Introduction
1. General information about chemotherapy
2. Situations that may occur during chemotherapy
3. Side effects
4. Nutrition
5. Protection from infection
6. General information
7. When should I go to the hospital (emergency conditions)?
8. General information about chemotherapy
Cancer is a health problem that is becoming increasingly important in our country as well as in the world. Medical oncology is the branch of medicine that deals with the prevention of cancer, screening, early diagnosis, treatment of cancer patients, and monitoring at every stage.
All patients applying to the clinic are evaluated in detail in multidisciplinary councils regularly held within our hospital, and current appropriate treatment methods for patients are taken by council decisions.
What is Chemotherapy?
It is a treatment method that kills tumor cells with drugs.
How Does Chemotherapy Work?
Chemotherapy shows its effect by stopping or slowing the growth of rapidly growing and multiplying tumor cells.
What Can Chemotherapy Do?
- It can completely cure the tumor
- It can control the tumor
- It reduces tumor symptoms
- It improves quality of life
How Often Will I Receive Chemotherapy?
Chemotherapy treatment protocols are very different and varies depending on
• Tumor type
• Stage of the disease
• Treatment goals
• Chemotherapy regimen
• Response to chemotherapy.
Frequency of Chemotherapy may be as follows:
• Once a week
• Every 2 weeks
• Every 3 weeks
• Every 4 weeks
• Orally for 14 days
• Orally for 5 days a week
• Orally continuously
How is Chemotherapy Administered?
• Via intravenous route
• By mouth
• Into the abdominal cavity
• On the skin
• Via a catheter or a port
Ways of Intravenous Administration
• From a vein in your arm
• Venous port
• Catheter
What is a Catheter-Port?
• Catheter: A soft tube placed under the skin with one end inside a vein and the other end outside.
• Venous port: A small, round disk made of plastic or metal placed under the skin. The catheter connects the disk to a large vein, usually in the chest area. The catheter and port make it easier for you to receive your treatment.
Chemotherapy Administration Devices
Potential side effects of chemotherapy:
• Allergy
• Fever
• Nausea-vomiting
• Mild rhythm problems
• Blood pressure changes
• Chemotherapy leaking outside the vein
Problems Related to Leakage of the Drug Under the Skin
• Some chemotherapy drugs can cause wounds on the skin and subcutaneous tissue when they leak under the skin.
• The best treatment is prevention!
• Closely monitor drug administrations during your treatment.
• If you notice severe pain, redness, or color change at the site of venous entry, immediately inform your nurse.
Signs of Leakage
• Burning
• Pain
• Redness
• Swelling
Can I Work During Chemotherapy?
• If your job is not heavy and your work environment is suitable, you can continue to work.
• If you feel tired or weak during treatment, you can ask your doctor for a medical report until your treatment process is over.
Can I Use Other Prescription and Non-prescription Drugs During Chemotherapy?
• Use only drugs approved by your doctor.
• Inform your doctor about all the drugs you take, including laxatives, allergy medications, cold medicines, pain relievers, and Aspirin.
• Ask your doctor before using dietary supplements or herbal medicines.
Side Effects
What is a Side Effect?
These are unwanted effects that occur during and after tumor treatment.
Why Do Side Effects Occur?
• Drugs affect not only tumor cells but also normal cells.
• Each chemotherapy drug may have different side effects.
What Can I Do About Side Effects?
• Inform your doctor.
• Use the drugs given for side effects properly and completely.
• Ask your nurse and doctor for non-drug treatments.
Nausea-Vomiting
• Chemotherapies can cause more or less nausea and vomiting.
• It may occur hours or days after administration.
• Treatment is possible in 70-80% of cases.
• Preventive medication is given before chemotherapy.
• Preventive medication is continued for 3-4 more days.
• Use the drugs given to you for the specified period, whether you have complaints or not.
Be Sure to Ask Your Doctor and Nurse
• Whether the drugs should be taken before or after treatment
• Whether they should be taken on an empty or full stomach
• How many times a day they should be taken
• How many days they should be taken
To Reduce the Effects of Nausea and Vomiting
• Have a light meal before treatment.
• Make sure your food and drinks are lukewarm and cool (not too hot or cold).
• Eat foods with pleasant aromas.
• Have small meals or snacks.
• Avoid
from oily, spicy, gassy (broccoli, beans, etc.), and strongly smelling foods and drinks.
• You can chew mint gum.
• When you feel nauseous, take deep and slow breaths, and get fresh air.
Hair Loss
• Some chemotherapies damage hair follicle cells.
• It starts 2-3 weeks after chemotherapy.
• It will come out completely a few months after the end of chemotherapy.
• Your hair may come out darker and often more lively.
Decrease in Blood Cells
There are 3 types of blood cells in our body. These are white blood cells (fight against microbes), red blood cells (carry oxygen to tissues), and platelets (cells that provide clotting). Some chemotherapies can affect the bone marrow, causing a decrease in one or all of these cell groups.
Symptoms That May Occur as a Result of Decrease in Blood Cells
• Fatigue
• Palpitations
• Bleeding
• Rash-redness on the body
• Fever (over 38 degrees)
• Cough-sore throat
• Chills-shivering
• Headache
ATTENTION!
Mouth Sores
• Some types of chemotherapy damage rapidly proliferating cells such as the mouth, throat, and lip line.
Suggestions
• Check your mouth and tongue every day.
• Maintain oral moisture (constantly sip water, and chew sugar-free gum).
• Clean your mouth, teeth, gums, and tongue (Use very soft toothbrushes and children's toothpaste).
• Do not use alcohol-containing mouthwashes (you can use a solution prepared with 1/4 teaspoon of baking soda, and 1/8 teaspoon of salt in a glass of warm water 3-4 times a day.
• Clean your teeth with soft dental floss every day.
• Make sure your dentures fit properly if you use them.
• Do not smoke or drink alcohol.
Fatigue - Weakness
Fatigue due to chemotherapy can vary from mild to severe.
Suggestions:
• Relaxation-rest (meditation, prayer, yoga, counseling, visual arts)
• Eat and drink well (5-6 small meals and snacks instead of 3 large meals a day)
• Consume at least 8 glasses of water or fruit juice a day.
• Plan rest time
• Be active (15 minutes of walking, doing yoga, and riding an exercise bike).
• Try to do more things (reading, knitting, cassette learning something new).
• Sleep at least 8 hours every night.
• Make a to-do list for your tasks.
• Ask for help from others (family members and friends).
Pain
Pain can be due to the tumor itself or due to chemotherapy.
Suggestions:
• There are a wide variety of strong options for combating pain. You can learn the most suitable treatment from your doctor.
• Use your pain relievers regularly (even if you don't have pain).
• Do not skip medication doses.
• Trying to take deep breaths, yoga or other relaxation methods may be helpful.
• The medications prescribed do not have addictive and/or habit-forming properties.
• Make an appointment with a pain specialist or a specialist dealing with supportive treatments when you have pain.
Constipation
Some chemotherapy drugs, painkillers, nausea medications, and inactivity can cause constipation.
Suggestions
• Drink at least 8 glasses of water or other fluids a day.
• Make sure you drink enough fluids when you increase your intake of fibrous foods.
• Be active every day (walking, cycling, or doing yoga)
• Ask your doctor, nurse, or dietitian for higher-fiber foods.
• If you haven't been to the toilet in the last 2 days, inform your doctor or nurse.
Diarrhea
Chemotherapy can damage the healthy cells of your small and large intestines, causing diarrhea and increasing your bowel movements. Diarrhea can also be caused by medications used for constipation and infections.
In Case of Diarrhea
• Have 5-6 small meals and snacks a day instead of 3 meals.
• Consume foods high in sodium and potassium salts (bananas, oranges, peaches, apricots, and potatoes).
• Drink 8-12 glasses of clean water a day.
• Avoid excessively sugary foods.
• Consume low-fiber foods (bananas, white rice, toasted bread, plain and vanilla yogurt)
• If your diarrhea does not go away within 24 hours and there is pain and cramps with diarrhea, consult your doctor or nurse.
• Use baby wipes or a spray bottle for post-toilet cleaning instead of toilet paper.
Loss of Appetite
• Chemotherapy can cause changes in appetite. Your appetite may be reduced by nausea, mouth or throat problems, or medications that cause you to lose your taste.
• Changes in appetite may be due to feeling tired or depressed.
Suggestions
• Eat 5-6 small meals and snacks instead of three large meals.
• Prefer high-cal
orie and protein-rich foods and drinks.
• Eat when you need to eat, not when you are hungry.
• If you can't eat solid food, you can drink milk, soft foods, fruit juices, or soup.
• If you have a metallic taste in your mouth, use plastic forks or spoons.
• Increase your appetite with some activities.
• Take a short walk before meals
• Do not reduce your appetite by using too much liquid before and during meals
• Discuss with your doctor about extra vitamins or nutritional supplements (such as high-protein drinks). If you haven't been able to eat for a long time and are losing weight, you may need medication to increase your appetite or you may need to be fed through a feeding tube or via intravenous route.
Sexual Changes
• Risk of infertility: Discuss with your doctor before starting treatment.
• Risk of getting pregnant: Be sure you take measures for contraception.
• Ask your doctor or nurse if sexual intercourse is safe during chemotherapy.
Nutrition
Pay attention to your diet during treatment. Because with good nutrition;
- You feel better.
- Your fatigue decreases.
- You can maintain a healthy weight.
A good nutrition
- Provides energy and strength.
- Reduces the risk of infection.
- Reduces side effects.
- Increases the quality of life.
Protection from Infection - 1
• Wash your hands!
People who will be in contact with patients should wash their hands with antibacterial soap for 15 seconds and then dry them with a paper towel or a towel other than the patient's.
• Cloth towels should be changed daily.
• Daily bath
• Do not scrub too hard
Protection from Infection - 2
• Stay away from people at risk of contracting infectious diseases.
- Be careful of people with contagious diseases such as colds, pharyngitis, diarrhea, and flu.
• Be careful of people who have recently been vaccinated against oral polio, rubella, measles, mumps, or chickenpox.
• Crowded environments are risky.
• You do not need to isolate yourself.
Protection from Infection - 3
Stay Away!
• Unhealthy people
• Pets
• Human and animal waste
• Stay away from dust and chemical irritants (such as cleaning agents)
Protection from Infection - 4
• An electric razor can be used instead of a razor.
• Do not have a manicure or pedicure while receiving chemotherapy.
• You must inform your doctor before any vaccination.
• Make sure all the food products you consume are clean and healthy.
• Do not buy and consume food products from unreliable places.
General Information
• It is recommended that patients measure their body temperature twice a day.
• It is recommended to humidify the air in the environment where the patients are.
• Do not hesitate to consult your doctor and nurse on every subject.
When to Go to the Hospital in an Emergency Condition?
• Fever over 38 degrees
• Bleeding (nose, gums, urine, skin, stool)
• Severe diarrhea
• Mouth sores so severe that you can't eat or drink anything
• Inability to pass stool and gas
• Non-stop vomiting
• When you feel bad