually temporary because healthy cells recover quicker than cancerous cells, and permanent damage is rare with most Chemotherapy treatments.

 

How is Chemotherapy carried out?

Most commonly, Chemotherapy is given to the patient:

  • By tablet or capsule (by mouth)
  • By injection through a vein into the bloodstream, using a syringe (bolus) or infusion (drip)

Sometimes, Chemotherapy needs to be administered through a "PICC" line (a small tube that is put into a large vein in your chest or arm, so blood samples can be taken and medicines and fluids given easily, it can stay in place for a long period of time) or a Chemo port. The Consultant will discuss various modalities in detail with you.

 

Is Chemotherapy painful?

Chemotherapy should not be painful. If you feel any pain or unusual sensation during the treatment, please inform the staff immediately. If the injection site is painful, sore or red when you are at home, please contact your Consultant for advice as soon as possible.

 

How do I go about getting the treatment?

Where you have your treatment will depend on which Chemotherapy drug(s) you are receiving. The amount of time taken to give the Chemotherapy can vary from a few hours to several days.

Most Chemotherapy can be given in less than a day so people can be treated as an outpatient or a day case. Sometimes, it is necessary to stay in the hospital overnight for your first Chemotherapy treatment; you will then receive the rest of your treatment as an out or day patient.

If your treatment involves several days of Chemotherapy and / or extra fluid, you will probably have to stay in hospital for a few days. If this is the case it will be explained to you before you commence your treatment.

 

What happens on the first day of my treatment?

On the first day of your treatment, a Chemotherapy counsellor will explain in great detail about the treatment and its side effects (which may occur). It is advisable that you eat and drink normally on your treatment day as well.

 

Is routine blood test necessary during the treatment?

Before each cycle of treatment you will need to have a routine blood test. We call this Complete Blood Count (CBC) test. This means we are looking at the number of red blood cells, white blood cells and blood cells called platelets in the blood.

All these blood cells are made in the bone marrow and Chemotherapy can affect the bone marrow causing a temporary fall in the number of these cells. Sometimes it may be necessary to delay your treatment by one or two weeks if your blood count has not returned to normal following the last cycle of Chemotherapy. We need to check that your blood count is normal before you have your next cycle of Chemotherapy.

A Complete Blood Count (CBC) blood test needs to be done before each cycle of Chemotherapy.

Your doctor will monitor your progress throughout your treatment. There are several tests which may be repeated during your treatment including Urea & Electrolytes (U&E's), Liver Function Tests (LFT's), Scans, X-rays and other Blood Tests. These are done to check on your health and see the way the Chemotherapy is affecting you. These will vary from person to person, depending on the diagnosis and Chemotherapy treatment.

 

What are the precautions I need to take to avoid infection during the treatment?

We advise you to:

  • Wash your hands carefully while in the hospital. Alcohol hand rub is kept by each hand wash basin and by the entrance of the clinical areas (wards, day unit and outpatients). It is quicker and easier to use than soap when your hands are not actually soiled but might be carrying "hidden bugs." Please wash your hands after using the toilet or if you have any diarrhoea
  • Maintain good personal hygiene, take a bath or shower every day
  • Keep your mouth clean, brush your teeth and rinse your mouth after meals
  • Use a soft toothbrush that won't hurt your gums
  • Be careful not to nick yourself when using scissors, needles or knives
  • Change your bed linen regularly
  • Avoid going to crowded places
  • Avoid inhalation of dust
  • Take care when handling pets
  • Stay away from people who have a disease / infection you can catch, such as cold, flu and measles. Inform us immediately if you are in contact with someone with an infectious or contagious disease such as Chicken Pox
  • Keep your environment clean, use a regular surface disinfectant

If you are at particular risk of an infection, due to the type of Chemotherapy you are receiving, you may be given "preventative" antibiotics. These should help protect you from the most common infections. Please ensure you take them regularly as directed.

The signs of an infection are:

  • A temperature of 38°C /100.5°F or above
  • If you feel hot and look flushed
  • If you are shivering or have hot and cold flushes
  • If you are feeling unwell, i.e. sore throat or a cough

If you have other signs of infection, such as urine infection or if you have a "central line" / PICC and the site looks red and feels hot.

Contact your Oncologist immediately

 

What are the steps I need to take when it comes to food?

We advise you to:

  • Wash your hands before handling any food items
  • Ensure all knives, utensils and chopping boards are clean before preparing food
  • Make sure all food is cooked thoroughly and is hot before serving
  • Avoid unpasteurised chees, milk and yogurt
  • Properly cook the eggs until the white and yolks are solid
  • Eat freshly prepared, well cooked and nutritious diet. Include pulses, cereals, food rich in fiber and green vegetables
  • Encourage rest after meals
  • Wash the fruits properly, peel a thick layer of the fruit skin and consume the soft part
  • Consider taking tetra packed juices if not contraindicated with any other disease like diabetes
  • Avoid spicy and oily food
  • Drink plenty of water (at least 10 -12 glasses per day)

 

What are the side effects of Chemotherapy?

Chemotherapy affects some of the normal cells and thus, may cause some side effects. The side effects you experience will depend on the particular drug or combination of drugs you receive. Some people do not get any side effects, but if you experience any, please inform your Consultant.

 

Some of the common and possible side effects are listed below:

Sore Throat

Sometimes, Chemotherapy can cause a sore or dry mouth and / or mouth ulcers. If the Chemotherapy causes the lining of your mouth and throat to become sore, or ulcerated, we would recommend you to:

  • Maintain a healthy mouth, clean your teeth twice a day using a soft toothbrush and fluoride toothpaste. Rinse your mouth thoroughly with water after cleaning
  • Clean your mouth and teeth two times a day, preferably morning and before bed
  • Remove dentures, bridges, braces and clean them after meals. Do not replace them if mouth soreness is severe
  • Rinse you mouth with an antibacterial mouthwash (Chlorhexidine) four times a day - this can be prescribed by the doctors at the hospital.
  • Try sucking ice, or adding crushed ice to drinks and eating ice cream or soft milk jellies as some people find it helpful
  • Avoid foods with sharp edges
  • Try using a mouthwash such as one teaspoon of bicarbonate of soda dissolved in a mug of warm water if your toothpaste stings, or brushing your teeth makes you feel sick
  • Avoid neat spirits, tobacco, hot spices, garlic, onion, vinegar and salty food as they may irritate your mouth
  • Avoid some crunchy foods as they may damage your gums when your blood cell counts are low
  • Try to drink at least 10 -12 glasses of fluid a day. This can include water, tea, weak coffee and soft drinks such as apple juice
  • Avoid acidic drinks, such as orange and grapefruit juice. Warm herbal teas may be more soothing
  • Let your doctor know if you have mouth ulcers, as you may need medicines to help heal the ulcers and clear infection

If the soreness fails to clear up quickly or you have problems eating and drinking normally, please contact your Consultant.

Taste

Some people while having Chemotherapy experience a change in their taste of food. This is usually temporary. You may find that you no longer enjoy certain foods; all foods may taste the same or you may experience a metallic taste in your mouth and sometimes you may find you can taste nothing at all.

Nausea and Vomiting

Chemotherapy may cause you to feel sick, but not necessarily to vomit, although this can occur. You will be given anti-sickness medication prior to your treatment and also to take home.

We advise you to:

  • Avoid preparing food when feeling nauseous
  • Eat small frequent meals
  • Avoid fatty and fried food
  • Avoid very sugary or spicy food
  • Sip fizzy drinks e.g. lemonade, soda water
  • Try food or drink with ginger e.g. ginger ale, ginger biscuits and fresh ginger in cooking
  • Eat some dry biscuits or crackers
  • Drink plenty of fluids

If vomiting persists for more than 24 hours, please contact your Consultant.

Diarrhoea and Constipation

Some Chemotherapy can cause a change in bowel habit, which can usually be managed by diet and /or medication

Diarrhoea

  • Drink plenty of fluids to replace fluid loss
  • Avoid alcohol, coffee and orange juice
  • Also eat less fiber - reduce raw fruit, vegetables and cereals
  • Avoid highly spicy or fatty food
  • If frequent diarrhoea persists for more than 24 hours, contact your Consultant immediately

Constipation

  • Drink plenty of fluids
  • Increase fiber (roughage), fruit and vegetable intake
  • Eat good sources of fiber e.g. whole wheat cereals, muesli, whole meal bread and flour, brown rice, whole meal pasta, fresh fruit and vegetables with skin on
  • Try natural remedies for constipation- syrup of fig, prunes and prune juice
  • Try to do gentle exercises
  • Take laxatives as prescribed by your doctor

If your normal bowel habit changes and constipation persists, contact your Consultant.

Hair Loss

  • Some Chemotherapy causes no hair loss or so little that it is hardly noticeable, but Chemotherapy treatment can make it dry and brittle, therefore once you start the treatment we recommend you to:
  • Reduce the amount of times in a week that you would wash you hair i.e. not more than once or twice a week
  • Use a mild Ph balanced shampoo
  • Pat dry with a towel to remove excess water rather than rubbing the hair when you wash your hair
  • Comb / brush your hair with a wide toothed / bristled comb or brush to reduce tension on the hair and hair follicle
  • Avoid plaiting your hair or wearing a tight band as this can damage and break your hair
  • It is advisable not to colour or perm your hair whilst you are undergoing Chemotherapy and for at least 3 months post treatment
  • Some Chemotherapy drugs do cause temporary partial hair loss or complete baldness, and you may also lose your body hair including eyebrows, chest hair and pubic hair

Hair usually begins to fall out approximately 10 - 14 days post your treatment starts, but sometimes this can happen sooner.

Skin

  • During your treatment, you may find your skin becoming very dry; apply a moisturizing cream to avoid skin cracking
  • Try to avoid too much exposure to the sun, and sit in the shade wherever possible
  • Wear loose clothing and use a high factor sun cream
  • If you have lost your hair, remember to protect your head, ears and the back of your neck from the sun by wearing a hat

Veins

When Chemotherapy is injected intravenously, the veins can sometimes become hardened and sore or darker in colour. The veins will usually return to normal form gradually. We can continue your treatment using other veins or a PICC / Chemo port.

Fatigue

Fatigue is very common during Cancer and its treatment. Doing light exercise can help you in tackling with the feeling of fatigue.

Other Possible Side Effects

These only occur with certain drugs and may include:

  • Tingling or numbness in the tips of the fingers and toes
  • Hearing loss, ringing or buzzing in the ears
  • Jaw pain
  • Muscle aches and fever
  • Watery eyes
  • Dry, red and sore skin on hands and feet

If there is a likelihood of any of these side effects in your treatment, you will be informed about it beforehand.

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