Chemotherapy 101: Essential Information for Patients and Caregivers

Chemotherapy can be a lifesaving treatment for those battling cancer, offering hope and the potential for recovery. In India, with nearly 1.4 million new cancer cases reported every year, chemotherapy has become a common and essential treatment. While the road ahead may seem daunting, understanding what to expect can make the journey a bit easier. In this article, we’ll explore every aspect of chemotherapy, providing you with the information you need to better understand the process and its implications.

What is Chemotherapy?

Chemotherapy is a type of cancer treatment that uses powerful drugs to target and destroy cancer cells in the body. These drugs can be administered orally, intravenously, or directly into specific areas, depending on the type and stage of cancer. Chemotherapy works by interfering with the cancer cells' ability to grow and multiply, which can help to shrink tumours, slow the progression of the disease, or eliminate cancer altogether. The process itself is not painful, and anaesthesia is not required during the treatment.

Why is Chemotherapy Used?

Chemotherapy serves several important purposes, depending on the type and stage of cancer. Here are some of the common uses of chemotherapy:

• Curing the Cancer: In some cases, chemotherapy can completely eliminate cancer cells, leading to a cure.
• Controlling Cancer Growth: When a cure isn't possible, chemotherapy can help shrink tumours or stop cancer from spreading, effectively managing the disease.
• Reducing Symptoms: Chemotherapy can also be used to alleviate symptoms caused by cancer, improving the patient’s quality of life.
• Preventing Recurrence: After surgery, chemotherapy may be used to eliminate any remaining cancer cells, reducing the risk of the cancer coming back.
• Palliative Care: In advanced stages of cancer, chemotherapy may be used to relieve pain and other symptoms, providing comfort and extending life as much as possible.

Each patient’s chemotherapy plan is tailored to their specific needs, aiming to achieve the best possible outcome.

What are the Side Effects of Chemotherapy?

Chemotherapy is a powerful treatment for cancer, but it can also affect healthy cells, which can cause various side effects. The specific side effects can vary depending on the type of chemotherapy drugs used, the dosage, and the individual’s overall health. Common side effects of chemotherapy include:

• Fatigue: Feeling extremely tired is one of the most common side effects, as chemotherapy can lower your energy levels.
• Nausea and Vomiting: Many patients experience nausea and vomiting, though medications are available to help manage these symptoms.
• Hair Loss: Chemotherapy can cause hair to thin or fall out, affecting not only the scalp but also eyebrows, eyelashes, and body hair.
• Increased Risk of Infection: Chemotherapy can weaken the immune system by reducing white blood cell counts, making you more susceptible to infections.
• Anaemia: Low red blood cell counts can lead to anaemia, causing symptoms like tiredness, shortness of breath, and dizziness.
• Mouth Sores: Some chemotherapy drugs can cause sores or ulcers in the mouth and throat, making eating and swallowing difficult.
• Changes in Appetite: Loss of appetite or changes in taste can occur, sometimes leading to weight loss.
• Diarrhoea or Constipation: Chemotherapy can affect the digestive system, leading to gastrointestinal issues.
• Skin and Nail Changes: Skin may become dry, sensitive, or prone to rashes, and nails may become brittle or discoloured.
• Cognitive Changes: Some people experience "chemo brain," which can include memory lapses, difficulty concentrating, and a feeling of mental fogginess.
• Emotional Impact: The physical toll of chemotherapy can also affect emotional well-being, leading to feelings of anxiety, depression, or frustration.

While these side effects can be challenging, many of them can be managed with medication and supportive care.

What are the Late-Developing Side Effects of Chemotherapy?

Chemotherapy can sometimes lead to late-developing side effects that may appear months or even years after treatment has ended. These effects vary depending on the type of chemotherapy, the dosage, and the individual’s overall health. Some of the common late-onset side effects of chemotherapy include:

• Fatigue: While fatigue often improves after treatment, some people may experience persistent tiredness for months or years.
• Heart Problems: Certain chemotherapy drugs can increase the risk of heart issues, such as weakened heart muscles (cardiomyopathy) or heart failure. This risk may develop long after treatment has ended.
• Lung Damage: Chemotherapy can cause long-term damage to the lungs, leading to problems such as chronic coughing, shortness of breath, or an increased risk of lung infections.
• Kidney and Urinary Issues: Some chemotherapy drugs can cause kidney damage, leading to long-term kidney issues. This may also result in problems with urination or bladder irritation.
• Nerve Damage (Peripheral Neuropathy): Chemotherapy can cause nerve damage, leading to numbness, tingling, or pain in the hands and feet. This condition, known as peripheral neuropathy, can be long-lasting.
• Cognitive Changes: Some individuals experience long-term cognitive changes, sometimes referred to as "chemo brain," including memory issues, difficulty concentrating, and mental fogginess.
• Bone and Joint Pain: Some people experience ongoing bone and joint pain after chemotherapy, which can affect mobility and quality of life.
• Hormonal Changes and Fertility Issues: Chemotherapy can affect reproductive organs, leading to hormonal changes or fertility issues. This may include early menopause in women or reduced sperm count in men.
• Secondary Cancers: Although rare, chemotherapy can increase the risk of developing a second, different type of cancer years after treatment. This risk is due to the potential damage chemotherapy can cause to healthy cells.
• Osteoporosis: Some chemotherapy drugs can lead to bone thinning (osteoporosis), increasing the risk of fractures.
• Hearing Loss: Certain chemotherapy drugs can cause long-term hearing loss or tinnitus (ringing in the ears).

It’s important to discuss the potential for long-term and late-developing side effects with your healthcare team before starting chemotherapy.

How to Prepare for Chemotherapy?

Preparing for chemotherapy can help you feel more in control and reduce anxiety about the treatment process. Here are some steps you can take to get ready:

Learn About Your Treatment

Discuss your chemotherapy plan with your oncologist. Understand the type of chemotherapy you'll receive, the schedule, possible side effects, and how the treatment is administered. Ask about what to expect during and after each session so you can plan accordingly.

Arrange Support

• Transportation: Chemotherapy can make you feel tired, so it's a good idea to arrange for someone to drive you to and from your appointments.
• Emotional Support: Having a friend or family member accompany you during treatment can provide comfort. If you're feeling anxious, consider speaking with a counsellor or joining a support group.
• Home Assistance: If possible, arrange for help with household chores, meals, or childcare during treatment days.

Manage Your Health

• Eat Well: A balanced diet before and during chemotherapy can help your body cope with treatment. Focus on nutritious foods and stay hydrated.
• Exercise: Gentle exercise, like walking, can boost your energy and reduce stress. Talk to your doctor about what level of physical activity is safe for you.
• Dental Check-Up: Chemotherapy can affect your oral health. Consider seeing a dentist for a check-up and cleaning before starting treatment to reduce the risk of infections.

Prepare For Side Effects

• Medications: Ask your doctor about medications to manage potential side effects, such as nausea or pain.
• Comfort Items: Bring items to your treatment sessions that will help you stay comfortable, such as a blanket, pillow, or headphones for listening to music or podcasts.
• Hair Loss: If chemotherapy may cause hair loss, you might want to prepare by choosing wigs, scarves, or hats in advance.

Organise Your Life

• Work and Finances: Talk to your employer about adjusting your work schedule if needed. Check with your insurance company to understand coverage for your treatment and any associated costs.
• Legal and Financial Planning: Consider organising important documents and discussing any necessary legal or financial planning with a professional.

Stay Positive And Mindful

Preparing mentally and emotionally is just as important. Practice relaxation techniques like deep breathing, meditation, or gentle yoga to manage stress. Focus on activities that bring you joy and comfort, and maintain a positive outlook. Remember, your healthcare team is there to support you every step of the way.

By taking these steps, you can approach chemotherapy with greater confidence and resilience, making the experience as smooth as possible.

Instructions Before Chemotherapy

Eating and Drinking: You are generally allowed to eat and drink before coming to the hospital for chemotherapy. It's a good idea to have a light meal and stay hydrated to help your body cope with the treatment. However, avoid heavy or greasy foods that might upset your stomach.

• Pre-Medications: Your doctor may prescribe certain pre-medications, such as anti-nausea drugs or steroids, to be taken at home before your chemotherapy session. These medications help manage side effects and prepare your body for the treatment. Be sure to take these medications exactly as directed.
• Medications and Supplements: Inform your healthcare team about any other medications, vitamins, or supplements you are taking. Some substances can interfere with chemotherapy, so your doctor may advise you to stop certain medications or adjust dosages.
• Dress Comfortably: Wear loose, comfortable clothing to your appointment. Choose a shirt with sleeves that can be easily rolled up if you’re receiving intravenous chemotherapy. It’s also a good idea to bring a warm sweater or blanket, as treatment rooms can be chilly.
• Prepare for Your Appointment: Bring any necessary items, such as your insurance card, identification, and a list of your current medications. It might also be helpful to bring something to pass the time, like a book, music, or a tablet.
• Hydration: Staying well-hydrated is important. Drink plenty of water before your appointment unless your doctor advises otherwise. Proper hydration can help your body process the chemotherapy drugs more effectively and reduce the risk of side effects.
• Transportation: Arrange for someone to drive you home after your treatment, especially if it’s your first session or if you’re unsure how your body will react to the chemotherapy. Some people feel tired or unwell afterwards and may not feel up to driving.
• Communicate with Your Healthcare Team: If you have any concerns, questions, or symptoms before your treatment, don’t hesitate to reach out to your healthcare team. They can provide guidance and make any necessary adjustments to your care plan.

By following these instructions, you can help ensure that your chemotherapy session goes as smoothly as possible.

What To Expect On The Day Of Chemotherapy

• Arrival and Admission: Arrive at the designated daycare unit at the time specified by your healthcare team. Be prepared for a check-in process where you may need to provide personal and insurance information.
• Blood Tests: Before your chemotherapy session, you will need to have a few blood tests done to assess your overall health and ensure your body can handle the treatment. Share these test results with your doctor or coordinator at least a day before your appointment.
• Pre-Treatment Assessment: Once you are settled in, your vital signs will be checked, including height, weight, pulse, blood pressure, and oxygen saturation. A pre-chemotherapy assessment will be conducted to ensure you are ready for the treatment.
• Informed Consent: The procedure will be explained to you in detail. You will be asked to sign an informed consent form, which indicates that you understand the treatment plan and any associated risks.
• IV Access and Pre-Medications: An oncology-trained nurse will establish an intravenous (IV) line for administering the chemotherapy. Before starting the chemotherapy drugs, you will receive pre-medications to help prevent nausea, vomiting, and allergic reactions.
• Administration of Chemotherapy: Once the chemotherapy drugs have been prepared by a trained pharmacist in a sterile environment, they will be administered according to the prescribed protocol. This may take several hours, depending on the specific drugs and dosage.
• Support Services: During your treatment, you may have access to additional support services such as nutrition advice, physiotherapy, or psychological counselling, tailored to your needs.
• Food and Beverages: Meals and beverages will be provided during your chemotherapy session to ensure you stay nourished and comfortable.
• Discharge and Follow-Up: After your chemotherapy session is complete, you will be given a detailed discharge summary outlining what was done during the treatment. You will also receive instructions on how to care for yourself at home, including information on managing side effects and when to seek medical help.

By understanding these steps, you can feel more prepared and confident as you go through your chemotherapy treatment.

General Instructions after Chemotherapy

• Dietary Recommendations: Follow the dietary instructions provided by your doctor or dietitian. Eating a balanced diet can help support your recovery and overall health. It’s also advisable to consume hygienic, home-cooked meals to avoid foodborne illnesses. Focus on foods that are easy to digest and rich in nutrients.
• Hydration: Drink plenty of fluids to stay hydrated. This helps flush out the chemotherapy drugs from your system and can alleviate some side effects.
• Managing Side Effects: Be aware that you may experience side effects such as nausea, vomiting, constipation, or diarrhoea. Minor side effects are common, and you should follow the specific instructions provided in the information leaflet given to you. For nausea and vomiting, your doctor may have prescribed anti-nausea medications. Take them as directed to manage these symptoms effectively.
• Monitoring Your Health: Keep track of your symptoms and any side effects. If you notice any severe or persistent symptoms, such as a high fever, significant pain, or unusual bleeding, contact your healthcare team immediately.
• Rest and Self-Care: Allow yourself plenty of rest. Chemotherapy can be draining, so give your body time to recover. In addition, practise good hygiene to prevent infections, as your immune system may be weakened.
• Follow-Up Appointments: Attend all scheduled follow-up appointments with your healthcare team. These visits are important for monitoring your recovery, managing side effects, and adjusting your treatment plan if needed.
• Contacting Your Healthcare Team: If you have any concerns or questions after your chemotherapy session, don’t hesitate to reach out to your healthcare team. They are available to provide guidance and support.

By adhering to these instructions and staying in close contact with your healthcare team, you can better manage your recovery and address any issues that arise after chemotherapy.

Wrap Up

Chemotherapy remains a cornerstone in the fight against cancer, offering the potential for remission and improved quality of life for many patients. While the treatment comes with its challenges and potential side effects, advancements in medicine and supportive care continue to enhance its effectiveness and manageability. At Max Hospitals, we are committed to providing you with exceptional care and support throughout your chemotherapy journey. Our dedicated team is here to guide you, address any concerns, and ensure you receive the best possible treatment tailored to your needs.