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Managing Side Effects of Chemotherapy: Care Instructions

Your Care Instructions

Cancer is often treated with medicines that destroy the cancer cells (chemotherapy). These medicines may slow cancer growth and prevent or stop the spread of cancer. Chemotherapy also can affect healthy cells and cause side effects.

Most people can work and do their normal activities after and even during chemotherapy, but they may need to limit their schedules. Some side effects of chemotherapy may include nausea and vomiting, loss of appetite, and being tired. Some medicines can cause diarrhea or mouth sores. Your doctor may prescribe medicines to treat the side effects. Your doctor will advise you to take extra care to prevent illnesses and infections, because chemotherapy weakens your natural defences.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

Nausea and vomiting

  • After vomiting has stopped for 1 hour, sip a rehydration drink, such as Pedialyte or Gatorade.
  • Drink plenty of fluids to prevent dehydration. Choose water and other fluids until you feel better.
  • When you are feeling better, eat small amounts of food.
  • Learn more about managing nausea and vomiting.

Loss of appetite

  • Try to eat food that has protein and extra calories to keep up your strength and prevent weight loss.
  • When you feel like eating, start with small amounts of food.

Pain control

  • If you experience any pain during treatment and your doctor prescribes medicines to control this, take the medicine as directed.
  • Often your doctor will have you take these medicines regularly to keep your pain under control. Medicine for pain may cause side effects. Let your doctor know if you feel constipated, have trouble urinating, or have nausea.
  • Try using relaxation exercises to lower your anxiety and stress, which can increase pain.
  • Keep track of your pain so you can tell your doctor what your pain is like. Write down where you feel pain, how long it lasts, what seems to bring it on, and how it feels. Also note what makes the pain feel better or worse.

Mouth sores

  • Make a rinse to keep your mouth from getting dry. Add 1 teaspoon (5 mL) baking soda and ½ teaspoon (2.5 mL) salt to 4 cups (1 L) of water. Use it to rinse your mouth 4 to 6 times each day.
  • When you feel like eating, start with small amounts of soft food.
  • Drinking through a straw may help with pain.

Diarrhea

  • Before you take any type of over-the-counter medicine, tell your doctor that you are having diarrhea.
  • Sip on fluids throughout the day to keep hydrated, unless you have been told to restrict or limit your fluids. Try water, milk, milk alternatives, broth, or rehydration drinks.
  • Eat 5 to 6 small meals and snacks throughout the day instead of eating 3 big meals. When your gut is feeling unwell, large amounts of food at one time may cause more discomfort. Try to eat a small meal or snack every 2 to 3 hours during the day.
  • Choose foods with soluble fibre. Soluble fibre may help your diarrhea by making your stools thicker. Foods with soluble fibre include:
    • soft, cooked vegetables or fruits with the skins and seed removed
    • peeled apples or applesauce, bananas, avocado, and potatoes and sweet potatoes with skin removed
    • barley, oatmeal, or oat bran
    • psyllium fibre supplements (talk to your doctor to ask if a soluble fibre supplement is right for you)

Weakness and feeling tired

  • Try to get some exercise, such as walking, but stop if you are too tired.
  • Do something you enjoy. Do you like to listen to music? Spend some time listening to your favourite music. Or find another way to relax by reading, watching a movie, or playing games.
  • Ask family and friends to help with home chores and other tasks.

To prevent infections

  • Wash your hands often during the day, especially before you eat and after you use the toilet.
  • Stay away from people who have illnesses that you might catch, such as influenza (flu) or a cold.
  • Try to stay out of crowds.

Hair loss

  • Use a mild shampoo and a soft hair brush.
  • Use sunscreen and a hat, scarf, or turban to protect your scalp from the sun.
  • Ask your doctor about other treatments that you may try to prevent or minimize hair loss. These may include the use of a cooling cap.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).

Call your doctor or nurse advice line now or seek immediate medical care if:

  • You have a fever.
  • You have abnormal bleeding.
  • You have new or worse pain.
  • You think you have an infection.
  • You have new symptoms, such as a cough, belly pain, vomiting, diarrhea, or a rash.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if:

  • You are much more tired than usual.
  • You have swollen glands in your armpits, groin, or neck.
  • You do not get better as expected.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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