Today we’ll talk about • How chemotherapy works • How to prevent and manage side effects • What to do if you get side effects • What to expect when you come in for treatment New Patient Chemotherapy Class What you need to know Class video available online: A class for new patients http://bit.ly/SMRCPchemoclass having chemotherapy (weblink is case sensitive) Last updated: September 1, 2017 1 2 Your supportive care team How does chemotherapy work? • Chemotherapy works by killing fast growing cells (cancer cells and healthy cells) • Side effects happen because healthy cells are affected • Time between treatments allow your healthy cells to recover We are here for you! Call 705-728-9090 x 43520 to meet with us. See flyer in your new patient package for more details, or visit www.rvh.on.ca 3 4
When do side effects start? Possible side effects of chemotherapy How long do they last? Hair loss/changes Chemotherapy • Side effects can happen any time during your treatment: Dry mouth affects fast growing immediately, or up to days afterwards cells Mouth sores Nausea • They will slowly disappear when treatment is over and Vomiting your healthy cells start to recover Diarrhea Constipation Remember : Low blood cell (Digestive system) counts Each person reacts differently to chemotherapy Fatigue Sexual health (blood cells) changes You may not get these side effects (reproductive system) 5 6 What to do when you have signs & symptoms: Symptom management phone service: Call the symptom management phone service what to expect Business hours After hours Cancer Centre CAREpath Monday – Friday Monday – Friday Symptom Support 8:00 am – 3:30 pm 6:00 pm – 8:00 am 1. Leave a message 1. A nurse will assess how you’re feeling and help Weekends and holidays 2. Triage clerk will call you you with your symptoms back to get more info 24 hours 2. You will need your 3. A nurse will assess how Cancer Centre CAREpath Patient Info Sheet you’re feeling and help (provided by Bayshore HealthCare Ltd) Symptom Support you with your symptoms 1-877-681-3057 (provided by the Simcoe Muskoka Regional Cancer Centre team) 4. You may be asked to • Have your Patient Info 705-728-9090 x79565 come to the Toxicity Sheet ready Assessment Clinic • Leave a message (Level 3, Cancer Centre) 7 8
What to do when you have signs & symptoms Low blood cell counts • Blood cell counts include: Use the My Health Diary – Red blood cells • Keeps track of how you’re feeling – White blood cells • Helps us understand your symptoms better – Platelets • Copies in Level 2 waiting room and www.rvh.on.ca • Your blood cell counts will be checked before each chemo treatment • The blood cell counts must be at a safe level for you to receive treatment • If the counts are not at a safe level, we will delay your treatment until it is safe 9 10 Low white blood cell counts – what to do If you get an infection – what to do Non-emergency issues: Fever Goal: prevent infections White patches/coating in mouth Temperature above Unusual sweating • Have a thermometer – check your temperature when 38.3ºC (100.9ºF) Diarrhea OR you feel unwell Burning feeling when urinating Above 38.0ºC (100.4ºF) for Severe cough/sore throat • Wash your hands often longer than an hour Chills • Stay away from people who are not feeling well • Keep skin clean and healthy Call Cancer Centre Symptom Call Cancer Centre Symptom Support or CAREpath Support or CAREpath You can also try: Go to nearest emergency if Walk-in clinic outside of phone hours Your family doctor Nearest emergency Bring Fever Card 11 12
Fever Card Fatigue (feeling tired) You will receive this card on • Most common side effect your first day of treatment. For help with fatigue: • One-on-one help with dietitian – call 705-728-9090 Important! x43520 to sign up Show this card each time • Watch video: you need to go to http://www.reframehealthlab. emergency com/cancer-fatigue/ Please note: • Book in Level 2 waiting room You still have to wait your You can go to the and www.rvh.on.ca turn in the ED. emergency department closest to your home and You may be asked to wear a you can still use this card. mask while waiting. 13 14 Nausea and vomiting Tips on preventing nausea and vomiting Drinking tips • Nausea and/or vomiting can happen after chemo treatment • Get enough fluids or a few days after. • Try: water, decaf tea, juice, jello, soup, popsicle, • If your treatment is likely to Gatorade cause nausea and/or vomiting, • Drink small amounts more often we will give you medications to prevent/control it. • Book in Level 2 waiting room and www.rvh.on.ca If your anti-nausea medication isn’t working, call Instead of: 1 big glass of Try: sips of water throughout the day 705-728-9090 x79565 water all at once (Symptom Line) • Limit caffeine and alcohol 15 16
Tips on preventing nausea and vomiting Diarrhea and constipation • Diarrhea – watery/loose bowel Eating tips movements • Eat small, frequent meals • Constipation - when your stools are hard/dry and difficult to pass • Talk to us if you have any changes or problems with your bowel routine • Books in Level 2 waiting room and www.rvh.on.ca Try: eating smaller amounts throughout the day Instead of: a big meal • Avoid sweet, fried or fatty foods • Try to avoid odors that bother you • Eat a light meal before your treatment 17 18 Oral health tips Hair loss • See your dentist before starting chemo, if possible • Hair loss can occur on all areas of the body. • Tell your oncologist or nurse before you have any dental • Your hair may thin or fall out work completely depending upon what type • Brush your teeth and gums with a soft toothbrush after of chemotherapy you are receiving every meal. Rinse toothbrush after use. • Ladies and Gents : ask us about hair prosthesis services in your community • Use salt and baking soda water rinse 4x per day • Ladies : attend a Look Good Feel Better session Call 705-728-9090 x43309 + + to register 1 L of water 1 teaspoon salt 1 teaspoon baking soda • Avoid commercial mouthwashes that contain alcohol 19 20
Let’s talk about sex… We’re here to help! • It’s okay to have sex while on treatment • Practice safe sex: avoid pregnancy Group classes Books in waiting • Avoid all body fluid contact from your loved one on areas Call 705-728-9090 chemo for 48 hours x43520 for – E.g. urine, stool, blood, vomit, semen and vaginal upcoming Ask Us SHIC Clinic sessions/register fluid About Private, confidential and – Use a condom (free condoms at the chemo clinic) Sex! professional support. Book an appointment: 705-728-9090 x43520 21 22 What to bring for your chemo visit • New Patient Package • Patient Info Sheet • Health Card • Appointment Sheet • List of medications • List of questions for your Care How to prepare for your treatment Team • My Health Diary • Lunch/snacks • Earphones • No pets 23 24
The 2-day system at the What to tell us Regional Cancer Centre (RVH) Video showing the 2-day system at RVH: • Changes to your medications http://bit.ly/SMRCPchemotour1 – Prescription medications Check-Up Day Treatment Day – Herbal medications 1. If doing bloodwork at Cancer 1. Come 15 mins before appt – Naturopathic remedies Centre, come 2 hours before time doctor appt time 2. Register on Level 3 – Over-the-counter medications 2. Register with a clerk on 3. Receive your chemotherapy • Changes to/new allergies Level 2 treatment • Any cancer-related symptoms – Ask for a pager 3. Have bloodwork done • Other hospital or emergency department (ED) visits 4. Complete symptom screening (since we last saw you) 5. Assessment by a nurse 6. See your oncologist Symptom screening kiosk 25 26 Symptom Screening When: a t each visit with a care Why? provider (e.g. doctor, nurse, social • Helps us manage your care worker, dietician) • Track how you are feeling • Help you with your symptoms early Helpful tips from patients and Using kiosk Using tablet caregivers Brought to you by: We see it Speak to us if your in your symptoms are not getting electronic addressed. chart. 27 28
Helpful tips Need a ride? Tired of driving? Canadian Cancer Society Stay at the Rotary House Wheels of Hope volunteer Cancer Lodge at RVH driver service $15/night $100 - $200 flat rate call 705-739-5662 1-800-263-6750 or visit www.rvh.on.ca Thank you! Buy multi-use Questions? Save your receipts and parking pass at RVH keep a travel log 10-day pass $80 for tax time. Visit the RVH parking office or a pay station 29 30 For more information: Online videos Supporting You Through Chemotherapy Class (27 mins) • http://bit.ly/SMRCPchemoclass Cancer Centre tour & 2-day system for chemo (6 mins) • http://bit.ly/SMRCPchemotour1 Tips from your fellow patients (5 mins) • http://bit.ly/SMRCPchemotips Other online resources : Simcoe Muskoka Regional Cancer Centre www.rvh.on.ca Canadian Cancer Society www.cancer.ca Cancer Information Services hotline, Peer Support, and list of Community Services 1-888-939-3333 31
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