Tips for Patients

Tips for Patients

Tips to help patients with lung cancer and their family members to manage the treatment process

Post-Chemotherapy Care

Chemotherapy or chemo is designed to kill fast-growing cancer cells.14 But it can also affect healthy cells and cause side effects. Some common side effects from chemo are fatigue, nausea and vomiting, diarrhea or constipation, loss of appetite, skin rashes, mouth sores, hair loss, and infections.14

 

Every person does not get every side effect, and some people get only few.14 Most side effects will go away after chemo is over but sometimes it can take months or even years for them to subside.14 However, there are ways for patients to manage these side effects.

 

- Fatigue from chemo: It can range from mild tiredness to feeling completely wiped out. It is different from feeling tired after a long day and does not get better with rest or sleep. Things that may help with fatigue are:15

  • Get plenty of rest, and allow time during the day for rest periods.
  • Eat a well-balanced diet, and drink plenty of liquids.
  • Limit activities; do only the things that are most important.
  • Get up slowly to help prevent dizziness after sitting or lying down.
  • Get help by asking family, friends, and neighbors when needed.

- Nausea and vomiting: These may start during treatment and last a few hours. Sometimes, severe nausea and vomiting can last for a few days. Be sure to tell a doctor or nurse if nausea has become intolerant, or if patients have been vomiting for more than a day. Things that may help with nausea and vomiting are:15

  • Avoid big meals. Eat frequent, small meals throughout the day.
  • Drink liquids at least an hour before or after mealtime instead of with meals.
  • Eat and drink slowly. Chew food well for better digestion.
  • Stay away from sweet, fried, or fatty foods.
  • Rest in a chair after eating, but do not lie flat for at least 2 hours after a meal.
  • Breathe deeply and slowly when you feel nauseated.

- Mouth sores: Chemotherapy may cause mouth sores, increase of bacteria in mouth, and chances of mouth infections.16 Things that may help with mouth sores are:15,16

  • Brush teeth with a soft bristled brush 2-3 times a day, and use a toothpaste with fluoride.
  • Rinse mouth 4 times a day with a salt and baking soda solution (mix one half teaspoon of salt and one half teaspoon of baking soda in 8 ounces or 240 mL of water).
  • Do not use mouth wash which contain alcohol. Please consult a doctor for the most appropriate mouth wash.
  • Foods high in salt, vinegar which can aggravate sores should be avoided.  Soft foods, such as papaya, fish, egg and tofu, are good options if patients are having difficulty in eating. 

- Hair loss from chemo: Some chemo drugs can cause hair to become brittle. The degree of hair loss depends on the medication used, dosage and length of treatment. Hair loss may continue throughout treatment and up to a few weeks after chemo ends.14 Things that may help with hair loss are:14,15,17

  • Before treatment, patients may consider cut hair short or shave head, and should take care to avoid bleaching, colouring, and perming hair.
  • During treatment, continue gentle hair care throughout chemo treatment. Wash hair only as often as necessary, use mild shampoos and soft-bristle hair brushes, and low heat if a hair dryer is used. Don’t use brush rollers to set hair.
  • After hair loss, protect scalp by using a sunscreen, hat, scarf, or wig when going outside. Use a satin pillowcase which creates less friction than cotton when sleeping on it.
  • Although hair loss may be stressful, patients should maintain a relaxed attitude to avoid additional stress Try to talk to a doctor, nurse, family member, close friend, or someone who has had hair loss caused by cancer treatment if needed, and remember that hair will grow back after treatment ends.

- Infections: Chemotherapy may reduce white blood cell (WBC) count over an extended period, weakening the patient’s immune system. During this period, patient may be more susceptible to illnesses or infections. Things that may help prevent infections are:15,16

  • Safe eating and drinking by avoiding raw foods, or anything that may be undercooked or spoiled.
  • Wash hands often during the day, especially before meals and after the use of toilet. 
  • Clean rectal area very well but gently after each bowel movement.
  • Keep house clean. Stay away from crowds, and stay away from people who have diseases, such as colds, flu, measles, or chicken pox.
  • Do not get any immunization shots (vaccines) without first checking with a cancer doctor.
  • Be careful with pets and animals. Do not play rough with cats. Scratches and bites can get infected. Stay away from puppies, kittens, and other very young animals.
  • Consult a doctor if patients suffer from any of the following symptoms:
    • Fever over 38°C
    • Chills
    • Prolonged diarrhea
    • Prolonged vomiting
    • Burning feeling when urinating
    • Severe cough or shortness of breath
    • Bleeding or unexplained bruising
    • Rash or signs of a possible allergic reaction, such as swelling, severe itching or wheezing

 

 

 

 

 

14. NCI. Chemotherapy and You. NIH Publication No. 11-7156. Printed June 2011. Updated 2018 version available at: https://www.cancer.gov/publications/patient-education/chemotherapy-and-you.pdf. Accessed: 6 May 2019.

15. ACS. A Guide to Chemotherapy. June 2015. Updated version available at: https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy.html. Accessed: 6 May 2019.

16. MedilinePlus. After Chemotherapy - Discharge. Available at: https://medlineplus.gov/ency/patientinstructions/000012.htm. Accessed: 6 May 2019.

17. Mayo Clinic. Chemotherapy and Hair Loss: How to Make the Best of It. Available at: https://www.mayoclinic.org/tests-procedures/chemotherapy/in-depth/hair-loss/art-20046920. Accessed: 6 May 2019.