Dos and Dont's in Chemotherapy

Chemotherapy Treatment

Chemotherapy drugs are medicines used to treat cancer. These drugs either kill cancer cells or prevent their growth and division. Chemotherapy treatment may be given before or after surgery or in combination with radiotherapy. In advanced cancer, chemotherapy may be used to slow down cancer growth and help control the spread of the disease.

How You Prepare for Chemotherapy

How you prepare for chemotherapy depends on which drugs you will receive and how they will be administered. Your doctor will provide specific instructions before your treatment. You may need to:

• Have a device surgically inserted before intravenous chemotherapy: If you will receive chemotherapy intravenously, your doctor may recommend a device such as a catheter, port, or pump. A catheter or port may be inserted into a large vein, usually in the chest, to administer chemotherapy drugs. These devices are not necessary for every patient but may be recommended for certain treatment plans involving repeated or prolonged intravenous therapy.
• Undergo tests and procedures to ensure your body is ready: Blood tests to check kidney and liver function, along with heart tests when indicated, can help determine whether your body is ready for chemotherapy. If a problem is identified, your doctor may delay treatment or adjust the chemotherapy drug or dosage to improve safety.
• Visit your dentist: Your doctor may recommend a dental examination to identify signs of infection. Treating existing dental infections before chemotherapy may help reduce complications, particularly because some chemotherapy drugs can weaken the immune system.
• Plan ahead for possible side effects: Ask your doctor about the side effects you may experience during and after chemotherapy. If treatment may affect fertility, discuss options for preserving sperm or eggs before starting treatment. If hair loss is expected, you may wish to arrange a suitable head covering.
• Make arrangements for help at home and work: Many chemotherapy treatments are given on an outpatient or day-care basis, allowing patients to continue some of their usual activities. However, the effects of treatment vary from person to person. Ask your doctor whether you may need time off work or assistance with household responsibilities, childcare, pets, or other commitments.
• Prepare for your first treatment: Ask your doctor or chemotherapy nurse how to prepare for your first session. Arrive well-rested and follow any dietary instructions provided by your healthcare team. A light meal may be suitable for some patients, depending on the treatment and individual circumstances. Consider asking a friend or family member to accompany you, especially for your first session, as some medicines may cause drowsiness or other effects that make driving unsafe.

Dos During Chemotherapy

1. Maintain good personal hygiene: Keep your body clean and follow the hygiene recommendations provided by your cancer care team.
2. Avoid crowded places when necessary: You do not need to stop socialising, but take precautions when your immunity is low. Avoid close contact with people who are sick, and follow your doctor's advice about reducing infection risks.
3. Adopt a healthy lifestyle:
   • Aim for 7–8 hours of sleep each night, or as much rest as your body needs.
   • Follow a balanced diet that provides the nutrients your body requires.
   • Limit foods high in saturated fats and choose nutritious food options.
   • Maintain a healthy weight with guidance from your healthcare team.
   • Stay physically active and exercise according to your energy levels and your doctor's advice.
   • Include fresh fruits and vegetables when they are safe for you to eat.
   • Obtain antioxidants and other nutrients from a balanced diet. Consult your doctor before taking antioxidant supplements.
   • Learn to recognise warning signs and symptoms that require medical attention.
4. Communicate with your cancer care team: Inform your doctor or nurse about any side effects or unusual symptoms during chemotherapy. Common side effects may include:
   • Nausea
   • Vomiting
   • Diarrhoea
   • Hair loss
   • Loss of appetite
   • Fatigue
   • Fever
   • Mouth sores
   • Pain
   • Constipation
   • Easy bruising or bleeding

   Many chemotherapy side effects can be prevented or managed with appropriate treatment. Some improve after treatment ends, although recovery time varies.

   Long-lasting and late-developing side effects: Some chemotherapy drugs may cause complications that become apparent months or years after treatment. Depending on the medicines used, these may include:

   • Damage to lung tissue
   • Heart problems
   • Infertility
   • Kidney problems
   • Nerve damage (peripheral neuropathy)
   • An increased risk of developing a second cancer

   Ask your doctor about your individual risk of late side effects and the symptoms you should watch for after completing treatment.

5. Clean your body daily: Take a bath or sponge bath as appropriate. Pay particular attention to areas that become sweaty, such as the underarms, skin folds, and intimate areas. Use gentle products and avoid irritating sensitive skin.
6. Maintain a positive attitude: Seek emotional support from family, friends, support groups, or a mental health professional when needed.
7. Eat fresh, properly handled food: Follow food safety practices and your healthcare team's dietary recommendations to reduce the risk of foodborne infections.
8. Practise hand hygiene: Wash your hands regularly and use hand sanitiser when appropriate. Follow your surgical team's instructions for caring for wounds and surgical sites.
9. Keep your nails trimmed and clean: Avoid cutting your cuticles or causing injuries around your nails, as these can increase the risk of infection.
10. Take prescribed medicines on time: Follow your doctor's instructions regarding chemotherapy medicines, supportive medicines, and other regular prescriptions. Do not change or stop medicines without medical advice.
11. Moisturise dry skin: Use a gentle, fragrance-free moisturiser to help relieve dryness and itching that may occur during chemotherapy. Inform your doctor about persistent rashes, skin irritation, or other changes.
12. Maintain adequate hydration: Drink fluids regularly throughout the day. The amount you need depends on your treatment, body condition, and other medical problems. A target of 2.5–3 litres per day may not be suitable for everyone, particularly people with kidney or heart conditions, so follow your doctor's advice.
13. Stay physically active: You may not have the stamina for strenuous exercise during treatment. Gentle walking, stretching, or other suitable activities can help maintain mobility and fitness. Adjust your activity to your energy levels and medical advice.
14. Seek counselling and attend follow-up appointments: Consider counselling if you need emotional support. Continue regular medical check-ups during and after chemotherapy to monitor recovery and identify potential complications.

Don'ts During Chemotherapy

1. Do not eat a heavy meal immediately before treatment if it makes you uncomfortable: Some patients find a light meal easier to tolerate. Follow your doctor's instructions, especially if fasting is required for a particular procedure or medicine.
2. Do not use tobacco or arecanut in any form: Avoid tobacco products and arecanut, including products such as betel quid containing these ingredients.
3. Avoid second-hand smoke: Stay away from smoking areas and avoid close exposure to other people's tobacco smoke.
4. Avoid alcohol unless your doctor confirms it is safe: Alcohol may interact with certain medicines or worsen treatment-related side effects. Ask your healthcare team whether you should avoid it completely.
5. Limit foods that worsen your symptoms: Avoid spicy, fried, heavily processed, or junk foods if they aggravate nausea, indigestion, or other symptoms. Limit salt-preserved foods, such as pickles, and avoid very hot beverages. Follow any dietary restrictions recommended by your doctor.
6. Do not ignore stress or emotional distress: Seek support when you feel overwhelmed. Relaxation techniques, counselling, and support from loved ones may help you cope with treatment.
7. Avoid prolonged inactivity: Rest when needed, but try to maintain gentle physical activity if your doctor considers it safe.
8. Avoid excessive sun exposure: Some chemotherapy drugs make the skin more sensitive to sunlight. Wear protective clothing, seek shade, and use a broad-spectrum sunscreen as recommended by your healthcare team.
9. Limit carbonated or cold drinks if they trigger symptoms: Choose fluids that you can tolerate comfortably and maintain adequate hydration.
10. Do not share personal items unnecessarily: Avoid sharing towels, razors, toothbrushes, and other personal hygiene items. This helps reduce the risk of spreading infections.
11. Wash fruits and vegetables thoroughly: Clean produce under safe running water and follow your cancer care team's instructions for food preparation.
12. Do not eat spoiled or improperly stored food: Follow food storage and refrigeration guidance. Do not consume food that has been left at unsafe temperatures or shows signs of spoilage.
13. Avoid raw or undercooked foods when infection risk is increased: Depending on your treatment and immune status, your doctor may recommend avoiding raw vegetables, unpasteurised products, and other foods that carry a higher risk of contamination. Ask your healthcare team which precautions apply to you.
14. Do not eat raw or undercooked meat, fish, or eggs: These foods may contain harmful microorganisms. Cook them thoroughly and follow safe food handling practices to reduce the risk of infection.

Important: Chemotherapy affects each patient differently. These recommendations are general guidance and should not replace advice from your oncologist or cancer care team. Contact your healthcare team promptly if you develop a fever or other signs of infection during chemotherapy. Follow the specific temperature threshold and emergency instructions provided by your treatment centre.