൴ment center and give you a better sense of who we are ... · • Open 7 days a week except major...
Transcript of ൴ment center and give you a better sense of who we are ... · • Open 7 days a week except major...
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Chemotherapy Orientation
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Agenda/Overview
• Oncology Team
• Chemotherapy Guidelines
• Potential Side Effects
• Questions and Answers
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We are …..
• 12 Oncologists/Hematologists • 1 Physician Assistant • 30 Nurses (all chemo-certified) • 3 Nurse Case Managers • 1 Social Worker • 12 Oncology pharmacists/2 technicians • 20 Medical Assistants
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We do ….
• Chemotherapy treatments • Injections • IV fluid hydration • Blood transfusions • Management of central lines
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About the Infusion Center
We have
• 30 Infusion Stations • Free Wi-Fi access and TVs available • Space for 1 person to be with you
during your infusion
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Infusion Center Phone and Hours
• 408-851-4325 • Open 7 days a week except major
holidays • Monday thru Friday 9AM- 7:00PM • Sat and Sun 9AM – 5 PM
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On the day of the treatment
• Wear loose clothing so the nurse can access your arm for IVs
• Check in at Dept 440 and a staff member will take you to the infusion chair
• Juice and crackers for snacks are available • We do not provide meals but you may bring
in food and beverage
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Patient Information and Guidelines for Chemotherapy
• What is chemotherapy? • Chemo cycle • M.D. appointments • Blood Tests/Labs • Liquids • Anti-nausea medications • Symptoms to report
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Chemotherapy
• Any drug(s) used to treat cancer • Many chemotherapy drugs are infused into
the vein through an IV • Others are given by mouth or by injection • Treatments are individualized and your
doctor will discuss the best treatment for you
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Chemotherapy dosing
• Based on your height and weight • You will be weighed each time you
come to the Infusion Center. Your dose will be adjusted for any weight change of more than 10% from original dose
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What is a chemo cycle? A cycle may involve several treatments.
Some examples of a cycle:
• One treatment every 2-4 weeks
• Every week for 2 – 3 weeks followed by one week of rest
• Daily treatment for 5-7 days every 3-4 weeks
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M.D. Appointments
• MD Appointments generally at different time than chemotherapy treatment
• If you have problems during treatment, let your doctor know or ask for an appointment to see your MD
• A family member, significant other or support person is welcome at your appointments
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Blood Work • Usually necessary before each treatment to
make sure your blood counts have recovered • To be completed 2 days before treatment • Lab work can usually be done at any Kaiser
facility (Homestead, Milpitas, Campbell, Mountain View) EXCEPT blood transfusion labs need to be done at the Homestead facility
• No lab slip needed. Orders are transmitted electronically
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Liquids • Drink two quarts of fluids a day • Any type of fluid
– Soup, juice, bouillon, Jell-o®, sports drinks like Gatorade®, non-caffeinated teas
• Important one day before and two days after chemotherapy
• Fluids flush the system • Avoid beverages with caffeine/alcohol • Stay well hydrated
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Dealing with the side effects of chemotherapy
• Low blood counts • Hair loss • Nausea • Mouth sores • Fatigue • Loss of appetite • Neuropathy • Skin changes
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Effects of chemotherapy on Blood Counts (CBC)
• Low WBC, puts one at risk for infection • Low RBC, makes one anemic • Low platelets, puts one at risk for bleeding
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Things to know about low white blood counts
• Hand-washing • People who are ill • Crowds • Temperature (call if >100.5 F) • Dentist appointment (check with your doctor
before scheduling dental appointment) • Pets • Use Common Sense • Fruits/Vegetables
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Food Handling Safety
• Thoroughly wash hands & food preparation area
• Wash all raw fruits & vegetables, water ok. • Avoid raw or undercooked meats, poultry,
fish, seafood, and eggs • Some foods best avoided: raw vegetable
sprouts, food from salad bars and deli counters, moldy or out dated packaged foods.
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How do you know you are anemic?
• Dizziness especially when you stand too quickly • Shortness of breath especially with walking • Pale-looking • May cause chest pain-Contact your doctor ASAP for
chest pain • Fatigue (but this could be from chemotherapy or cancer
itself) • Rapid heart rate Your doctor may talk to you about blood transfusions or
injections to stimulate red blood cell production
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Low Platelets
• Unexplained bruising • Nose bleeds • Bleeding gums • Avoid aspirin-like products (Ibuprofen, Motrin,
Advil, Aleve). May use acetominophen (Tylenol) for pain or fever. If not effective, contact your doctor
• Talk to your doctor about using aspirin or aspirin-like products
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Hair Loss (alopecia)
• Hair loss is temporary (not all chemo causes hair loss)
• Usually starts between the first and second treatment (the first sign is tingling of the scalp)
• Hair loss can occur on all parts of the body • Will start to grow back within several weeks after
stopping chemo and should be fully back about 3-4 months after stopping treatment
• Hair may come back curlier than your usual hair but will eventually regain characteristics of the hair you had before chemo
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Tips to deal with hair loss
• Shop for hair covers/wigs before hair loss starts • Natural hair wigs are more expensive and
require more work to maintain • Use hair net at night to contain hair • May want to cut your hair short before it falls out • Hair dyes or perms not recommended while on
chemo--wait six months. Do a patch test first! • Use gentle cream or lotion on your scalp when it
is dry • Use soft hair brushes
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Nausea
• Take your prescribed meds at the first sign of nausea. You may need to take two or more kinds of nausea medications
• Eat small meals/crackers/dry toast • Avoid fatty/fried foods • Stay well hydrated • Avoid unpleasant odors/tastes
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Anti-Nausea Drugs • If you have questions regarding your anti-
nausea meds, bring them to first chemotherapy session
• Take all medications as directed • Many are constipating, to combat use: Colace (stool softener), Senokot (senna),
Miralax Increase fluids/fiber Do not use enemas unless last resort
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Mouth sores prevention • Use soft toothbrush • Floss very gently • Rinse mouth frequently • Salt water rinses every two to four hours
– 8 oz warm water – ¼ tsp salt and baking soda
• Avoid alcohol-based mouth washes (such as Listerine)
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Fatigue and Activity • Many treatments can cause fatigue
• Be as active as you can
• May need planned rest periods
• Pace your activities • Listen to your body (if you are tired,
rest; if you feel good, resume normal activities)
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Problems Eating
• Appetite often decreases while on chemo
• Weight loss not good while on treatment
• Need to still eat to keep up energy and strength
• Eat healthy food containing protein and Calories
• Talk to a dietitian if you have problems eating
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Neuropathy
• Numbness and Tingling in the hands and feet
• Some chemotherapy drugs, not all, can cause this side effect
• This side effect can persist for a long time after treatment
• Tell your oncologist if you start to have this side effect
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Skin Changes • Skin may be more
sensitive to the UV rays of the sun.
• Skin may become dryer. • Some chemo can cause
skin or nails to become discolored or darker.
• Some chemo can cause acne-like rash.
• Some chemo can cause temporary flushing and redness.
• When in the sun, wear protective clothes or sunscreen of at least 15.
• Use alcohol-free moisturizers.
• Skin and nail discoloration eventually resolves.
• Acne-like rash best treated with alcohol-free moisturizers.
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Symptoms to report
• Fever over 100.5 (also chills without fever can be a sign of infection)
• Diarrhea not controlled with Imodium • Constipation not improve using laxatives • Mouth sores • Vomiting not relieved with anti-nausea meds • No fluid intake for over 12 hours while awake • Shortness of breath • Extreme dizziness
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Multivitamins/ Supplements • Mega doses of Vitamin and Mineral supplements
usually not necessary unless recommended by physician.
• Generally, One-A-Day type Vitamin and Mineral supplement OK to continue.
• Check with physican if OK to continue any Herbal supplement you may be taking.
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Final Notes
Thank you for watching this
presentation. Hopefully by
knowing the guidelines and what
to expect, your chemotherapy
experience will be an easier one.