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Overview of Chemotherapy
Taken from Gyn/OB department handout.
Chemotherapy Treatment

Each drug attacks the cancer cells in different ways. Sometimes several drugs are used in combination. Cancer-fighting drugs may be given by mouth, injected into the muscle, injected directly into the bloodstream, topically applied to the skin, or intraperitoneally (putting drugs into the abdomen).

Your doctor decides how many treatments you will need based on the type of cancer, the drugs you receive, the tumor's response to those drugs, and how well you tolerate the side effects.

It is very important to remember that most side effects of chemotherapy are temporary and will gradually disappear after the treatment stops.

Cancer chemotherapeutic agents are distributed throughout your whole body. These agents not only affect cancer cells. They also affect normal cells that are rapidly dividing, such as cells in the digestive tract (mouth, stomach, and intestines), bone marrow and hair follicles, and therefore may cause side effects.

Potential Side Effects in the Digestive Tract
(Mouth, Stomach, and Intestinal Cells)

If digestive tract cells are affected, you may experience nausea, vomiting, diarrhea, constipation, mouth and throat soreness, or lack of appetite. Some suggestions to combat these problems are:

  • Eat foods served cold or at room temperature.
  • Eat small frequent meals.
  • Suck on hard candies.
  • Eat toast or candies upon rising in the morning.
  • Drink carbonated beverages.
  • Avoid fried, sweet, spicy, or highly salted foods.
  • For constipation: Drink lots of fluids daily and eat a high fiber diet.
  • For diarrhea: Eat low-residue, low-fat diet.
  • For mouth and throat soreness: Avoid highly acidic foods and rinse with a solution of one tsp. of baking soda and one cup of warm water.

If these problems persist, your physician may prescribe a medicine to relieve a specific problem. Remember, it is not unusual for your senses to be affected by chemotherapy. Things may not taste the same, odors may be unpleasing. It is important to remember to eat as much as you want of those things that are appealing to you. Well-balanced meals that are high in vitamin C, calories, protein, and iron may help your body tolerate the chemotherapy better. If you need assistance in deciding the best diet for you, your nurse may have the dietician speak with you.


Effects on Bone Marrow

White blood cells (WBC), red blood cells (RBC) and platelets are produced in the bone marrow. The effects of chemotherapy on your bone marrow will usually appear some seven to 14 days after your treatment. A reduction in WBC means you are more susceptible to infections. Symptoms include: temperature of 100F/38C or higher, chills, loose stools for more than two days, cough, pain, or frequency during urination. You will need to notify your doctor if any of these symptoms are experienced. You may wish to avoid crowds to prevent acquiring contagious diseases.

A reduction in RBC means your body tissues may not be getting oxygen and you will feel tired, dizzy, chilly, have a headache, or become short of breath. You should notify your doctor if these symptoms occur.

A reduction in the number of platelets could cause nosebleeds, bleeding gums, increase in bruising, black tarry stools, or the inability to form scabs after a small injury. To avoid injury while platelet count is low, avoid sharp objects, aspirin, or aspirin-containing products, enemas or rectal medicines, harsh toothbrushes. Also, if dental work is needed, inform your dentist that you are receiving chemotherapy. Your physician will order regular blood tests to monitor the chemotherapy's effects on your bone marrow. It is very important that you have your blood drawn on the scheduled dates.

Temporary Hair Loss

While most types of chemotherapy affect hair follicles all over the body, this is temporary, and when treatment has stopped, hair growth will resume in the scalp, face, eyebrows, armpits, pubic area, and legs.

Hair loss is usually not gradual. About two weeks after your first treatment you will notice thinning of hair. Your scalp also may be sore. Once this happens, your hair will begin to thin more rapidly. Some patients wear scarves and others prefer wigs. Wear whatever is comfortable.

Generally when you begin chemotherapy treatments, you will have days when you feel well, and other days when you feel tired and not feeling as well. You can best judge how you feel and what activities you feel capable of doing. Do as much or as little as you feel up to doing. During chemotherapy you should continue your usual lifestyle and normal activities.

If you decide that you will need assistance at home, our social worker may be helpful. Home health care can be arranged. You will complete your chemotherapy regimen, with the help, support, and encouragement of your family, friends, and the medical team.

Straight Talk about Side Effects
Sean Patrick , OvCa Survivor
Before starting chemo most people are concerned whether they will have side effects and what they will be like. Every person does not get every side effect and some people hardly get any. How severe the side effects are varies greatly from person to person. Before starting chemo ask your doctor about which side effects are most likely to occur, how long they will last, how serious they might be and when you should seek medical attention.

Anti-cancer drugs are designed to kill the rapidly growing and dividing cancer cells. But certain normal cells also multiply quickly and these are the cells that chemo is most likely to affect - cells in the digestive track, the reproductive system, blood cells in the bone marrow and hair follicles. This is why chemo patients lose their hair during treatment.

The most common side effects are vomiting, nausea, hair loss and fatigue. Other effects include an increased chance of bleeding, infection or anemia. Less common but possible are hearing loss, ringing in the ears, nerve damage, numbness or tingling in the fingers and toes (neuropathy), kidney damage and allergic reaction.

Most side effects from treatment are temporary and will go away once therapy ends. However some ovarian cancer therapies may cause kidney damage. This may be prevented by drinking lots of fluids.

The good new is most of the side effects can be managed. The anti-nausea drugs currently being used are far superior than those even a few years ago. Most patients undergoing chemo now experience very little nausea and vomiting. Two relatively new drugs, epoetin alpha and Nupogen, help with combating the fatigue of anemia and the threat of infection from a low white cell count.

The best way to make sure you are taking care of yourself is to make sure you discuss any side effects with your doctor or oncology nurse so they can develop a treatment plan to minimize their effects on your life. If you are still concerned ask your doctor if he/she has any patients you can talk to who have been through your type of chemo. Talking to people first hand can help alleviate any fears you might have.

Questions and Answers About Chemotherapy
Sharon Thompson, RN, OCN , Johns Hopkins Oncology Nurse

Coping with Chemotherapy Side Effects

Chemotherapy and You (CancerNet)

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