Chemotherapy 101

1. presents Chemotherapy 101

2. Developed by the Huntsman Cancer Institute Outpatient Clinics Staff Welcome

3. What is cancer? Cancer is the general name for more than 100 diseases in which abnormal cells grow out of control and form malignant tumors.

4. A.Normal cell division 1- damaged cell 2- cell death Cancer cells do not follow the rules. They grow out of control. They can forget to die. • Cancer cell division

5. Cancers are named according to the organ where they first developed, (such as kidney or breast) or for the type of cell that became cancerous (such as leukemia or melanoma). Breast cancer cell

6. If cancer spreads to other parts of the body, it keeps its old name. For example, if kidney cancer spreads to the lungs, it is called kidney cancer which has metastasized to the lung.

7. Chemotherapy or “chemo” • What is it? • How does it work? • How is it given? • Is it safe? • Is it effective? Rosy periwinkle –Vincarosea. Compounds from the rosy periwinkle flower, vincristine and vinblastine, are used to treat some cancers.

8. What is it? Chemotherapy is the use of drugs to treat cancer.

9. How does chemotherapy work? Chemotherapy drugs work by interrupting the cell division process. This keeps the cancer cells from multiplying.

10. Chemotherapy can help: CURE to keep cancer from growing back CONTROL to slow the growth or spread of cancer PALLIATE to decrease tumor symptoms

11. Most chemotherapy can’t target only the cancer cells. Chemotherapy will destroy some healthy cells, causing side effects. Your health care team carefully monitors chemotherapy side effects.

12. Your doctor personalizes your chemotherapy to fit you and your cancer. • Our doctors use national protocols or treatment guides that have been tested for safety and effectiveness to decide on your treatment plan.

13. Clinical Trials • Clinical trials test new treatments. • Some patients participate in clinical trials. • Ask your health care provider if you are eligible.

14. Chemotherapy drugs are strong medicines. • Your doctor, pharmacist, and nurse will make sure that they are given safely.

15. Your doctor prescribes chemotherapy in cycles of treatment followed by rest. • The rest period gives your body time to rebuild healthy new cells. • The number of treatment cycles depends on what cancer you have, the national protocols, and your response to treatment.

16. Your health care team will review your treatment plan with you. Chemotherapy works best if you take every treatment on schedule. Work with your health care team to avoid skipping or missing treatments. Sometimes your doctor may delay a cycle to help you with side effects.

17. Chemotherapy is usually given intravenously (IV). The infusion nurse will insert an intravenous catheter or IV.

18. Some of you will have surgery to implant a device that gives easy access to your vein. The device, called a port, stays in place throughout all cycles of your treatment. A nurse accesses a patient’s venous access device or port.

19. Your first chemotherapy appointment • Please have someone bring you to your appointment. • Please bring only one guest, age 16 or older, with you. • Please limit cell phone use in the infusion suite.

20. At every appointment • We weigh you because your chemotherapy dose depends on your exact height and weight that day. • We draw your blood to check the numbers of red cells, white cells, and platelets (your blood count). • It usually takes 45 to 90 minutes to analyze your blood and mix your chemotherapy.

21. Why is your blood count so important? Chemotherapy drugs may decrease the number of your blood cells. The cycle’s rest period gives your body time to build the blood cell numbers back up. Sometimes your body may be slow to replace these cells. If your blood count is too low, your doctor may postpone your treatment.

22. After the pharmacist and nurse check your lab results, trained pharmacy technicians mix your personal chemotherapy formula.

23. While you wait • Puzzle table, reading material, and wireless service for your laptop in the waiting room • Free computer access and cancer information in the Cancer Learning Center and Linda B. and Robert B. Wiggins Wellness Center on the first floor • Food and drinks at The Point or Point Bistro on the sixth floor

24. HCI infusion nurses are chemotherapy specialists. We watch you very closely during your treatment to make sure you are comfortable and doing well.

25. Infusion times can vary from 15 minutes to eight hours or more, depending on the treatment your doctor has ordered.

26. After your infusion The nurse will give you information on possible side effects and tell you whom to call if you have problems. Be sure to check with the scheduler for your next appointment.

27. How will I feel during treatment? Each person responds differently. Some people feel well enough to continue their normal schedules at home or work. Others feel more tired.

28. Chemotherapy’s effects on your blood count can increase your risk for infection.

29. Preventing Infection • Your first defense is hand washing. • You, your caregivers, family members, and visitors need to wash hands frequently. • Carry and use hand sanitizer when you leave the house.

30. Use a thermometer to monitor your temperature at home. • Take your temperature if you feel sick or unusually hot or cold. • If you have a fever over 100.5°F, call your health care provider right away. Do not take Tylenol or aspirin unless instructed to do so.

31. Fatigue is the most commonly reported side effect of chemotherapy. • Take a daily walk or continue your usualexercise routine, if you can. • Eat a healthy diet. • Plan daily activities ahead of time. • Prioritize your activities to conserve energy. • Get plenty of rest. • Let others help with chores.

32. Fluids Keeping hydrated with fluids is important during chemotherapy treatment. Fluids are in water, beverages, and food. Keep a bottle of water or juice with you at all times and sip on it often. If you have vomiting problems, try to drink two quarts of fluids a day for a few days afterward.

33. Nutrition • Eat smaller portions more frequently. • Try milkshakes, smoothies, or soup for extra calories if you are losing weight. • Some chemo causes a metallic taste. Try using plastic utensils to ease this effect. • Some people gain weight during chemotherapy.

34. Everyone Worries About Nausea and Vomiting • Not everyone experiences nausea. • Nausea and vomiting can occur during or for several days after receiving treatment. • Take antinausea medication as prescribed. • Let your nurse or doctor know if you’re unable to keep medications down or drink fluids.

35. Oral Care • Brush your teeth with a soft toothbrush. • If you have not had regular dental care, see a dentist before beginning chemotherapy. • If your mouth feels sore, rinse three or four times daily with warm salt water solution (one teaspoon salt in eight ounces water), swish vigorously, and spit.

36. Skin Care • Chemo can cause skin changes such as dryness, itching, and sun sensitivity. Nail condition can also change. • Keep your skin clean with a mild, moisturizing soap and moisturize with gentle lotions. • Protect your skin from injury. • Avoid direct, intense sun exposure. • Use sunscreen (minimum 30 SPF) and wear protective clothing when outdoors.

37. Preventing Bleeding Use a very soft toothbrush. Blow your nose gently. Use an electric shaver instead of a razor. Avoid injuries that could cause cuts or bruises. If you cut yourself, apply gentle but firm pressure to stop the bleeding.

38. Constipation • Try over-the-counter laxatives, stool softeners, or fibers described in the constipation teaching sheet. • Drink fluids. • Take daily walks if you can. • Eat well-washed fruits and vegetables.

39. DiarrheaDiarrhea is having more than five liquid bowel movements in a 24-hour period. • Your health care provider can suggest a diet plan to help ease this problem. • Take an antidiarrhea medication. • Drink fluids. • Call your provider if your diarrhea is bloody, it lasts more than 24 hours, or you have symptoms of dehydration.

40. When should I call the doctor? Fever over 100.5°F Redness or swelling at IV site Uncontrolled vomiting and diarrhea Blood in urine or stool Any questions, concerns, or problems If any of these problems occur, call the doctor right away.

41. Supporting your emotional needs is essential to your cancer treatment. Huntsman Cancer Institute provides many services as benefits for patients and their loved ones.

42. Keep your family and friends informed

43. Huntsman Cancer Institute’s patient and family support staff are part of your health care team. At no additional charge, they do the following: • Help you and your loved ones cope with difficult emotions and life changes • Offer counseling on adjusting to a diagnosis, treatment, or hospitalization • Collaborate with your providers in your care • Assist you and your family with access to hospital and community resources

44. The Linda B. and Robert B. Wiggins Wellness Center offers the following: • Nutrition Counseling • Stress Reduction Services • Fitness Program • Bone Health and Osteoporosis Program • Acupuncture • Look Good…Feel Better Program • Yoga • YourStory Program • Sexual Health Clinic • Fertility Preservation

45. Are youstressed? • Do you experience any of these symptoms? • difficulty concentrating • trouble sleeping • too much worry • problems with coping HCI offers free private consultations to help you learn stress management techniques. Call the Wellness Center at 801-587-4585.

46. Cancer Learning Center —a walk-in cancer information library • Books, videos, and audio materials • Internet access for additional research • Cancer information specialists to help • Free, personal responses to phone and e-mail requests for cancer information • 801-581-6365 1-888-424-2100 toll free patient.education@hci.utah.edu

47. Online resources HOPE Guide huntsmancancer.org National Cancer Institute cancer.gov American Cancer Society cancer.org

48. HCI’s team of cancer experts is here to help you through every phase of the cancer experience.