What to Expect: Chemotherapy

You have received a cancer diagnosis. Now what happens?

Before your treatment begins, your medical oncologist will meet with you to review your medical records and perform a physical exam. Based on the size and location of your cancer, your age, your health and a number of other factors, your doctor will work with you to develop a personalized treatment plan. This plan may include chemotherapy, which can be administered either orally or intravenously. The doctor will discuss the potential risks and benefits of chemotherapy with you. If you decide to receive chemotherapy, you will be asked to give written permission, called "informed consent." This consent form confirms that you have received information about your treatment plan and any potential side effects. It also confirms that you are willing to undergo therapy.

What should you expect during your chemotherapy treatment?

We will draw blood and review the results before your chemotherapy begins. The medication must be mixed by a pharmacist. This all takes time so please be patient. Your safety is of the utmost importance to us. Your nurse will access your Power Port or Mediport if you have one. A port is a small medical appliance that is inserted beneath the skin, usually in the chest area. A catheter connects the port to a vein so medications can be administered into the blood stream. If you have a port, please wear a button-down top to assure easy access to the port site. This helps to maintain a sterile environment and to prevent infection. You may be asked to remove your shirt if necessary. A gown will be provided for your comfort. If you do not have a port, a nurse will start an IV in your arm.

Your treatment includes fluids, pre-chemotherapy medications to prevent side effects such as nausea or a possible allergic reaction. This will be followed by the actual chemotherapy medications. Depending on your lab results, you may need other medications or replacement therapy. Your nurse will closely monitor you and explain procedures or answer any questions you may have. You may need to return to the office another day for injections to boost your blood count or for labs to monitor your blood count. The doctor may simply want to check on how well you are tolerating the treatment. After your chemotherapy session is finished, the IV catheter will be removed. Your nurse or physician will review possible side effects.

Your physician may prescribe medications to manage side effects. You will be given a schedule for medications that may need to be taken. If your chemotherapy is an oral medication, we will order the medication through a specialty pharmacy and dispense it to you in our office with specific instructions. We will carefully monitor you in our office through appointments with a physician and lab work. After your treatment or office appointment, we will give you a form with your next appointment. Please take this form to the front desk so your appointment can be scheduled. We will be give you the office phone number. We have an answering service that is available 24 hours a day, seven days a week. Do not hesitate to call our office with any concerns. No concern is too small to be addressed. Possible concerns that should be reported include: diarrhea, fever greater than 100.2, uncontrolled nausea, vomiting, not eating or drinking, bleeding, fatigue or pain.

Blood pressure photo

What should you expect after your chemotherapy treatment?

In 7-10 days after your chemotherapy treatment, your blood count may drop. This is called NADIR — when your count is at its lowest. White blood cells fight infection, hemoglobin, HGB, carries oxygen through the blood and platelets help the blood to clot. Please take your temperature at this time and call our office if your temperature is greater than 100.2. It is important to stay away from people including children who are sick. Stay away from crowded areas such as stores, schools, etc. Wash your hands frequently.

Helpful Guidelines to Assist During Your Treatment
  • Arrive at your scheduled time. Check in at the front desk. Please bring your insurance card, photo ID and medication list with you. Take a seat in the waiting room. Please note that there are many doctors who work here. Patients are coming for many different reasons. A nurse will escort you to either the treatment or exam area based on the reason for your appointment and your scheduled appointment time.
  • Do not make other appointments the same day of your treatment day unless you need to combine radiation and chemotherapy. You may need to be here for most of the day. You may bring a friend or family member to offer moral support and comfort. Space limits only one family member or friend in the treatment area. It is good to have someone drive you for your first treatment. Some medications may make you sleepy or cause other side effects that may make driving difficult.
  • Take your medications as you would normally take them. If you require pain medication, please bring that with you as pain medication is not supplied in our office.
  • Eat a light breakfast. You do not have to fast for blood work. We have a snack area stocked with coffee, water, soda and snacks and we provide a boxed lunch for patients. There is also a cafeteria and snack shop on site for the convenience of family and friends.
  • For chemotherapy treatments, a TV is available in every room. You may also bring books, music or puzzles to make your treatment time more relaxing.
  • If you are tired, rest and ask for help if necessary. Please keep your appointments and have labs checked as recommended.
  • You may not see your doctor every visit during treatment, especially if everything is going well and according to plan. Your doctor is always available if you would like to see him or her if you have any questions or concerns.

Glossary

Medical oncologist: a doctor who specializes in diagnosing and treating cancer. This doctor will oversee your treatments and work closely with other members of the oncology team to develop your treatment plan.

Certified Registered Nurse Practitioner: an advanced practice registered nurse who has completed additional training beyond that of a registered nurse (RN).

Nurse practitioners help coordinate care with the physician by evaluating patients, ordering tests and prescribing medications.

Oncology nurse: specializes in caring for patients with cancer, including administering chemotherapy. Your nurse is there to offer support to you and your family, answer questions, provide information about your treatment, monitor your health during treatment and work with you to manage potential side effects.

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