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Preparing for chemotherapy
Preparation begins once the doctors and the person with cancer decide that chemotherapy is an option.
The medical oncologist is a cancer specialist who oversees chemotherapy treatment and works with other members of the healthcare team to plan and deliver treatments. To help plan the treatment, the medical oncologist will usually:
- take a personal health history and perform a physical examination to identify conditions that could affect chemotherapy
- For example, some people may not be good candidates for certain types of chemotherapy if they have underlying lung, heart, liver or kidney diseases.
- review all test results and surgery and pathology reports
- order additional tests to make sure a person is fit enough to have chemotherapy, including:
- Urinalysis is used to check kidney function.
- Blood tests are done to assess blood counts, blood clotting, and liver and kidney function.
- Electrocardiogram (ECG) is used to check the heart (especially if the drugs given could affect heart function).
- Imaging tests can determine the size and location of tumours and if nearby organs or lymph nodes are affected.
- arrange for any other healthcare professionals needed to help prepare for chemotherapy treatment
- For example, a registered dietitiandietitianA healthcare professional who specializes in food and nutrition. can help if treatment will affect what a person can eat or the appetite.
Preparation depends on the type of chemotherapy being planned and how it will begiven.
- Special medicines are often given about 20–30 minutes before chemotherapy. These drugs help reduce side effects, such as nausea and vomiting. They are sometimes called premedications.
- Many chemotherapy drugs are given into a vein (intravenously, or IV), so an IV needle or catheter is inserted.
- Sometimes a special type of soft, flexible catheter, called a central venous cathetercentral venous catheterA catheter (flexible tube) that is passed through a vein in the neck, groin or chest into the vena cava (the large vein leading into the heart)., is used to deliver the drugs. It may be used especially if chemotherapy will be given over a long period of time, if the drugs will damage the veins or if it might be difficult to start an IV. This catheter is put into a large vein and may be implanted under the skin. It stays in place for as long as it is needed.
The medical oncologist decides what type of chemotherapy drugs to use and determines the dose, schedule and length of treatment. These will depend on:
- the type of cancer
- the goal of the treatment
- the stagestageA description of the extent of cancer in the body, including the size of the tumour, whether there are cancer cells in the lymph nodes and whether the disease has spread from its original site to other parts of the body. of the cancer
- the person’s age
- the body surface area, or BSA (calculated using height and weight)
- the person’s overall health
- other types of cancer treatment given or planned
- how the person responds to chemotherapy
People often want to know if they need to do anything special to prepare for chemotherapy treatment. To help cope and recover from chemotherapy:
- Eat a well-balanced diet high in calories and protein to get the energy and nutrients your body needs to heal.
- Get lots of rest.
- Let the doctor or healthcare team know if you are taking any medicines and natural health products, including over-the-counter medicines, antioxidantsantioxidantsAny substance that help protect cells from damage caused by free radicals (unstable molecules made during metabolism, which is the chemical processes needed for cell function, growth and reproduction). or high doses of vitamins or minerals. Some of these products may interfere with the effectiveness of chemotherapy drugs or increase side effects. The benefits or harmful effects of using these products during or shortly after treatment are not fully known.
- Don’t smoke. Studies have shown that people with certain types of cancer are at a greater risk of their cancer recurring (coming back) and of new cancers developing if they continue to smoke. Smoking can also reduce a person’s appetite and can worsen some side effects (such as a sore mouth).
When children are diagnosed with cancer, both children and their family have questions and concerns about chemotherapy. They want to know how it is given and how to manage side effects. Being prepared and knowing what to expect when chemotherapy is given to children can reduce anxiety for both children and parents. Parents and caregivers can prepare and help children cope with chemotherapy by giving them explanations that are appropriate to their age and maturity.