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Chemo you_teaching_pres

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Chemo you_teaching_pres

  1. 1. CHEMOTHERAPY AND YOU Lions Gate Hospital The Dr. Paul Klimo Medical Oncology Clinic
  2. 2. TODAY WE WILL FOCUS ON: <ul><li>Chemotherapy side effects </li></ul><ul><ul><li>What to expect </li></ul></ul><ul><ul><li>How to manage </li></ul></ul><ul><ul><li>When to call </li></ul></ul>
  3. 3. WHAT IS CHEMOTHERAPY? <ul><li>The use of drugs to destroy or control the growth of cancer cells </li></ul><ul><li>May use one drug or a combination </li></ul>
  4. 4. HOW IS CHEMOTHERAPY GIVEN? <ul><li>Intravenous (into a vein) </li></ul><ul><li>Oral ( by mouth) </li></ul><ul><li>Other routes </li></ul>
  5. 5. IS CHEMOTHERAPY PAINFUL? <ul><li>NO! </li></ul><ul><li>If you feel burning, or notice redness or swelling in the area of the needle, tell your nurse immediately </li></ul><ul><li>If you feel pain, or notice redness or swelling after you are at home, phone the Telephone Triage Nurse </li></ul>
  6. 6. CAN I TAKE OTHER MEDICATIONS WHILE I AM ON CHEMOTHERAPY? <ul><li>Check with your cancer doctor (oncologist) or clinic nurse before starting any new medications. </li></ul>
  7. 7. CHEMOTHERAPY SIDE EFFECTS
  8. 8. NORMAL CELLS AFFECTED BY CHEMOTHERAPY <ul><li>Bone marrow (red blood cells, white blood cells and platelets) </li></ul><ul><li>Lining of the mouth, throat, stomach, intestines </li></ul><ul><li>Peripheral nerves (nerve endings) </li></ul><ul><li>Reproductive system </li></ul><ul><li>Hair follicles </li></ul>
  9. 9. WHITE BLOOD CELLS <ul><li>(the cells that fight infection) </li></ul><ul><li>White blood cells may be decreased following your chemotherapy </li></ul><ul><li>Neutrophils, a type of white blood cell, fight bacterial infection </li></ul>
  10. 10. SIGNS OF INFECTION <ul><li>Temperature of 38°C (100.4°F) or higher </li></ul><ul><li>Areas of redness or tenderness </li></ul><ul><li>Chills, shakes </li></ul><ul><li>Sore throat/ mouth sores </li></ul><ul><li>Productive cough </li></ul><ul><li>Itching or burning in genital area </li></ul><ul><li>Pain/ burning/ frequent urge to urinate </li></ul>
  11. 11. TO PREVENT INFECTIONS : <ul><li>WASH YOUR HANDS! </li></ul>
  12. 12. FEVERS AFTER CHEMOTHERAPY <ul><li>Remember you are at risk for infection after your chemotherapy treatment </li></ul><ul><li>Take your temperature every 4 hours if you are not feeling well </li></ul>
  13. 13. FEVERS <ul><li>If you have a fever, 38°C or higher </li></ul><ul><li>( 100.4°F or higher), phone the Chemotherapy Clinician immediately. </li></ul><ul><li>If you have a fever after 4 p.m. or during the weekend, go to the nearest Emergency Department. </li></ul><ul><li>DO NOT TAKE ACETAMINOPHEN (Tylenol ™) for your fever until you have completed the above. </li></ul>
  14. 14. RED BLOOD CELLS (HEMOGLOBIN) <ul><li>Feel tired </li></ul><ul><li>Feel short of breath with activity </li></ul><ul><li>Have a headache </li></ul><ul><li>Have no symptoms </li></ul>If your red blood cell count is low you may:
  15. 15. PLATELETS (the cells that help the blood to clot) <ul><li>Bruises or small purple spots on your body </li></ul><ul><li>Nose bleeds </li></ul><ul><li>Bleeding gums </li></ul><ul><li>Blood in your urine or stool </li></ul>If your platelet count is low you may notice:
  16. 16. TO PREVENT BLEEDING <ul><li>Use a soft toothbrush </li></ul><ul><li>Blow your nose gently </li></ul><ul><li>Use the bowel routine recommended to prevent constipation </li></ul><ul><li>Talk to your oncologist about blood thinners and aspirin- based drugs </li></ul>
  17. 17. PAIN MANAGEMENT <ul><li>Do not use ASA (aspirin) or ASA based drugs for pain – discuss use of ASA drugs with oncologist ( daily heart/stroke prevention) </li></ul><ul><li>Talk to your oncologist about pain relief options </li></ul><ul><li>Ibuprofen (advil) is okay to use occasionally </li></ul>
  18. 18. BLOOD WORK PRIOR TO CHEMOTHERAPY <ul><li>Blood work should be done within 2 days of each chemotherapy treatment </li></ul><ul><li>If you live out of town, blood work may be arranged in your home community </li></ul>
  19. 19. CHEMOTHERAPY DELAYS <ul><li>Chemotherapy may be delayed if: </li></ul><ul><ul><li>Blood counts are too low </li></ul></ul><ul><ul><li>You have other side effects </li></ul></ul><ul><ul><li>If blood work is not done prior to treatment </li></ul></ul>
  20. 20. NAUSEA AND VOMITING <ul><li>Nausea is not a side effect of every drug </li></ul><ul><li>It may be immediate or delayed </li></ul><ul><li>Fill your prescription at your local pharmacy </li></ul>
  21. 21. MANAGING NAUSEA AND VOMITING <ul><li>Take anti-nausea pills as directed !! </li></ul><ul><li>Eat frequent, small meals (6-8 times a day) </li></ul><ul><li>Eat bland food </li></ul><ul><li>Drink 8-10 glasses of fluids daily </li></ul>
  22. 22. LOSS OF APPETITE (ANOREXIA) <ul><li>Taste and smell may be changed by chemotherapy </li></ul><ul><li>Eat small meals often (6-8 meals a day) </li></ul><ul><li>Eat food high in protein and calories </li></ul><ul><li>Consult dietitian if needed </li></ul>
  23. 23. MOUTH PROBLEMS: Dental work <ul><li>Let your dentist know you are receiving chemotherapy </li></ul><ul><li>Discuss any dental work that needs to be done with your clinic nurse or doctor </li></ul><ul><li>Get regular dental cleaning </li></ul>
  24. 24. MOUTH PROBLEMS: Sore Mouth <ul><li>If you have tender gums or a sore mouth, look at your mouth in the mirror </li></ul><ul><li>Rinse your mouth with baking soda and water / or salt and warm water after eating and as often as you can (every 2-4 hours) </li></ul><ul><li>Use a soft toothbrush </li></ul><ul><li>Do not use over the counter mouthwash! </li></ul>
  25. 25. DIARRHEA <ul><li>Drink fluids slowly </li></ul><ul><li>Eat small, frequent meals </li></ul><ul><li>Eat bland food </li></ul><ul><li>Stop dairy products if diarrhea develops </li></ul><ul><li>Take medications as prescribed </li></ul><ul><li>Call if diarrhea lasts longer than 24 hours </li></ul>
  26. 26. CONSTIPATION <ul><li>Follow suggestions in the constipation </li></ul><ul><li>booklet. The nurse will be able to give you a handout </li></ul><ul><li>Speak to the nurse or oncologist in clinic </li></ul><ul><li>Call if no bowel movement in three days </li></ul><ul><li>Increase fluids, fiber and fruits and vegetables </li></ul>
  27. 27. FATIGUE <ul><li>Plan regular bedtime and wakeup times </li></ul><ul><li>Pace yourself </li></ul><ul><li>Delegate responsibilities </li></ul><ul><li>Plan a regular exercise program </li></ul><ul><li>Inform your Physician/nurse at your next appointment </li></ul>
  28. 28. REPRODUCTIVE SYSTEM CHANGES <ul><li>Changes may be temporary or permanent </li></ul><ul><li>Women </li></ul><ul><ul><li>May or may not menstruate </li></ul></ul><ul><ul><li>May experience symptoms of menopause </li></ul></ul><ul><li>Men </li></ul><ul><ul><li>May have decreased sperm count </li></ul></ul>
  29. 29. HAIR LOSS <ul><li>May have total hair loss, thinning or no loss at all </li></ul><ul><li>Depends on the chemotherapy drug </li></ul><ul><li>Usually occurs within 3 weeks after your first treatment </li></ul>
  30. 30. SKIN – MUSCLE – NERVE CHANGES <ul><li>Skin </li></ul><ul><ul><li>use sunscreen SPF 30 </li></ul></ul><ul><ul><li>wear a hat and keep covered outdoors </li></ul></ul><ul><li>Muscle </li></ul><ul><ul><li>muscle weakness </li></ul></ul><ul><li>Nerve </li></ul><ul><ul><li>numbness or tingling in your </li></ul></ul><ul><ul><li>hands or feet, ringing in the ears </li></ul></ul>
  31. 31. TIMING OF COMMON CHEMOTHERAPY SIDE EFFECTS Fatigue Neutropenia Chemo 5 10 15 20 25 Days Nausea/ Vomiting Mouth Sores Hair Loss
  32. 32. When to Contact the LGH Oncology Clinic <ul><li>Fever of 38º C/ 100.4 º F </li></ul><ul><li>Chills, shaking </li></ul><ul><li>Mouth sores and/or pain on swallowing </li></ul><ul><li>Severe constipation or diarrhea </li></ul><ul><li>Abnormal bleeding </li></ul><ul><li>Bruising or small purple or red spots </li></ul><ul><li>Unrelieved shortness of breath </li></ul><ul><li>Marked pain or soreness at injection site </li></ul><ul><li>Any new rashes or lumps </li></ul><ul><li>Any unusual strong or new pain </li></ul>
  33. 33. <ul><li>CONTACT NUMBERS </li></ul><ul><li>LGH Main Desk: 604-984-5753 </li></ul><ul><li>Nurse Clinician 604-984-5831 </li></ul><ul><li>Pharmacist 604-988-3131 ext 4488 </li></ul><ul><li>Social Worker 604-984-3709 </li></ul><ul><li>Dietitian 604-988-3131 ext 4719 </li></ul><ul><li>NS Community 604-986-7111 </li></ul>
  34. 34. APPOINTMENTS <ul><li>If you cannot attend your chemotherapy appointment as scheduled, call the </li></ul><ul><li>LGH Oncology Clinic Booking Office 604-984-5753 </li></ul>
  35. 35. FLU VACCINE <ul><li>Flu vaccines are recommended for cancer patients and their families </li></ul><ul><li>Vaccinations are offered October to December by your family physician or local public health clinic </li></ul><ul><li>Discuss the timing of your vaccine with your clinic nurse or oncologist </li></ul>
  36. 36. DOCTORS RESPONSIBLE FOR YOUR CARE <ul><li>Your oncologist (cancer doctor) is responsible for your cancer treatment </li></ul><ul><li>Your family doctor is responsible for all non-cancer related health problem </li></ul>
  37. 37. INFECTIOUS DISEASES <ul><li>You MUST call the Telephone Triage Nurse before your next visit if you think you have been exposed, or have been diagnosed with an infectious disease </li></ul>
  38. 38. Living with Cancer <ul><li>Support Services available at LGH Oncology Clinic: </li></ul><ul><ul><li>Pharmacy </li></ul></ul><ul><ul><li>Social Work </li></ul></ul><ul><ul><li>Counselling </li></ul></ul><ul><ul><li>Pastoral Care </li></ul></ul><ul><ul><li>Dietary </li></ul></ul><ul><ul><li>Symptom Management/Drug Reimbursement Nurse </li></ul></ul>
  39. 39. Chemotherapy is a hazardous waste <ul><li>Chemotherapy takes 48 hours to clear your body </li></ul><ul><li>Chemotherapy is excreted in your urine, stool, vomit, sperm, and vaginal fluids </li></ul><ul><li>Please take precautions to protect your family members. </li></ul>
  40. 40. Acknowledgment <ul><li>The Lions Gate Hospital Oncology Clinic thanks the Cross Cancer Institute for permitting reproduction of this presentation for teaching purposes. </li></ul><ul><li>This power point presentation is available on our website at </li></ul><ul><li>www.coastalpalliativecare.ca </li></ul>

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