0:01 hello and welcome to the new case talk
0:04 for patients starting chemotherapy
0:07 you should be attending this talk if you
0:09 have been told by a consultant that
0:11 you'll be starting a course of
0:12 chemotherapy
0:16 you may have received a pack in the post
0:18 which has given you information
0:19 regarding your appointment for your new
0:22 case talk your treatment and also when
0:25 you'll be seeing the doctor
0:27 you will have also received lots of
0:29 information leaflets on how to stay well
0:31 during treatment
0:34 so what to expect from today's new case
0:37 talk
0:38 this talk will provide information and
0:41 guidance for friends and family and
0:44 yourself on how to stay well during
0:46 treatment
0:48 we will also give you specific
0:50 information about your treatment and
0:54 including any other questions that you
0:56 may have
0:58 after watching this presentation you
1:01 will get a quote from one of our nurses
1:03 and on the time slot specified in your
1:07 pack
1:08 this appointment is for 15 minutes and
1:11 this is where the nurse will speak to
1:12 you about any concerns you may still
1:15 have after watching this presentation
1:18 the nurse will also speak to you about
1:20 possible side effects for your
1:22 individual treatment
1:26 this talk is also to help answer any
1:29 questions which you may still have
1:31 regarding starting chemotherapy
1:34 feel free to make some notes and jot
1:36 down any questions which you may have
1:39 that is not clear in these slides or you
1:42 may have that do not get answered during
1:44 this presentation
1:48 so what is chemotherapy
1:51 chemotherapy is a drug use for the
1:53 treatment of cancer
1:55 chemotherapy can either destroy cancer
1:58 cells or chemotherapy can slow down or
2:02 reduce the multiplication of cancer
2:04 cells
2:06 chemotherapy is administered when
2:09 surgery and radiotherapy cannot reach
2:13 certain areas of the cancer
2:15 now unfortunately in this process
2:19 chemotherapy doesn't only kill cancer
2:21 cells but damages healthy cells as well
2:24 such as gut mouth skin nails and hair
2:30 but unlike cancer cells
2:32 healthy cells can recover
2:36 and this is what makes patients feel
2:37 unwell when having chemotherapy
2:41 different chemotherapies
2:45 work in different ways so not all
2:48 cancers behave in the same way therefore
2:51 every single patient is given
2:54 chemotherapy which is individualized for
2:57 their self for their diagnosis
3:00 so everybody's chemotherapy will vary
3:02 depending on what the consultant will
3:04 think will work best for them
3:07 sometimes they can this can mean a
3:09 single agent so one chemotherapy
3:11 sometimes it can be multiple
3:14 chemotherapies or sometimes it can also
3:16 mean a combination of chemotherapy and
3:19 immunotherapy but when the nurse gives
3:22 you a call she will go through what
3:25 chemotherapies you'll be having
3:27 how long it will take and how how many
3:30 treatments will be involved in the
3:32 process
3:33 each one varies in time so we tend to
3:35 have some treatments which are eight
3:37 hour long and some treatments that come
3:39 anything up to five minutes long but
3:41 this will be clarified by the end of
3:43 your new case talk
3:45 the doctor's team provide patients with
3:48 information on the individual treatment
3:50 if you haven't received this you can
3:52 receive information on your individual
3:54 treatment on the MacMillan website
3:58 during the 15-minute consultation the
4:01 nurse will go nurse will go through and
4:03 discuss your treatment in specific and
4:06 this is where you will have a chance to
4:07 raise any concerns you may have
4:11 you may have received a purple card in
4:13 the post which has appointments on there
4:16 on the card you will have an appointment
4:18 to see the doctor an appointment to
4:21 start treatment and also some contact
4:23 numbers which may be handy for you
4:25 whilst on treatment
4:27 your appointment time will depend on the
4:29 chemotherapy you are having sometimes
4:31 sometimes you may be called in the day
4:33 before your appointment to change your
4:35 appointment time in case there is a
4:37 delay with your treatment
4:40 we do try to accommodate longer
4:42 treatments in the morning and shorter
4:43 treatments in the afternoon so we have
4:45 enough time in the day to accommodate
4:47 all of our patients but we do understand
4:50 some patients may have individual
4:52 circumstances where they cannot attend
4:54 that appointment and if you have certain
4:57 appointments that you do need instead
5:00 these speak to our nurse in charge or
5:03 Ward sister to see what they can do for
5:05 your circumstance
5:07 when attending this week please hand in
5:09 your purple appointment card at the desk
5:11 this will alert the nurses of your
5:13 arrival
5:14 and admin will also book in their
5:16 appointment for your next doctor visit
5:18 and your next chemotherapy visit
5:21 unfortunately on the chemotherapy Suite
5:23 they can be delays to appointment times
5:26 due to numerous unprecedented events we
5:29 do apologize if you are waiting to come
5:31 in for your chemotherapy but the nurses
5:34 are aware that you are here we do try to
5:37 keep you updated and let you know what
5:38 is happening and what the time delays
5:40 are but if you have been there for a
5:43 little while and nobody has come out to
5:45 speak to you and you are concerned feel
5:47 free to find one of our team to explain
5:49 and look into what has happened
5:53 contact numbers
5:55 if you have any questions regarding
5:57 appointment General queries appointment
6:00 times something you're not too sure
6:02 about please ring the chemotherapy Suite
6:04 on 0116-258-6107
6:09 if you have any general queries
6:11 regarding your treatment which is not
6:13 urgent please call your consultant's
6:15 medical secretary which you'll be given
6:18 contact details for
6:21 all queries regarding your normal
6:25 regular medication long-term conditions
6:27 or anything that your GP is supporting
6:30 you for already carry on keeping in
6:33 close contact with the GP to do that
6:35 still
6:37 we do have an emergency line number
6:39 dedicated for patients who experience
6:41 problems related to chemotherapy which
6:44 will discuss a little bit further in the
6:47 next few slides
6:48 you will also receive information
6:50 details for specialist nurses
6:53 dietitians support nurses which will
6:56 also help your journey whilst on
6:58 chemotherapy
7:00 on the chemotherapy Suite
7:03 unfortunately it is a very small sweep
7:06 and due to health and safety we do only
7:09 allow staff and patients in the
7:11 treatment area
7:12 relatives and friends are more than
7:14 welcome to bring in family members for
7:16 the treatment but they will have to wait
7:18 in the lobby area
7:20 um until they do finish treatment
7:23 sometimes in exceptional circumstances I
7:27 understand patients may need a friend or
7:29 family member with them
7:31 please speak to the nurse doing a new
7:33 case talk if this is the case for when
7:35 you come in for treatment
7:37 if you are arriving by ambulance please
7:39 alert one of our nurses as soon as you
7:41 get here to ensure we can arrange a
7:43 return ambulance for you promptly
7:46 eating and drinking
7:48 on the day of treatment
7:50 please take your normal medications as
7:52 prescribed by your GP or doctor on the
7:55 day of your treatment unless told
7:56 otherwise
7:58 please do not fast prior to treatment
8:02 all patients should have something to
8:03 eat or drink before they do come in
8:06 there is always tea coffee sandwiches
8:08 jelly biscuits yogurts available on the
8:10 street for patients and will be offered
8:12 but if you feel you would like to bring
8:15 in a pack up or bringing your own food
8:17 that is allowed also
8:22 blood tested and prior to every single
8:25 chemotherapy session
8:27 now if you have not had chemotherapy
8:29 before and you are starting treatment
8:30 your bid results can be anything up to
8:33 two weeks old
8:36 but all consequent treatment after your
8:39 first one
8:41 your Bloods have to be within five days
8:43 of starting treatment
8:45 what blood test too is they check that
8:47 you are well enough to have your
8:49 chemotherapy and your blood cells have
8:51 recovered enough from having your lust
8:53 treatment
8:54 you will receive a platform every cycle
8:56 ready for your next treatment
8:58 these Bloods can be no older than five
9:01 days
9:02 for example if you're having treatment
9:04 on a Friday then the earliest duplets
9:06 can be done is a Monday if you're still
9:08 unsure on what date have your Bloods
9:10 please speak to one of our nursing team
9:13 you can have your blood test taken at
9:14 your GP surgery and normally if you let
9:16 them know that every two weeks or every
9:18 three weeks on a Tuesday you need a
9:20 blood test they tend to be quite
9:22 accommodating
9:24 we also have our walk-in centers uh
9:26 walking through botany clinics on all
9:28 three Hospital sites
9:29 but if you are still struggling to get
9:32 Bloods done properly speak to one of our
9:34 nursing team to see what else we can
9:36 arrange for yourselves
9:38 delay in obtaining blood results May in
9:41 turn delay treatment
9:44 what to expect
9:47 once a nurse has been allocated to start
9:48 your treatment and your treatment has
9:50 been checked you will then be called
9:51 into one of our chemotherapy chairs
9:54 at this point the nurse will check your
9:57 details your information and check you
9:59 in
10:00 if you need any pre-medication for your
10:03 chemotherapy this will then be given to
10:05 you
10:06 and your treatment will be set up
10:08 at this point the nurse will notify you
10:10 of the process how long your visit will
10:12 be what it will involve and also give
10:15 you any medications you need to go home
10:17 with
10:18 if you have any questions regarding any
10:20 of these things please raise it with
10:21 your nurse at this point
10:24 if you are unwelly it's really important
10:26 that you do seek medical help before
10:29 coming in for your chemotherapy
10:31 treatment whether that is speaking to
10:34 your oncologist ringing the emergency
10:36 line or ringing your GP or informing the
10:38 suite so they can direct you please
10:40 ensure you let somebody know and not
10:43 wait till your treatment date if you are
10:45 feeling unwell
10:48 how is chemotherapy given
10:51 so chemotherapy can be given through a
10:54 vein in your hand so what happens is you
10:57 come into the chemotherapy sweep the
10:59 nurse will will put a small cannula into
11:01 your hand and it normally goes in the
11:03 back of your hand and this will allow
11:05 the nurses to infuse an intravenous
11:08 chemotherapy through your body
11:10 but I must raise it it's really
11:12 important that if you find any
11:14 discomfort burning stinging or notes any
11:16 redness or swelling notify one of our
11:19 nurses immediately as on some occasions
11:21 this can be caused by chemotherapy
11:24 some patients have a central line
11:26 inserted into the upper part of the arm
11:28 which involves a procedure prior to the
11:30 chemotherapy
11:32 if this is the case when the nurse calls
11:34 you for your individual talk they will
11:36 let you know
11:37 chemotherapy can also be given as
11:39 tablets which is
11:41 given from specialized trained
11:43 pharmacists who will dispense it to you
11:45 and explain to you what it involves and
11:47 how to take the medication
11:51 the emergency line
11:53 so all patients that are having
11:56 chemotherapy have a dedicated line to
11:59 discuss any side effects on if they're
12:01 feeling unwell whilst on treatment
12:03 so
12:05 if you are feeling unwell it is related
12:08 to chemotherapy it is important that you
12:10 bring the number which has been sent to
12:13 you in the post on your red alert card
12:15 the number is
12:18 0808-178-2212 it is available 24 hours
12:21 seven days a week if you are unable to
12:24 get through leave a message and somebody
12:26 will call you back within 30 minutes
12:31 side effects
12:33 this is one of the most biggest worries
12:35 and concerns for most of the patients
12:37 thought in treatment
12:39 side effects will vary depending on the
12:41 type of chemotherapy you will be
12:43 receiving and also how each individual
12:45 reactional treatment
12:47 although you are made aware of all the
12:49 common side effects it is highly
12:51 unlikely for you to experience all the
12:54 side effects
12:55 most patients experience some or none of
12:59 the side effects but rarely all of them
13:01 but we have to make sure we alert
13:03 patients of everything to look out for
13:05 so they know what to do if they get any
13:07 ensure you are informing the oncology
13:10 team of any side effects or problems you
13:12 are occurring when starting your
13:14 treatment
13:16 infection this is another common side
13:19 effect from starting chemotherapy
13:21 one of the healthy cells that you need
13:23 to fight infections in your body are
13:26 like cells and white cells are reduced
13:30 whilst on chemotherapy so this can
13:32 increase the risk of an infection
13:36 if you do get an infection and is caused
13:39 by a low number of white cells in your
13:40 body it is known as neutropenia
13:45 infection for a patient on chemotherapy
13:48 can be life charging this is why it's
13:50 very important if you do feel unwell you
13:52 know what to look out for and you know
13:54 who to call and signs and symptoms of an
13:57 infection
14:00 we advise all patients to have a
14:03 thermometer at home before starting
14:05 treatment
14:07 having a temperature is one of the most
14:09 common signs of having an infection
14:11 this is why we ask all patients that if
14:14 you're feeling well for the first check
14:16 to be carried out is your temperature
14:18 this doesn't need to be done daily or
14:21 routinely but only if you're feeling
14:23 unwell
14:24 so if you have a temperature is above
14:26 37.5
14:28 you may it may be an indicator of
14:30 infection you must ring us up and let us
14:32 know but also bear in mind that not all
14:35 patients will get a raise temperature so
14:37 if you are feeling unwell and you're in
14:40 doubt give us a call and get advice
14:43 please do not take any medication until
14:46 you have spoken to one of our medical
14:47 team first as taking medications such as
14:50 paracetamol May mask the fact that you
14:53 have a temperature
14:56 this is a small list of things that we
14:58 ask patients to look out for so if you
15:01 have a sore throat sore mouth cough a
15:03 call-like symptoms diarrhea vomiting a
15:06 rash open area Rudder swollen chills
15:10 sweats frequent urination and burning
15:13 um these are all signs that it may be a
15:16 side effect to the treatment
15:18 also any other common side effects which
15:20 are raised on the chemo information
15:22 sheet keeper those in mind
15:24 what we do say to all of our patients is
15:26 you know your body you know how you feel
15:28 on a normal day and you know when you're
15:30 feeling a bit rough
15:32 so if you are feeling a bit rough and
15:34 you feel like it is related to
15:35 chemotherapy please make sure you ring
15:38 the emergency line and get advice
15:41 most chemotherapies can cause nausea and
15:44 vomiting not all chemotherapies
15:47 so on some chemotherapies you are given
15:50 provisional anti-sickness medication
15:53 it is really important that you take
15:55 medication that has given you for
15:56 provisional basis as it is always easy
15:59 to combat side effects if you start
16:02 taking the medication prior to getting
16:04 symptoms
16:06 it is a lot harder to manage once you
16:08 are starting to get symptoms
16:10 so
16:12 if you are feeling sick
16:13 you have taken the medication as
16:15 prescribed by your doctors and nurses
16:18 and you are still feeling sick it is
16:20 lasting for more than two hours and
16:22 you're struggling to eat or drink please
16:24 ring the emergency line and get advice
16:27 if you have diarrhea
16:29 it is important to rest and drink plenty
16:32 of fluids to stay hydrated
16:34 if you have done so and if you have
16:37 taken any anti-laxative medication
16:39 prescribed to you by your doctor and
16:42 you're still experiencing diarrhea which
16:44 is what to be loose happening overnight
16:46 or lasting for more than two hours
16:48 please again call the emergency line to
16:50 get advice
16:53 sore mouth this is another common side
16:56 effect from treatment
16:57 if you do develop a small sore mouth
17:00 this includes mouth sores redness back
17:03 patches on your mouth or tongue or
17:05 trouble a pain to swallow please contact
17:06 us and let us know there is an
17:09 information leaflet in your pack which
17:10 tells you how to look after your mouth
17:12 and how to stay well whilst on treatment
17:15 we do say to all of our patients avoid
17:17 any dental work during treatment if you
17:20 do need any dental work try to have that
17:22 done before you start your chemotherapy
17:25 if you cannot do so and you are having
17:28 problem with your teeth please inform
17:30 somebody so we can see what's the best
17:32 port of action once you start your
17:34 treatment
17:35 we also advise all our patients use a
17:38 soft toothbrush to avoid damaging the
17:40 gums along with a gentle mouthwash which
17:42 is alcohol-free to help keep the mouth
17:45 clean
17:48 if you do wear dentures please make sure
17:51 the Dentures you were wearing are good
17:52 fitting dentures they are not tight and
17:55 when you are cleaning your gum area make
17:57 sure that you've got no ulcers or red or
18:00 areas on your skin
18:02 if you notice that you have any bruising
18:04 bleeding or rushes
18:06 please ensure you let us know so please
18:09 contact us if you develop any bruising
18:11 that you cannot explain if you have any
18:13 abnormal bleeding including blood in
18:16 your urinal stools no heavy nose bleeds
18:19 if you notice any rashes on your body
18:22 please let us know we also say to all of
18:25 our patients moisturize your skin get
18:28 your skin in good condition to help
18:30 avoid any skin irritation
18:33 your skin is a lot more sensitive so we
18:35 also advise patients to use electric
18:37 razors rather than normal razor blades
18:42 hair loss
18:44 not all chemotherapy drugs cause hair
18:46 loss when the nurse gives you a call
18:48 they will inform you whether the
18:50 treatment you are having will make you
18:51 lose your hair
18:53 if you do lose your hair whilst on
18:55 chemotherapy this is not permanent and
18:58 your hair will grow back okay
19:00 so
19:02 when you do lose your hair on treatment
19:04 it's not only on your head but all over
19:06 your body so this can be eyelash
19:08 eyebrows legs arms
19:10 but like I said hair loss on
19:13 chemotherapy is not permanent
19:16 they have got the option for Wig
19:18 fittings available so if you are going
19:21 to lose your hair and you would like a
19:23 wig fitting it is really important you
19:24 let one of our nurses know so we can
19:26 refer you over to our MacMillan Center
19:28 to arrange this
19:29 we do advise all our patients try
19:32 getting a wig fitting referral completed
19:35 before you start your chemotherapy so
19:38 you have a wig in place before you start
19:39 losing your hair
19:41 patients on chemotherapy do get
19:43 discounted rates on their wigs down in
19:46 McMillan Center so if you are not sure I
19:48 do say to all our patients go have a
19:50 visit to the McMillan Center base
19:52 downstairs and they can give you more
19:53 information regarding the weeks that
19:55 they Supply
19:57 we also offer pull caps on some
20:00 treatments to help prevent hair loss
20:02 what is a cold cut
20:06 a cold cup is a jelly-like app and what
20:09 it aims to do is once you put the cap on
20:11 your head it freezes your hair follicles
20:13 and reduces the amount of hair that is
20:17 lost
20:18 this depends on individual patients
20:22 please speak to your nurse whether this
20:24 is something you would be interested in
20:27 we do advise all patients on
20:29 chemotherapy to use a lot more delicate
20:31 products on their hair such as mild
20:33 shampoo and avoid any heated products on
20:36 your hair or perm in your hair
20:40 fatigue is a common side effects whilst
20:42 on chemotherapy
20:44 if you do experience extreme footage
20:46 please keep your consultant notified of
20:50 this
20:52 it is very common to feel tired whilst
20:54 on treatment so it's really important
20:56 that you listen to your body you take it
20:58 easy then you do not push yourself too
21:01 far
21:03 gentle exercise and short walks can help
21:07 but if you still feel quite tired
21:10 throughout all your treatment please
21:12 speak to one of our team avoid
21:14 activities that will can cause you any
21:17 injuries
21:19 we say whilst on treatment still carry
21:22 on going to the shops theaters Cinemas
21:24 going out where you normally go but just
21:27 be an extra bit more precautious so
21:30 going when it's less busy
21:32 using hand wash and wearing a face mask
21:36 if you have friends and family visiting
21:38 asking them are you well are you unwell
21:42 if you're not well please come back when
21:44 you're feeling better as you are more
21:46 prone to getting what they're getting
21:48 what do you do if somebody in your house
21:50 is unwell the only thing you can do is
21:53 keep a closer eye on yourself the first
21:55 signing symptom that you're getting what
21:57 they get in or you may have a
21:59 temperature you must let us know
22:00 straight away
22:02 if you have pets see if you can get
22:05 somebody else to clean up after them if
22:07 not ensure that you wear gloves and wash
22:10 your hands with warm soapy water
22:11 afterwards
22:19 fertility
22:20 some chemotherapies can cause
22:22 infertility not all chemotherapies so if
22:25 you do plan to father a child or get
22:27 pregnant in the future you must speak to
22:29 your consultant before you start
22:31 treatment regarding your fertility
22:32 options we also say to all of our
22:35 patients there is chemotherapy pressure
22:37 in all bodily fluids so please avoid
22:40 becoming pregnant or fathering a child
22:41 whilst on treatment therefore we do
22:44 advise all of our patients to use
22:46 standard line protection whilst on
22:48 chemotherapy
22:52 eating and drinking
22:55 chemotherapy causes up a buildup of
22:57 toxins in your body the more fluid you
22:59 drink the more toxins you will be
23:00 flushing out
23:01 so keep hydrated keep drinking fluids
23:05 this does not include tea and coffee
23:06 wash your hands before eating or
23:09 drinking these are simple things we
23:11 should be doing on a daily basis but
23:12 please make sure you keep an extra eye
23:14 whilst you are on chemotherapy sometimes
23:17 we tend to eat food that's gone off by a
23:19 day we advise not to and just getting
23:21 rid of it it does say eat a
23:24 well-balanced diet but I say to my
23:26 patients you may have a reduced appetite
23:27 you may have a change in taste so eating
23:30 little and often of whatever you can
23:32 manage is good
23:33 avoid anything raw and unpasteurized and
23:36 ensure you're reheating your food
23:38 properly if you are still struggling to
23:40 eat or drink please speak to our
23:43 dietitian team or our nurses so we can
23:45 help support you through your chemo
23:47 Journey
23:49 we do advise all of our patients to have
23:52 a free vaccination and covert
23:54 vaccination before starting chemotherapy
23:58 if you haven't had any of your
24:00 vaccinations this is not to worry please
24:03 speak to one of our team and they will
24:05 advise you when is the best time to have
24:07 your vaccination whilst on treatment
24:12 drinking alcohol
24:14 there are small number of treatments
24:16 where we advise patients to have no
24:18 alcohol
24:19 but most treatments we say yes to small
24:22 amounts of alcohol
24:24 your nurse will discuss this with you
24:27 further on your individual consultation
24:31 we do advise any staff on chemotherapy
24:35 not to go away abroad until they've
24:38 spoken to one of our doctors first so if
24:41 you are planning to go away anywhere
24:43 speak to your tea before you book
24:44 anything
24:46 if it is sunny your skin is a lot more
24:48 sensitive
24:50 please wear Factor 50 cream cover up and
24:54 stain the shade as much as possible
24:56 if you do go away anywhere in the UK
24:58 take your chemo card with you so if you
25:00 are unwell or need medical assistance
25:02 they are aware of your diagnosis
25:04 treatment and the center looking after
25:06 you
25:08 we do have the McMillan information
25:10 center which is based downstairs in the
25:13 Osborne building
25:14 they provide a lot of information and
25:17 support to people with cancer and their
25:19 families they have information and
25:21 support regarding Finance benefit
25:22 clinics they also have plenty of
25:25 information and support groups to help
25:27 patients and friends and family
25:29 and
25:31 drop in or give them a call to arrange
25:33 an appointment to see what advice or
25:35 support they could offer you
25:39 just to go over today's presentation
25:43 you will be followed up by a call from
25:45 one of our nurses on your allegated date
25:47 they will go through your treatment in
25:50 specific and help answer any other
25:52 questions that you may have
25:54 please feel free to make notes of any
25:56 questions or concerns that you may have
25:58 to discuss this with your nurse
26:01 just to remind you we have two telephone
26:03 numbers the chemo suite number which is
26:06 outlined
26:07 and the emergency line number which is
26:10 for patients when they are feeling
26:12 unwell
26:13 so
26:15 if you are feeling unwell and is related
26:17 to chemotherapy please ring the
26:19 emergency line
26:22 I hope this has given you enough
26:24 information on what will happen when you
26:27 do start your treatment if you still
26:29 have concerns feel free to raise this
26:31 with your nurse or doctor
26:34 thank you for listening and thank you
26:37 for watching our video and if you have
26:39 any questions we will hope to speak to
26:41 you soon thank you
Chrome Extension