10 Things Every Cancer Patient Should Know About Chemo

Published Dec 4, 2014

By Lisa C. Richardson, MD, MPH, Special to Everyday Health

“Will I lose my hair? Can I still be around my grandson? Do I have to wear a mask?”

These are a few of the questions my patients often ask me as I talk with them about the side effects of chemotherapy.

During these conversations, I start off talking about certain side effects they may have heard about: hair loss, nausea, and loss of appetite. When I move on and start talking about another side effect, called neutropenia (one of the most serious side effects of chemotherapy),I can quickly tell they’re not as familiar with this one. But it’s a side effect ever cancer patient should be aware of.

Neutropenia means you have a low white blood-cell count. Chemotherapy drugs work by killing fast-growing cells in the body. These drugs kill healthy white blood cells as well as cancer cells. Because white blood cells are one of the body’s main defenses against infection, you will have a higher risk of infection when you’re on chemo.

As an oncologist, this side effect is one of my main concerns for my patients. Infection can not only make you sick, it can also delay chemo treatment, put you in the hospital, or, even worse, cause death. To help prevent an infection, here are the top 10 things every cancer patient should know:

1. Take Action If You Get a Fever

If you’re only going to remember one thing from this article, this is the one I want you to remember: If you spike a temperature of 100.4 degrees or higher, call your doctor immediately. Also, take your temperature any time you feel unwell or not “right.” Many times, fever may be your body’s only sign of an infection.

2. Know the Signs and Symptoms of Infection

If you experience any of these signs or symptoms call your doctor right away:

    Chills and sweats
    A changing cough or a new cough
    A sore throat or a new mouth sore
    Shortness of breath
    Nasal congestion
    A stiff neck
    Burning or pain with urination
    Increased urination
    Unusual vaginal discharge or irritation
    Redness, soreness, or swelling in any area (including around surgical wounds and ports)
    Diarrhea
    Vomiting
    Pain in your abdomen or rectum
    New onset of pain
    Changes in your skin
    Changes in your mental status

3. Ask Your Doctor When You’ll Be Most at Risk

Chemotherapy treatment will usually involve a number of chemo doses (sometimes called cycles). In the 7 to 12 days after you finish each chemotherapy dose is when you have the fewest white blood cells in your body. Because of this, it will be extra hard for your body to fight off germs during this time.

Find out from your doctor or nurse exactly when your white blood cell count will be at its lowest, and be extra careful during this time.

4. Wash Your Hands With Soap and Water, and Ask Others to Do the Same

It’s that simple. One of the best ways to keep yourself from getting sick is to keep your hands clean. Be bold. Don’t be afraid to ask your family, friends, visitors, doctors, and nurses to wash their hands too. If soap and water are not available, it’s okay to use an alcohol-based hand sanitizer.

5. Get a Flu Shot

The CDC recommends that people with cancer get the seasonal flu shot as soon as it is available. Talk to your doctor or nurse about this.

6. Take Your Medication

Whether you are taking medicine in a hospital, clinic, or at home, follow these tips:

    Take your medication exactly as your doctor prescribes.
    Do not skip a dose.
    Plan ahead so you don’t run out of your medicine.
    Never take medicine that is prescribed for someone else, even if it’s the same type and dose as yours.
    Do not use leftover or outdated medications.
    Report any side effects you experience right away.
    Talk to your doctor before taking any over-the-counter medications.

7. Pay Attention to Your Catheter or Port

To lower your risk of developing an infection, always follow your nurse or doctor’s instructions and keep your device clean and dry, washing your hands before touching or caring for the device.

Contact your doctor or nurse immediately if you notice any redness, swelling, soreness, or drainage near your catheter or port.

8. Practice Good Personal Hygiene

The medicines you take to treat your cancer may cause your skin to change in a number of ways. These changes, like dry skin and irritation, can lead to openings in the skin where germs can enter and infection set in

    Bathe every day using warm water and a mild soap.
    Avoid soaking in spas or hot tubs.
    Be sure to clean your feet, groin, underarms, and other sweaty areas well.
    Do not rub skin with a towel — pat it dry instead.
    Do not share your bath towel with other family members.
    Use unscented lotion or moisturizing cream on your skin after it has dried completely.

9. Enjoy the Things You Love to Do

Going out in public: If you feel up to it, it’s generally fine for someone getting chemotherapy to visit public places, or to have friends and family visit. Try to avoid situations where you might come into close contact with people who could be sick, and make sure you wash your hands afterward.

Caring for your pet: You can still care for your pet as long as you protect your skin from direct contact with pet waste. I suggest wearing vinyl or household cleaning gloves. Wash your hands immediately afterward. If you get scratched or bitten, immediately wash the wounds well with soap and water.

Gardening: You can still enjoy gardening if you take steps to protect your skin from cuts and scrapes by wearing gardening gloves, and washing your hands with soap and water afterward.

10. Avoid Certain Foods

To protect yourself, avoid the following:

    Undercooked or raw meat or eggs.
    Raw or unpasteurized products (check the label on dairy products, such as milk and cheese, and on fruit juices, to ensure they are pasteurized). Raw and unpasteurized products contain bacteria that may cause you to become ill.
    Unwashed fruits or vegetables.

I also encourage you to visit the CDC’s website on preventing cancer infections, where you’ll find resources and information to help you stay healthy during your cancer treatment.

Check out the original post from Everyday Health here.

 Lisa C. Richardson, MD, MPH, is the Director of CDC’s Division of Cancer Prevention and Control (DCPC), and the lead investigator of CDC’s Preventing Infections in Cancer Patients program. She provides leadership and direction for all scientific, policy and programmatic issues related to four national programs: the Colorectal Cancer Control Program, the National Breast and Cervical Cancer Early Detection Program, the National Comprehensive Cancer Control Program, and the National Program of Cancer Registries.