Today s topics How chemotherapy works Possible side effects of chemotherapy How to prevent and manage side effects How to prepare for your treatment Supporting You Through Your Chemotherapy A class for new patients having chemotherapy Last updated: April 29, 2016 1 Class video available online: http://bit.ly/smrcpchemoclass 2 What is chemotherapy? How does chemotherapy work? Chemotherapy is a method of treating cancer by using medications: Cancer cells are fast growing cells Chemotherapy works by killing fast growing cells (cancer cells and healthy cells) Side effects happen because healthy cells are affected Intravenously (through the vein) Orally (by mouth) By injection Time between treatments allow your healthy cells to recover 3 4
Why use chemotherapy? Can You Take Other Medications When You re Getting Chemotherapy? To shrink tumors To destroy cancer cells in other parts of the body To reduce pain and/or symptoms of cancer Yes, but tell your oncologist all the medications you are taking right now Keep a list of medications you are taking Prescription medications Herbal medications Naturopathic remedies Over-the-counter medications Bring list of medications each time you visit Tell us if your list of medications change Includes medication tracker 5 6 Possible side effects of chemotherapy Possible Side Effects of Chemotherapy And what to do when it happens 7 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) 8
When do side effects start? How long do they last? What to do when you have signs & symptoms 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. 9 Call the Cancer Centre Triage Line 705-728-9090 x79565 if you are having side effects or symptoms Phones and messages are answered Mon Fri, 8 am 3:30 pm Track signs/symptoms on your patient diary Refer to CCS Chemotherapy Booklet 10 Low blood cell counts Low white blood cell counts what to do 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 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 See page 47 in CCS Booklet for more tips 11 12
If you get an infection what to do How to take your temperature Fever Temperature above 38.3ºC (100.9ºF) OR Above 38.0ºC (100.4ºF) for longer than an hour Non-emergency issues: White patches/coating in mouth Unusual sweating Diarrhea Burning feeling when urinating Severe cough/sore throat Chills 38.3ºC Go to nearest emergency Bring Fever Card Call Cancer Centre Triage Line 705-728-9090 x79565 Phones and messages are answered Mon Fri, 8 am 3:30 pm After hours/weekends: Walk-in clinic Your family doctor Telehealth 1-866-797-0000 Nearest emergency 13 100.9ºF A digital thermometer may be easier for you 14 How to take your temperature Fever Card Do not drink hot or cold fluids 20 minutes before taking a temperature Painkillers such as acetominophen (e.g. Tylenol ) and non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen (e.g. Advil, Motrin ) can mask signs of a fever Many drugs may contain painkillers. Ask your nurse/pharmacist. 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 room closest to your home and you can still use this card. 15 16
Fever Card Fatigue (feeling tired) Benefits of Fever Card: Alerts ER staff that you re a cancer patient Allows ER staff to run the right tests to find out the cause of your symptoms Most common side effect Many reasons for fatigue, but may be caused by The cancer treatment The cancer itself Low blood counts For help with fatigue: See page 42 in CCS booklet One-on-one help with dietitian call 705-728-9090 x43520 to sign up Watch video: http://www.myfavouritemedicine. com/cancer-fatigue/ Please note: You still have to wait your turn in the ER You may be asked to wear a mask while waiting 17 18 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. See page 52 in CCS booklet for tips If your anti-nausea medication isn t working, call 705-728-9090 x79565 (Triage Line) Drinking tips Get enough fluids Try: water, decaf tea, juice, jello, soup, popsicle, Gatorade Drink small amounts more often Instead of: 1 big glass of water all at once Limit caffeine and alcohol Try: sips of water throughout the day 19 20
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 Avoid sweet, fried or fatty foods Try to avoid odors that bother you Eat a light meal before your treatment 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 See page 38 (constipation) and 40 (diarrhea) in CCS booklet for tips 21 22 Dry mouth and mouth sores Oral health tips See your dentist before starting chemo, if possible Tell your oncologist or nurse before you have any dental work See page 41 in CCS booklet for tips Brush your teeth and gums with a soft toothbrush after every meal Rinse your toothbrush well after each 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 23 24
Hair loss Let s talk about sex 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 See page 44 in CCS booklet for tips 25 It s okay to have sex while on treatment Think about sperm banking or egg retrieval before starting chemo Practice safe sex: avoid pregnancy and passing body fluids to your partner Use a condom (free condoms at the clinic) 26 We re here to help! Emotional health: it s important too! It s normal to feel anger anxiety sadness loneliness fear helplessness 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! 27 Try: Writing it down Talk to someone Take time for yourself Eat and sleep well We re here to help! Call 705-728-9090 x 43520 for an appointment 28
Your supportive care team How to prepare for your treatment 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 29 30 What to bring for your visit The 2-day system Health Card Appointment Sheet List of medications List of questions for your Care Team My Health Diary Earphones (for the video system at the chemo chair) Lunch/snacks Only patients can eat in the chemo suite List of Medications Questions Appointment Sheet 31 Check up day 1. Get bloodwork done 2. See your oncologist In-person at the Regional Cancer Centre (RVH, Barrie) Via videoconference (OTN or telemedicine) at your local hospital 32
The 2-day system Tired of driving to Barrie for your appointments? Rotary House Cancer Lodge Treatment day Depending on your chemotherapy, you may receive treatment at: 1. Regional Cancer Centre at RVH (Barrie) 2. Orillia Soldiers Memorial Hospital (Orillia) 3. Muskoka Algonquin Healthcare (Huntsville) a hotel-like accommodation for cancer patients Located on RVH campus $15/night + tax For more info: Talk to us, call 705-739-5662, or visit www.rvh.on.ca 33 34 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 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 35 For more information: Online videos (Also available on DVDs ask us for a copy) 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 37