Types of Chemotherapy
There are various ways of treating cancers:
1. Chemotherapy
2. Radiotherapy
3. Combination of the above
Chemotherapy can be delivered by various methods:
1. oral tablet
2. injection
3. combination of tablets and injection
Lethargy & Tiredness
· Get plenty of rest. Sleep longer at night and
take naps during the day
· Do exercise in between rest according to
your own tolerance level
· Get help in daily activities
· Eat a well-balanced diet
· Drink plenty of fluids, minmum 2 litres a day
e.g. water, juice, soup and milk
Mouth Ulcer
· Good oral hygiene is essential
Rinse your mouth after each meal
Brush teeth with soft bristled toothbrush
· Ensure adequate fluid intake
(more than 3 litres or 8 glasses of water per day)
· Avoid food that is too cold or too hot.
· Choose soft, soothing food such as porridge,
cooked cereals, soft fruits.
· Avoid food that are spicy, rough, too coarse or dry
Constipation
· Eat high fibre diet, e.g. fruits and vegetables, grains and cereals
· Drink plenty of fluids
· Intake of warm fluids and prune juice is helpful
· Encourage physical activity as tolerated
Hair Loss
Some chemotherapy drugs cause no hair loss, some cause hair to thin, while others cause complete hair loss.
The hair usually grows back after the treatment is over. However, it may grow back with a different texture.
Preventing hair loss
· Use mild, unperfumed shampoo
· Try not to wash your hair too frequently
· Dab your hair dry rather than rubbing it
· Brush or comb your hair gently with a soft hairbrush or wide-toothed plastic comb
· If you have long hair, avoid pleating it as this may damage it
· Avoid using elastic bands to tie back long hair
· Avoid dyes, perms and other products containing strong chemicals
· Avoid products containing alcohol
e.g. hair spray, which can irritate the scalp
· Avoid excessive heat from heated rollers, hair dryers and hot brushes
When you lose your hair
· You might want to think about having your air cut short or shave your head completely rather than wait for your hair to fall out
· You may want to wear a soft hat or turban in bed to collect loose hair
· Use a sunscreen, sunblock, hat or scarf to protect your scalp from the sun
· You may choose to wear a wig, scarf or a cap if you feel that your appearance needs a change
When your hair grows back
· It is best to avoid perming or colouring your hair for at least 6 months after the end of treatment, as you hair may still be weak
Principles of Treatment
2. Histological grade - aggressiveness
3. Stage of cancer – extent of spread
Side Effects of Chemotherapy
Side effects of chemotherapy vary from person to person. Some occurs early and others may occur later.
Nausea / Vomiting
Uncommon these days because of availability of good medicine (anti-emetic) to prevent this side effect.
· Try to relax during chemotherapy
· Stay away from fried or fatty food
· Take food that is easy to digest
· Chew your food well and eat slowly
· Try to avoid odours that bother you
eg. smoke or perfume
· If you experience nausea even before chemotherapy is started, try to avoid heavy meals or you may choose not to eat during chemotherapy, but remember to maintain your fluid intake
Loss of Appetite
· Try a variety of food
· Drink liquids at least an hour before or after meal time
instead of with your meals
· Take advantage of “good” days to increase your food intake
Diarrrhoea
· Maintain adequate fluid intake
· Take low-residue, lactose-free diet
· Avoid spicy and fatty foods, alcohol and tobacco
· The perianal region should be kept clean
(wash with water after defecation) to prevent infection
Bone Marrow Suppression
Chemotherapy not only kills cancer cells, it can also affect the production of normal blood cells.
The bone marrow produces 3 types of blood cells :
- Red blood cells
- White blood cells
- Platelets
Anaemia (low haemoglobin)
· Have your Haemoglobin(Hb) checked regularly
· Eat food high in iron, vitamins & minerals
· Nutritional supplement or iron and vitamin supplement may be taken if necessary
· Plan & limit activities to save energy and prevent tiredness when anaemia happens
· Get adequate amount of rest and sleep
· Regular, light exercise such as walking can significantly help to relieve tiredness
· Get help in daily activities
Thrombocytopenia (low platelet count)
· Be sure to let your doctor know if you have unexpected bruising, small red spots under the skin, reddish/pinkish urine, or black/bloody bowel motions
· Report any bleeding from your gums or nose. Let your doctor know if you have fever
· Maintain a safe environment to prevent fall or injury
· Use a laxative if constipated, to avoid straining, which can cause rectal tear and bleeding
· Postpone or minimize, if appropriate, any invasive medical or surgical procedures, e.g. dental extractions
· Do not use sharp instruments for personal grooming, e.g. use an electrical razor for shaving and soft toothbrush
· Apply pressure to injection site, e.g. press more than 10 minutes
Neutropenia (low white blood cell count)
· Maintain high standard of personal hygiene.
Wash hands before food and bathe daily
· Avoid crowded places and avoid cuts
· Avoid uncooked food, e.g. no salads, uncooked eggs or raw meat
· Discourage visitors and avoid those with symptoms or signs of infection,
e.g. cough and flu
· No flowers or plants are allowed in the room,
as they may be the source of fungal infection
· Avoid having a busy schedule during period of neutropenia, if you are an outpatient
· While at home, check body temperature regularly.
If it exceeds 38C, inform your nurse or doctor immediately
· Eat a high protein diet
Medications to Treat Nausea and Vomiting
Different Types of Blood Cells