The primary goal of our practice is to administer chemotherapy and non-chemotherapy treatments in a safe, comfortable and highly professional environment. We focus on treating our patients and their families with exceptional care and dignity providing the personalized and individualized attention that people with a serious disease require and deserve.  We have licensed and certified professionals who will provide individualized education regarding the patient’s treatment, the anticipated effects of the treatment and methods to greatly reduce or eliminate the side effects of their particular chemotherapy regimen.

Coping With the Side Effects of Chemotherapy

Chemotherapy drugs are used to kill cancer cells, but while killing cancer cells, it may also kill some healthy cells that grow rapidly. This is why most chemotherapy drugs have side effects. Some common side effects of chemotherapy are:

• Nausea and vomiting
• Diarrhea
• Dry skin
• Sores in the mouth
• Hair loss
• Sensitivity to cold
• Fatigue (tiredness)
• Anemia (not enough red blood cells)
• Leukopenia (not enough white blood cells)
• Neuropathy
• Thrombacytopenia (not enough platelets)

As with any drug, everyone reacts differently. Some people who take chemotherapy drugs experience mild side effects, whereas other people may have more severe side effects, which a doctor or nurse will have to help them manage. There are some things you can do on your own to make it easier to cope with some of these side effects.

Treatment times can range from 5 minutes to several hours, so it is therefore requested that those patients receiving lengthy treatments schedule appointments times earlier in the day.

On the day of the treatment, you are requested to arrive at least 10 minutes before your scheduled appointment and to first check in with the receptionist. You will then be instructed to have a seat, and the doctor will be notified of your arrival. After visiting with the doctor, you will be called to the treatment room as soon as a nurse is available to care for you. Patients are allowed to have visitors in the treatment room, but in consideration of other patients, each patient is asked to have no more than one visitor in the room.

Patients who will be in the treatment room for extended periods should bring a cold lunch from home (a refrigerator is available). It is recommended for you to wear warm comfortable clothing. The nursing staff is dedicated to making your treatments as easy and stress-free as possible. Our focus is to meet both the physical and emotional needs for all of our patients.

Other Signs and Symptoms To Report To Your Nurse or Doctor

• Fever
• Shaking or chills
• Cough or sore throat
• Flu-like symptoms
• Feeling of burning when urinating
• Redness or swelling, especially around a cut, sore, pimple, or boil

Side Effects

Nausea and vomiting

Right before each chemotherapy treatment, the nurse usually gives the patient a medication known as an antiemetic, to prevent nausea and vomiting. In between treatments, you may be able to prevent nausea and vomiting by remembering to do the following:

• Eat smaller, more frequent meals and snacks throughout the day
• Eat slowly and chew thoroughly
• Avoid greasy, high-fat foods, such as hamburgers, fried foods, and potato chips
• Right after eating, rest sitting up, and avoid lying down
• Be aware that your favorite foods may taste different to you during your treatment
• Avoid beverages that contain alcohol

Constipation

Some people undergoing treatment for cancer can become constipated because of the chemotherapy drugs or prescription pain medication they are taking. Others may be constipated because they are suddenly less active or are experiencing a change in their diet or eating habits. If there are extreme changes in your normal bowel habits, it is necessary to communicate this to your health care team. Sometimes, a simple change in diet can help. However, it might be necessary to include the use of a laxative or stool softener, as instructed by the doctor or nurse.

Some Helpful Hints to Deal With Constipation

• Drink plenty of fluids (water, fruit juices, and prune juices) to help loosen the bowels
• Eat a diet high in fiber. High-fiber foods include bran, whole-wheat breads and cereals, raw or cooked vegetables, fresh and dried fruit, figs, dates, and prunes
• If possible, get some exercise. Even a short walk daily can be beneficial

Use of Laxatives in Treating Constipation

The use of Senokot® tablets is normally recommended in the treatment of constipation. Senokot® is a natural laxative, which stimulates the bowel. Unless otherwise instructed by your doctor or nurse, it is recommended to take 2 tablets at bedtime. If you do not have a bowel movement in the morning take 2 more Senokot® tablets after breakfast. If there is still no movement, take 3 Senokot® tablets at bedtime.
Sometimes it may be necessary to add a stool softener, such as Colace®/Docusate if the constipation continues. In some instances, other medications may need to be prescribed. Patients should ask a doctor or nurse before using suppositories or enemas, as these treatments can sometimes cause bleeding or infection.

If there continues to be a problem and constipation lasts for several days, it is important to call your doctor.

Diarrhea

Foods To Eat

Bananas      Rice    Applesauce    Toast

When you can tolerate the B.R.A.T. foods well, you can start to add the following bland, low-fiber foods.

• Chicken – white meat, without the skin
• Canned or cooked vegetables, without the skin
• White fish – cod, haddock, or sale
• Crackers, white bread
• Scrambled eggs
• Pasta (without sauce)
• Oatmeal or Cream of Wheat
• Cooked or mashed vegetables

Foods To Avoid

These foods can make diarrhea and cramping worse, so do not eat them.

• Fatty, greasy, fried, or spicy foods
• High-fiber foods (bran, raw fruits, and vegetables)
• Dried fruits, beans, popcorn, nuts, peas, and corn
• AVOID milk and dairy products
• Very hot or cold beverages, including alcohol
• Coffe, tea, and drinks containing caffeine
• Very sweet desserts and candies

Medicines To Avoid

• Laxatives, such as Milk of Magnesia®, Dulcolax®, Metamucil®, Colace®, and Senokot®
• Medicines that contain magnesium Maalox®, Mylanta®, and Bufferin®

It is important during diarrhea to try to increase your fluid intake, to avoid dehydration. To prevent this, it is important to drink clear, mild fluids (water, clear soups, or both). These will replace fluids and necessary nutrients and minerals lost through diarrhea.

Diarrhea can be controlled by the use of Imodium A-D, taken as directed on the package or by special instructions given to you by your doctor or nurse.

If diarrhea persists after all the above steps have been taken, it is necessary to call your doctor or nurse.

Care of Mouth, Gums, and Throat

Some chemotherapy drugs can cause sores in the mouth and throat. They can also make these tissues dry and irritated, and in some cases, cause them to bleed. In addition to being painful, mouth sores can become infected by the many germs that live in the mouth. Because infections can be hard to fight during your treatments, it is important to try and prevent them.
Here are some suggestions for keeping your mouth, gums, and throat healthy.

• If possible, see your dentist prior to treatment, to have your teeth cleaned and to take care of any problems such as cavities, gum disease, or poorly fitted dentures
• Brush your teeth after every meal with a soft-bristled toothbrush and rinse the toothbrush well after each use
• Avoid commercial mouthwashes, which contain alcohol and salt, as they can be drying to tissues and gums
• Rinse your mouth with cool water frequently, and especially after each meal and before going to bed

If you develop sores in the mouth, be sure to contact your doctor or nurse because you may need medical treatment for the sores. If the sores are painful or keep you from eating, you can also try these ideas.

• Ask the doctor if you may apply Maalox® or Milk of Magnesia® to the sores or gums, with a cotton swab. The doctor may also want to prescribe a medicine that can be used to further ease the pain.
  

• Eat foods at room temperature. Hot foods can irritate a tender mouth and throat
• Choose soft, soothing foods: ice cream, milkshakes, soft fruits, custards, puddings, Jello®. You can also puree cooked foods in the blender to make them easier to eat
• Try to drink plenty of fluids

Avoid irritating acidic foods, such as tomatoes, citrus juice, spicy or salty foods, and rough, coarse, or dry foods, such as raw vegetables, granola, and toast.

It is important to contact the office at the onset of sores in the mouth and throat,
to avoid a more serious infection.

How To Reduce the Risk of Infection

Chemotherapy can attack not only cancer cells, but also some healthy, normal cells. Some of the healthy cells can be the white blood cells, which are the cells that protect the body from infection. Prior to each treatment, and sometimes in between treatments, your doctor will order a blood test, which will indicate the white cell count. If the white blood cell (WBO) count is lower than normal, your doctor may want to past postpone treatment or reduce the dose of your drugs. The WBC count will gradually return to normal when either of these measures is taken.
When WBC is lower than normal, it is important to try to prevent infection by taking these steps.

• Wash your hands often. Be sure to wash them before eating and before and after using the bathroom
• Try to avoid crowds and people who have colds, flu, or viruses
• Get lots of rest and try to eat well
• Be careful not to cut yourself when using scissors or knives. If you do experience a cut, clean it right away with water, soap, and antiseptic
• Practice good hygiene by bathing or washing daily and brushing your teeth with a soft-bristled toothbrush
• Wear protective gloves when gardening or cleaning after animals