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Starting chemotherapy - information for patients | UHL NHS Trust
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hello and welcome to the new case talk
for patients starting chemotherapy
you should be attending this talk if you
have been told by a consultant that
you'll be starting a course of
chemotherapy
you may have received a pack in the post
which has given you information
regarding your appointment for your new
case talk your treatment and also when
you'll be seeing the doctor
you will have also received lots of
information leaflets on how to stay well
during treatment
so what to expect from today's new case
talk
this talk will provide information and
guidance for friends and family and
yourself on how to stay well during
treatment
we will also give you specific
information about your treatment and
including any other questions that you
may have
after watching this presentation you
will get a quote from one of our nurses
and on the time slot specified in your
pack
this appointment is for 15 minutes and
this is where the nurse will speak to
you about any concerns you may still
have after watching this presentation
the nurse will also speak to you about
possible side effects for your
individual treatment
this talk is also to help answer any
questions which you may still have
regarding starting chemotherapy
feel free to make some notes and jot
down any questions which you may have
that is not clear in these slides or you
may have that do not get answered during
this presentation
so what is chemotherapy
chemotherapy is a drug use for the
treatment of cancer
chemotherapy can either destroy cancer
cells or chemotherapy can slow down or
reduce the multiplication of cancer
cells
chemotherapy is administered when
surgery and radiotherapy cannot reach
certain areas of the cancer
now unfortunately in this process
chemotherapy doesn't only kill cancer
cells but damages healthy cells as well
such as gut mouth skin nails and hair
but unlike cancer cells
healthy cells can recover
and this is what makes patients feel
unwell when having chemotherapy
different chemotherapies
work in different ways so not all
cancers behave in the same way therefore
every single patient is given
chemotherapy which is individualized for
their self for their diagnosis
so everybody's chemotherapy will vary
depending on what the consultant will
think will work best for them
sometimes they can this can mean a
single agent so one chemotherapy
sometimes it can be multiple
chemotherapies or sometimes it can also
mean a combination of chemotherapy and
immunotherapy but when the nurse gives
you a call she will go through what
chemotherapies you'll be having
how long it will take and how how many
treatments will be involved in the
process
each one varies in time so we tend to
have some treatments which are eight
hour long and some treatments that come
anything up to five minutes long but
this will be clarified by the end of
your new case talk
the doctor's team provide patients with
information on the individual treatment
if you haven't received this you can
receive information on your individual
treatment on the MacMillan website
during the 15-minute consultation the
nurse will go nurse will go through and
discuss your treatment in specific and
this is where you will have a chance to
raise any concerns you may have
you may have received a purple card in
the post which has appointments on there
on the card you will have an appointment
to see the doctor an appointment to
start treatment and also some contact
numbers which may be handy for you
whilst on treatment
your appointment time will depend on the
chemotherapy you are having sometimes
sometimes you may be called in the day
before your appointment to change your
appointment time in case there is a
delay with your treatment
we do try to accommodate longer
treatments in the morning and shorter
treatments in the afternoon so we have
enough time in the day to accommodate
all of our patients but we do understand
some patients may have individual
circumstances where they cannot attend
that appointment and if you have certain
appointments that you do need instead
these speak to our nurse in charge or
Ward sister to see what they can do for
your circumstance
when attending this week please hand in
your purple appointment card at the desk
this will alert the nurses of your
arrival
and admin will also book in their
appointment for your next doctor visit
and your next chemotherapy visit
unfortunately on the chemotherapy Suite
they can be delays to appointment times
due to numerous unprecedented events we
do apologize if you are waiting to come
in for your chemotherapy but the nurses
are aware that you are here we do try to
keep you updated and let you know what
is happening and what the time delays
are but if you have been there for a
little while and nobody has come out to
speak to you and you are concerned feel
free to find one of our team to explain
and look into what has happened
contact numbers
if you have any questions regarding
appointment General queries appointment
times something you're not too sure
about please ring the chemotherapy Suite
on 0116-258-6107
if you have any general queries
regarding your treatment which is not
urgent please call your consultant's
medical secretary which you'll be given
contact details for
all queries regarding your normal
regular medication long-term conditions
or anything that your GP is supporting
you for already carry on keeping in
close contact with the GP to do that
still
we do have an emergency line number
dedicated for patients who experience
problems related to chemotherapy which
will discuss a little bit further in the
next few slides
you will also receive information
details for specialist nurses
dietitians support nurses which will
also help your journey whilst on
chemotherapy
on the chemotherapy Suite
unfortunately it is a very small sweep
and due to health and safety we do only
allow staff and patients in the
treatment area
relatives and friends are more than
welcome to bring in family members for
the treatment but they will have to wait
in the lobby area
um until they do finish treatment
sometimes in exceptional circumstances I
understand patients may need a friend or
family member with them
please speak to the nurse doing a new
case talk if this is the case for when
you come in for treatment
if you are arriving by ambulance please
alert one of our nurses as soon as you
get here to ensure we can arrange a
return ambulance for you promptly
eating and drinking
on the day of treatment
please take your normal medications as
prescribed by your GP or doctor on the
day of your treatment unless told
otherwise
please do not fast prior to treatment
all patients should have something to
eat or drink before they do come in
there is always tea coffee sandwiches
jelly biscuits yogurts available on the
street for patients and will be offered
but if you feel you would like to bring
in a pack up or bringing your own food
that is allowed also
blood tested and prior to every single
chemotherapy session
now if you have not had chemotherapy
before and you are starting treatment
your bid results can be anything up to
two weeks old
but all consequent treatment after your
first one
your Bloods have to be within five days
of starting treatment
what blood test too is they check that
you are well enough to have your
chemotherapy and your blood cells have
recovered enough from having your lust
treatment
you will receive a platform every cycle
ready for your next treatment
these Bloods can be no older than five
days
for example if you're having treatment
on a Friday then the earliest duplets
can be done is a Monday if you're still
unsure on what date have your Bloods
please speak to one of our nursing team
you can have your blood test taken at
your GP surgery and normally if you let
them know that every two weeks or every
three weeks on a Tuesday you need a
blood test they tend to be quite
accommodating
we also have our walk-in centers uh
walking through botany clinics on all
three Hospital sites
but if you are still struggling to get
Bloods done properly speak to one of our
nursing team to see what else we can
arrange for yourselves
delay in obtaining blood results May in
turn delay treatment
what to expect
once a nurse has been allocated to start
your treatment and your treatment has
been checked you will then be called
into one of our chemotherapy chairs
at this point the nurse will check your
details your information and check you
in
if you need any pre-medication for your
chemotherapy this will then be given to
you
and your treatment will be set up
at this point the nurse will notify you
of the process how long your visit will
be what it will involve and also give
you any medications you need to go home
with
if you have any questions regarding any
of these things please raise it with
your nurse at this point
if you are unwelly it's really important
that you do seek medical help before
coming in for your chemotherapy
treatment whether that is speaking to
your oncologist ringing the emergency
line or ringing your GP or informing the
suite so they can direct you please
ensure you let somebody know and not
wait till your treatment date if you are
feeling unwell
how is chemotherapy given
so chemotherapy can be given through a
vein in your hand so what happens is you
come into the chemotherapy sweep the
nurse will will put a small cannula into
your hand and it normally goes in the
back of your hand and this will allow
the nurses to infuse an intravenous
chemotherapy through your body
but I must raise it it's really
important that if you find any
discomfort burning stinging or notes any
redness or swelling notify one of our
nurses immediately as on some occasions
this can be caused by chemotherapy
some patients have a central line
inserted into the upper part of the arm
which involves a procedure prior to the
chemotherapy
if this is the case when the nurse calls
you for your individual talk they will
let you know
chemotherapy can also be given as
tablets which is
given from specialized trained
pharmacists who will dispense it to you
and explain to you what it involves and
how to take the medication
the emergency line
so all patients that are having
chemotherapy have a dedicated line to
discuss any side effects on if they're
feeling unwell whilst on treatment
so
if you are feeling unwell it is related
to chemotherapy it is important that you
bring the number which has been sent to
you in the post on your red alert card
the number is
0808-178-2212 it is available 24 hours
seven days a week if you are unable to
get through leave a message and somebody
will call you back within 30 minutes
side effects
this is one of the most biggest worries
and concerns for most of the patients
thought in treatment
side effects will vary depending on the
type of chemotherapy you will be
receiving and also how each individual
reactional treatment
although you are made aware of all the
common side effects it is highly
unlikely for you to experience all the
side effects
most patients experience some or none of
the side effects but rarely all of them
but we have to make sure we alert
patients of everything to look out for
so they know what to do if they get any
ensure you are informing the oncology
team of any side effects or problems you
are occurring when starting your
treatment
infection this is another common side
effect from starting chemotherapy
one of the healthy cells that you need
to fight infections in your body are
like cells and white cells are reduced
whilst on chemotherapy so this can
increase the risk of an infection
if you do get an infection and is caused
by a low number of white cells in your
body it is known as neutropenia
infection for a patient on chemotherapy
can be life charging this is why it's
very important if you do feel unwell you
know what to look out for and you know
who to call and signs and symptoms of an
infection
we advise all patients to have a
thermometer at home before starting
treatment
having a temperature is one of the most
common signs of having an infection
this is why we ask all patients that if
you're feeling well for the first check
to be carried out is your temperature
this doesn't need to be done daily or
routinely but only if you're feeling
unwell
so if you have a temperature is above
37.5
you may it may be an indicator of
infection you must ring us up and let us
know but also bear in mind that not all
patients will get a raise temperature so
if you are feeling unwell and you're in
doubt give us a call and get advice
please do not take any medication until
you have spoken to one of our medical
team first as taking medications such as
paracetamol May mask the fact that you
have a temperature
this is a small list of things that we
ask patients to look out for so if you
have a sore throat sore mouth cough a
call-like symptoms diarrhea vomiting a
rash open area Rudder swollen chills
sweats frequent urination and burning
um these are all signs that it may be a
side effect to the treatment
also any other common side effects which
are raised on the chemo information
sheet keeper those in mind
what we do say to all of our patients is
you know your body you know how you feel
on a normal day and you know when you're
feeling a bit rough
so if you are feeling a bit rough and
you feel like it is related to
chemotherapy please make sure you ring
the emergency line and get advice
most chemotherapies can cause nausea and
vomiting not all chemotherapies
so on some chemotherapies you are given
provisional anti-sickness medication
it is really important that you take
medication that has given you for
provisional basis as it is always easy
to combat side effects if you start
taking the medication prior to getting
symptoms
it is a lot harder to manage once you
are starting to get symptoms
so
if you are feeling sick
you have taken the medication as
prescribed by your doctors and nurses
and you are still feeling sick it is
lasting for more than two hours and
you're struggling to eat or drink please
ring the emergency line and get advice
if you have diarrhea
it is important to rest and drink plenty
of fluids to stay hydrated
if you have done so and if you have
taken any anti-laxative medication
prescribed to you by your doctor and
you're still experiencing diarrhea which
is what to be loose happening overnight
or lasting for more than two hours
please again call the emergency line to
get advice
sore mouth this is another common side
effect from treatment
if you do develop a small sore mouth
this includes mouth sores redness back
patches on your mouth or tongue or
trouble a pain to swallow please contact
us and let us know there is an
information leaflet in your pack which
tells you how to look after your mouth
and how to stay well whilst on treatment
we do say to all of our patients avoid
any dental work during treatment if you
do need any dental work try to have that
done before you start your chemotherapy
if you cannot do so and you are having
problem with your teeth please inform
somebody so we can see what's the best
port of action once you start your
treatment
we also advise all our patients use a
soft toothbrush to avoid damaging the
gums along with a gentle mouthwash which
is alcohol-free to help keep the mouth
clean
if you do wear dentures please make sure
the Dentures you were wearing are good
fitting dentures they are not tight and
when you are cleaning your gum area make
sure that you've got no ulcers or red or
areas on your skin
if you notice that you have any bruising
bleeding or rushes
please ensure you let us know so please
contact us if you develop any bruising
that you cannot explain if you have any
abnormal bleeding including blood in
your urinal stools no heavy nose bleeds
if you notice any rashes on your body
please let us know we also say to all of
our patients moisturize your skin get
your skin in good condition to help
avoid any skin irritation
your skin is a lot more sensitive so we
also advise patients to use electric
razors rather than normal razor blades
hair loss
not all chemotherapy drugs cause hair
loss when the nurse gives you a call
they will inform you whether the
treatment you are having will make you
lose your hair
if you do lose your hair whilst on
chemotherapy this is not permanent and
your hair will grow back okay
so
when you do lose your hair on treatment
it's not only on your head but all over
your body so this can be eyelash
eyebrows legs arms
but like I said hair loss on
chemotherapy is not permanent
they have got the option for Wig
fittings available so if you are going
to lose your hair and you would like a
wig fitting it is really important you
let one of our nurses know so we can
refer you over to our MacMillan Center
to arrange this
we do advise all our patients try
getting a wig fitting referral completed
before you start your chemotherapy so
you have a wig in place before you start
losing your hair
patients on chemotherapy do get
discounted rates on their wigs down in
McMillan Center so if you are not sure I
do say to all our patients go have a
visit to the McMillan Center base
downstairs and they can give you more
information regarding the weeks that
they Supply
we also offer pull caps on some
treatments to help prevent hair loss
what is a cold cut
a cold cup is a jelly-like app and what
it aims to do is once you put the cap on
your head it freezes your hair follicles
and reduces the amount of hair that is
lost
this depends on individual patients
please speak to your nurse whether this
is something you would be interested in
we do advise all patients on
chemotherapy to use a lot more delicate
products on their hair such as mild
shampoo and avoid any heated products on
your hair or perm in your hair
fatigue is a common side effects whilst
on chemotherapy
if you do experience extreme footage
please keep your consultant notified of
this
it is very common to feel tired whilst
on treatment so it's really important
that you listen to your body you take it
easy then you do not push yourself too
far
gentle exercise and short walks can help
but if you still feel quite tired
throughout all your treatment please
speak to one of our team avoid
activities that will can cause you any
injuries
we say whilst on treatment still carry
on going to the shops theaters Cinemas
going out where you normally go but just
be an extra bit more precautious so
going when it's less busy
using hand wash and wearing a face mask
if you have friends and family visiting
asking them are you well are you unwell
if you're not well please come back when
you're feeling better as you are more
prone to getting what they're getting
what do you do if somebody in your house
is unwell the only thing you can do is
keep a closer eye on yourself the first
signing symptom that you're getting what
they get in or you may have a
temperature you must let us know
straight away
if you have pets see if you can get
somebody else to clean up after them if
not ensure that you wear gloves and wash
your hands with warm soapy water
afterwards
fertility
some chemotherapies can cause
infertility not all chemotherapies so if
you do plan to father a child or get
pregnant in the future you must speak to
your consultant before you start
treatment regarding your fertility
options we also say to all of our
patients there is chemotherapy pressure
in all bodily fluids so please avoid
becoming pregnant or fathering a child
whilst on treatment therefore we do
advise all of our patients to use
standard line protection whilst on
chemotherapy
eating and drinking
chemotherapy causes up a buildup of
toxins in your body the more fluid you
drink the more toxins you will be
flushing out
so keep hydrated keep drinking fluids
this does not include tea and coffee
wash your hands before eating or
drinking these are simple things we
should be doing on a daily basis but
please make sure you keep an extra eye
whilst you are on chemotherapy sometimes
we tend to eat food that's gone off by a
day we advise not to and just getting
rid of it it does say eat a
well-balanced diet but I say to my
patients you may have a reduced appetite
you may have a change in taste so eating
little and often of whatever you can
manage is good
avoid anything raw and unpasteurized and
ensure you're reheating your food
properly if you are still struggling to
eat or drink please speak to our
dietitian team or our nurses so we can
help support you through your chemo
Journey
we do advise all of our patients to have
a free vaccination and covert
vaccination before starting chemotherapy
if you haven't had any of your
vaccinations this is not to worry please
speak to one of our team and they will
advise you when is the best time to have
your vaccination whilst on treatment
drinking alcohol
there are small number of treatments
where we advise patients to have no
alcohol
but most treatments we say yes to small
amounts of alcohol
your nurse will discuss this with you
further on your individual consultation
we do advise any staff on chemotherapy
not to go away abroad until they've
spoken to one of our doctors first so if
you are planning to go away anywhere
speak to your tea before you book
anything
if it is sunny your skin is a lot more
sensitive
please wear Factor 50 cream cover up and
stain the shade as much as possible
if you do go away anywhere in the UK
take your chemo card with you so if you
are unwell or need medical assistance
they are aware of your diagnosis
treatment and the center looking after
you
we do have the McMillan information
center which is based downstairs in the
Osborne building
they provide a lot of information and
support to people with cancer and their
families they have information and
support regarding Finance benefit
clinics they also have plenty of
information and support groups to help
patients and friends and family
and
drop in or give them a call to arrange
an appointment to see what advice or
support they could offer you
just to go over today's presentation
you will be followed up by a call from
one of our nurses on your allegated date
they will go through your treatment in
specific and help answer any other
questions that you may have
please feel free to make notes of any
questions or concerns that you may have
to discuss this with your nurse
just to remind you we have two telephone
numbers the chemo suite number which is
outlined
and the emergency line number which is
for patients when they are feeling
unwell
so
if you are feeling unwell and is related
to chemotherapy please ring the
emergency line
I hope this has given you enough
information on what will happen when you
do start your treatment if you still
have concerns feel free to raise this
with your nurse or doctor
thank you for listening and thank you
for watching our video and if you have
any questions we will hope to speak to
you soon thank you
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