Chemotherapy

How does chemotherapy work?

Cancer cells divide and multiply in an uncontrolled way. Chemotherapy can destroy cancer cells or stop them from growing.

Chemotherapy may also affect your healthy cells and lead to side effects that will be managed or prevented by your care team. Please speak to your doctor to learn more.

How long is my treatment plan?

The length of a treatment plan varies depending on your needs and your doctor's recommendations. You may require chemotherapy, immunotherapy, or a combination that could include radiation and/or surgery. There may also be other types of therapy that are recommended after this treatment such as hormone treatment or targeted therapy. Please ask your oncologist for more information.

Chemotherapy treatment plans usually include many cycles. Each cycle includes the treatment day and the recovery days after treatment. Some cycles include multiple treatment days and rest days. Ask your doctor or nurse what your chemotherapy cycle is.

Your plan will depend on:

• the type of cancer you have
• the stage of your cancer
• the side effects you experience
• how your cancer responds to drugs

We will create a plan that is tailored to your specific needs.

How long is each chemotherapy treatment?

Treatment time varies depending on the type of drugs you receive. A treatment can range from 10 minutes to six hours.

How is chemotherapy given?

The way you receive your chemotherapy will depend on the kind that is prescribed for you. You may receive chemotherapy as an outpatient in the clinic or, in some cases, you may be admitted to the hospital.

Chemotherapy may be given:

• orally (by mouth as a tablet or capsule)
• intravenously (e.g. through an IV, PICC line, port, or other means)
• subcutaneously (by needle injection under your skin or into your muscle)

Nausea and vomiting

Nausea is when you feel queasy or sick to your stomach; vomiting is when you throw up.

Nausea and vomiting symptoms may begin within hours of chemotherapy and may last for several days. Not everyone will experience nausea or vomiting. These side effects can be caused by your treatment or the type of cancer you have. Your care team will work towards providing you with medications to try and prevent nausea and vomiting. The medications that are given to prevent and treat nausea and vomiting may also be caused by constipation.

To manage nausea and vomiting after chemotherapy:

• take your medications for nausea and vomiting exactly as directed by your oncologist. Do not wait for nausea to get worse before taking your medication.
• phone your oncologist, nurse or pharmacist if nausea is severe, lasts longer than 48 hours, is not improved with your nausea pills or if you have vomited several times in that day.
• drink fluids often and eat small amounts every two to three hours throughout the day.
• avoid hot, fatty or spicy foods. If the smell of certain foods makes you feel sick, have someone else cook the meal or eat the food cold.
• relax after eating, but do not lie down flat.

For more information, a “what to eat” booklet is available in the clinic. You can also speak with a dietitian if you are experiencing nutrition problems related to nausea or vomiting or are concerned about your diet. If needed, your oncologist can refer you a registered dietitian.

Fatigue

Fatigue is more than feeling tired. Feelings of fatigue do not go away after a rest or a good night's sleep. If you experience fatigue, you may quickly feel tired from doing things like showering, cooking, going for a short walk or climbing stairs. You may also have a hard time concentrating or remembering things.

You may feel fatigue from the cancer itself, the chemotherapy or treatment protocol, or for other reasons. If you are experiencing fatigue, please share this with a member of your cancer health care team.

Loss of appetite

You may not feel like eating for a few days after chemotherapy. If you can, try to eat small amounts of food as this can ease some of your side effects and give you energy. This is especially important if you have diabetes.

If your tastes have changed, consider adding spices for flavour. Drink fluids that provide you with calories and protein, such as milk, soy beverages, smoothies, and liquid nutritionals (e.g. Ensure, Boost). You can meet with a registered dietitian if you are experiencing any nutrition problems or have questions or concerns about your diet. Please speak to your oncologist about a referral.

You can also review the “what to eat” booklet available in the clinic for more helpful information.

Mouth soreness or discomfort

Chemotherapy can damage the cells that line your mouth and throat and can make eating difficult. Chemotherapy can cause:

• dryness or soreness in your mouth, tongue or throat
• mouth sores
• infection in the gums, mouth or throat

Strategies are available to help prevent and soothe such symptoms. Please ask your nurse for details.

Stomach soreness or discomfort

Chemotherapy can irritate your stomach. If you have a history of ulcers or problems with acid or heartburn, discuss your concerns with your nurse or oncologist. Inform your doctor or nurse if you are suffering from indigestion, heartburn, gas or stomach pain.

Hot, spicy and acidic foods (tomatoes, citrus fruits), caffeine, alcohol and tobacco can worsen the problem. You can also discuss medication options with your oncologist or pharmacist.

Change in bowel habits

Both constipation (difficulty having a bowel movement) and diarrhea (loose, watery stools three or more times a day) can be side effects of certain chemotherapy drugs. And constipation can be a side effect of pills taken for nausea and vomiting. Both should be discussed with your oncologist or nurse if they last more than a few days.

Sexual health

Many people with cancer wonder how the disease and treatment might affect their ability to have and enjoy sex. They want to find ways to make sure that they can have the kind of sex life they want during and after treatment.

Having cancer can raise many new questions about safety and sex. The answers depend on your treatment. Hugging and cuddling with your partner is almost always okay, but ask your doctor if there are times when you should not have sex and what you should do to protect your partner and yourself when you do. For example, your doctor may advise you to avoid having sex with penetration for a few weeks after surgery or if you are at risk of bleeding or catching an infection. Your doctor may also tell you to use a condom or other barrier for a number of days after chemo to protect your partner from drugs that can get into semen or vaginal fluids.

Sexual changes are different for women and men. Please speak to your doctor or nurse for more information.

Pregnancy

Avoid getting pregnant or getting someone pregnant while you are being treated for cancer. The treatment you need may harm the baby. Talk to your doctor about what kind of birth control to use during treatment. If you think you would like to have a child in the future, talk to your health care tam before you start treatment. Treatment could affect your ability to get pregnant or to get someone pregnant.