What to Expect During Chemotherapy: Tips for Patients
When people hear the word cancer, bald heads and IV poles may come to mind. That’s because most people know cancer patients often lose their hair as a side effect of chemotherapy, which are powerful drugs prescribed by oncologists and hematologists to treat cancer. In this article, we identify what to expect during chemotherapy.
How Does Chemotherapy Work?
Chemotherapy (often called chemo) can be used alone or in combination with other treatments like surgery, radiation or other drugs. High doses may be used to prepare patients before a stem cell or bone marrow transplant. Sometimes it is used to shrink a tumor before surgery, making the cancer easier to remove.
Chemo works by killing fast-growing cancer cells. Unfortunately, it also kills some fast-growing healthy cells in its wake (like hair follicles and the lining of the digestive system). Side effects like hair loss, vomiting and diarrhea are likely to be temporary because the good cells will grow back (unlike other treatments, such as radiation).
How Do Cancer Patients Get Chemo?
Oncologists and hematologists prescribe a treatment protocol based on the latest research for different types of cancer.
Protocols vary depending on the diagnosis. Different combinations of drugs can be administered over many cycles. Depending on the diagnosis, it could be a 10-week cycle repeated 10 times, or a single cycle of nine treatments in combination with surgery or radiation.
When people hear the word “chemo" they are likely to picture an IV, since it is one of the most common routes for administering these drugs, and it is often portrayed this way in TV shows and films. Chemo can also be taken by mouth or injected into different parts of the body like the spine, an artery, body cavity, a muscle, or the tumor itself. It can also be applied topically.
Most chemotherapy is done at a hospital, but it can also be administered at home or at a doctor’s office. Whether your protocol is long or short, we have got some tips for getting through it.
Before Chemo
Safety is always first. Your healthcare team will tell you how to stay safe during your chemo treatments. Chemo must be handled carefully using protective equipment by health care workers, which is something you probably will not need to worry about. Something that can happen is a badly placed IV injecting chemo into your tissue instead of a vein. It’ll hurt and it is serious. Make sure to tell your chemo nurse as soon as possible so they can tend to the problem.
There are also some other safety issues to consider:
- Precautions to take while using the toilet
- What to do if you get bodily fluids on your clothes or bedding
- How to handle the drugs if you are taking them home
- Sex or no sex
- Precautions for sex, including oral sex
Talk to Your Doctor
You’ll want to talk to your doctor about managing side effects before starting treatment. There are drugs that can help with nausea and precautions to take to prevent infection (like avoiding sick people entirely). There are also options for making your IV hookups less painful to protect your veins from long-term damage, like a port-a-cath.
Make Yourself Comfortable
Let’s face it, chemo sucks. But you can make it go as smoothly as possible.
Here are some tips from the Leukemia & Lymphoma Society:
- Get some “chemo-wear"
- Pack a “chemo bag" with essentials for your trips to the hospital like magazines, your favorite blanket, a bottle of water and healthy snacks
- Chemo can take hours, so bring some entertainment to pass the time, like that Spotify or Netflix playlist you created,/li>
- Stay hydrated
- Make sure your doctor has prescribed medication for constipation or diarrhea, just in case
- Put together an anti-nausea kit: ginger chews, ginger pills, peppermint or ginger tea
Reach Out for Support
Your loved ones can help best when you give them specific requests that they can handle for you when you are no longer able.
If there is someone in your orbit who has been through chemo, talk to them and find out what helped. Sharing your ups and downs with someone who understands what you are going through is one of the most important steps you can take.
What to Expect During Chemotherapy Treatment
Staying healthy is one of the most important things. Once you have started chemo, there are things you can do to stay as healthy as possible while your body is getting bombarded by chemicals, like:
- Avoiding mouth sores by saying no to spicy food, drinking plenty of water, brushing your teeth more frequently and using a medicated mouthwash
- Eating nutritious food and having small meals throughout the day
- Regulating your sleep hygiene to combat fatigue, which means going to bed and getting up at the same time every day
- Listening to your body. If you are still tired (and you likely will be) take a nap. If you have a small spurt of energy, go for a walk.
- Staying grounded in your normal routine as much as you can
Cancer patient Kim Tronic also shared what she calls “chemo truths" to help other patients:
- It can get boring, but that is what your Netflix playlist is for.
- You’re stronger than you think. Being faced with a life or death situation triggers your survival instinct, which helps you do things you never thought you could do.
- You’re not alone. Keep reaching out to your health care team, volunteers and other cancer survivors. They are rooting for you.
- Don’t pay attention to what chemo looks like on TV. Chemo clinics can be full of the warmth and kindness you need to keep going (and may even have a therapy dog).
- Side effects vary from person to person. Take one day and one problem at a time.
- Stay as positive as you can. Prepare for the worst but hope for the best.
- Don’t stress yourself out mentally. If you tried to pick up a book you have been meaning to read and find you cannot read, find something less taxing to pass the time. (Did I mention Netflix?)
Also, do not forget to avoid strong odors, have fun (get yourself a crazy wig or some funky scarves) and journal about your experience. With cancer being as demanding as it is, there is a good chance you will forget an important moment.
Managing Side Effects
So far, I have mentioned commonly known side effects like hair loss and nausea. But your body is a magical wonderland that may find new and ways to react to treatment.
Here are a few key side effects you will want to manage:
- Fertility. Younger patients should check with your doctor about ways to preserve fertility.
- Fatigue. Keep a routine that includes enough rest and exploring solutions like supplements.
- Fog (as in brain fog). There are so many causes, symptoms and solutions for brain fog I cannot list them all. Take care of your health and explore options like cognitive rehabilitation.
- Infection. Chemo makes you more vulnerable to infection and you may get one despite your best efforts to stay safe. If you have symptoms of an infection, seek medical help right away.
- Low blood counts. Your blood will be tested before each chemo treatment to make sure you are strong enough to receive it. Sometimes you will need a blood transfusion before you can proceed and the worst part is the time it will add to your stay, but you are ready for that.
Side effects are inevitable, and the list is long. For more info, the Canadian Cancer Society has kindly compiled a comprehensive list of side effects for you.
After Chemo
So, you have done all the right things and made it through chemo. This is a banner moment, so mark the important milestone.
Next: Take It Slow
Once the party is over, the impact of chemotherapy can linger. You just went through something major and your journey is not finished. Hair takes time to grow back, bodies need to heal, minds need to rest, emotions need to be processed and healed. Take your recovery slowly and keep listening to your body. It’s unlikely you will be back to jogging around the block right away and your immune system may still be compromised.
Take Time to Process Your Feelings
It’s important to tell the truth about how you are doing so you can get the help you need. Don’t sugar coat your chemo experience in the name of being positive. Positive thinking can only take you so far.
Acknowledging that you are vulnerable, sad, angry, frustrated and at the end of your tether at times is perfectly fine and the best thing to do for your mental health. It will make you stronger because you will not be carrying the weight of all that emotional baggage.
Process your emotions by feeling things when you are ready. If you are feeling stuck and need someone to help you work through it, find a mental health professional who can help. The sooner the big feelings are dealt with, the easier things will be.
The Rest of Your Life
Cancer and chemo really bite. There’s no doubt about it. But here’s one of the perks; you have just joined a club of people who have some pretty cool things in common. You may now have a new sense of humor that will lighten your heart at the darkest moments, as well as a new appreciation for life and hair
So, do not worry, get ready. You now know what to expect during chemotherapy. You’ve got this.