Chemotherapy can cause your immune system to become low. It is important that you take precautions to minimise your risk of picking up an infection.  It is important to contact the 24 hour helpline number on 03332226646 if you are:

• Feeling Unwell
• Feel Shivery or Flu Like
• Have a temperature of 37.5 or above

Professional Advice

• Check your temperature every day and if you feel unwell check it even more regularly.
• Avoid contact with people that are unwell where possible.
• Avoid swimming pools.

Patient advice

• Ask visitors to use antibacterial hand wash when they visit you.
• Try and stay away from crowded areas when possible.
• Understand how your thermometer works before you start chemotherapy.

Chemotherapy targets fast growing cells, which is why it can affect the lining inside your mouth. Your mouth can become dry, sore and occasionally ulcerated. Taste can also be altered.

Professional and Patient Advice

Sore Mouth

• Contact the 24 hour helpline number on 03332226646 if you have an ulcerated mouth which is making eating and drinking difficult.
• Use any mouth care products as prescribed
• Avoid any drinks or mouthwash containing alcohol
• Take pain killers 20-30 minutes before eating
• Avoid salty or spicy food
• Try luke-warm food and drinks, as very hot or cold food can cause irritation
• Use a soft tooth brush

Dry Mouth

• Frequent drinks, even if it’s just a sip
• Avoid caffeine drinks
• Avoid alcoholic drinks
• Moisten meals by having plenty of sauce or gravy
• Try ice cream

Taste changes

• Eat strong flavoured food as long as your mouth is not sore
• Avoid foods that taste unpleasant
• Fresh pineapple can stimulate taste buds
• Use mouth wash regularly
• Think of food as fuel! It’s important to keep eating to give your body the nutrients it needs.

Diarrhoea

Diarrhoea is passing loose or watery faeces more than three times a day. It affects everyone from time to time, but can be caused by certain chemotherapy treatments.

Diarrhoea is treated by replacing the fluids, salts and minerals that are lost.

Professional Advice

• Take Loperimide tablets as explained by the chemotherapy nurses. If you still have diarrhoea after taking loperimide please call the 24 hour helpline number on 03332226646
• Increase your fluid intake to ensure you don’t become dehydrated
• Avoid consuming foods high in fiber such as nuts, seeds, fruit or whole grain products
• Take rehydration sachets if provided to you after chemotherapy.

Patient Advice

• Avoid fatty and spicy foods
• Eat binding foods such as potatoes, white rice, white  bread, rich tea biscuits and bananas

Constipation

Professional advice

• If you have been supplied laxative medication, please take it as prescribed.
• Increase your fluid intake
• Contact the 24 hour helpline number for assistance if laxatives are unsuccessful
• Eat high fibre food

Patient advice

• Eat plenty of fresh fruit and veg
• A little bit of exercise can encourage a bowel movement
• Drink caffeinated drinks
• Kiwi Fruit, prunes and beetroot can also help

Not all chemotherapy causes nausea or vomiting, and many patients don’t experience this at all. However, everyone is different and there are many medications which can relieve these symptoms.

Professional advice

• Take your anti-sickness tablets as instructed, especially for the first 3 days after chemotherapy
• Ring the helpline number on 03332226646 if you have nausea or vomiting to the point where your fluid and food intake are restricted
• Avoid alcohol
• Eat plain foods
• Eat small meals often
• Avoid preparing food if you feel nauseous

Patient advice

• Drink ginger beer and eat ginger biscuits
• Snack on jelly babies and crisps
• Allow full fat fizzy drinks to go still, and drink through a straw
• Avoid spicy or greasy foods
• Avoid onions and mushrooms for the first few days as it bloats
• Eat what you want when you want it

Not all chemotherapy treatments will cause your hair to fall out. Your oncologist will discuss this with you prior to chemotherapy.

If you are having chemotherapy that causes hair loss you have many options to consider.

After your first session of chemotherapy it will take around 2-3 weeks for the hair to start falling out.

You will receive a wig referral form after the appointment with your Oncologist. This will provide you with the option of which service you would like to choose. Ring the number and arrange an appointment for your wig consolation. If you have not been given a form, ask when chemotherapy day centre staff and we can arrange one for you.

Patient advice

• Some people advise cutting your hair shorter before starting chemotherapy to get used to a shorter length
• Be aware that the scalp becomes tender just before the hair starts to fall out
• Some patients decide to shave their hair off before it falls out as they feel they have taken back some control
• Have a head scarf as well as a wig, as sometimes you can feel too hot in the wig

Useful websites for wigs and headscarf’s

• Salon Ten
• Wills Wigs
• Jo & Co (Shrewsbury)

Some patients may be eligible to use the cool cap. Ask at your pre assessment if you are interested. For more information and aftercare advice about these please visit the Paxman Website.

Some chemotherapy treatments can cause the skin to become dry, sore and sensitive to the sun.

Capecitabine tablet chemotherapy can cause the skin to become sensitive on your hands and feet. Hand and foot syndrome or Palmar-Plantar (PPE) can affect the skin on the hands and feet. This can result in tenderness, redness, tingling and peeling of the skin on the palms and soles.

Many patients relieve this by using Udderly Smooth on their hands and feet to keep their skin moisturised and to prevent peeling and cracking of the skin.

Other chemotherapy types, especially Docetaxol, can cause changes to your finger and toe nails as well. This is not permanent and will get better after the completion of chemotherapy.

Professional advice

• Apply moisturiser cream at least twice a day
• Ensure you use fragrance free moisturiser cream
• Avoid fragranced soap / body wash
• Don’t spray body spray / perfume directly to the skin
• Take pyridoxine supplements if you have been given them
• If your hands/feet are red or sore try and keep pressure off them and keep cool
• Use high factor sun cream to prevent burning
• Stay in the shade when possible
• Call the 24 hour helpline number if you have sore / feeling skin on your hands and feet which is preventing you carrying out normal daily activities

Patient advice

• Use Udder cream available at udderlysmooth.co.uk
• Rest if the skin on your hands or feet feel feels sore
• Use un-fragranced moisturisers daily

Many patients experience some form of fatigue or tiredness during the course of their chemotherapy treatment. This is the most common side effect of chemotherapy. It is expected that you will feel tired after chemotherapy, but we do not expect you to be so exhausted that you have to spend more than 50% of the day sleeping or resting. If you are concerned that you have excessive fatigue levels please contact the helpline number on 03332226646.

Professional advice

• Be honest about your fatigue level when seen by your Oncologist. You may need an alteration of your treatment
• Light exercise is beneficial physically and psychologically, but only exercise to your limits.

Patient advice

• Know your limits and don’t try to push past them, otherwise you will feel extremely tired
• Be as active as you can, but ensure you rest and relax for a good amount of time to recover
• Make the most of good points in your cycle as you need to rest more when you feel tired

Patients diagnosed with cancer and receiving chemotherapy have a greater chance of developing blood clots. It is important to stay as active as possible to ensure a good blood flow around the body as this will help reduce the risk.

Please contact the 24 hour oncology helpline number urgently on 03332226646 if you develop any of the following symptoms:

• Swelling or pain in the leg or calf.
• Warmth and redness of the leg.
• Unexplained shortness of breath.
• Chest pain (particularly when breathing in)
• Blood being produced when you cough.

Blood Clots, Cancer and You from anticoagulation uk on Vimeo.

Women

Fertility can be altered after receiving chemotherapy. If you would like egg harvesting this should be discussed with your Oncologist prior to starting any chemotherapy. It is still possible to become pregnant naturally after receiving chemotherapy, but it is unlikely.

Being diagnosed with cancer and receiving chemotherapy treatments can alter your sexual function. This can be due to a combination of different factors such as hormone changes, possible body image changes and side effects like fatigue.

The hormonal changes caused by chemotherapy include:

Hot flushes and sweats, vaginal dryness and a lower interest in sex. It is common for women to develop vaginal thrush during chemotherapy – Please contact your GP for treatment.

Chemotherapy can affect the levels of the female sex hormones. If you have not had a natural menopause, you may notice changes to your periods. Sometimes periods stop altogether. Some women may have an early menopause. Your Oncologist will inform you if your treatment may affect your periods.

If your periods stop, it is still important to use contraception. This is because it may still be possible to become pregnant. You will need to use a reliable method of contraception during your treatment.

Being honest with your partner and talking openly about your concerns regarding sex can bring you closer together and ease any worries you have.

Men

Chemotherapy can reduce your sperm count. This could affect your ability to father a child after completion of chemotherapy. Sperm collection should be undertaken prior to the start of chemotherapy if you are thinking of starting a family in the future. This should be discussed with your Oncologist at your initial consultation.

Chemotherapy can cause side effects such as fatigue, which can then cause you to have less interest in having sex.

It is unusual for chemotherapy to cause erectile dysfunction, although a minority of treatments can cause some temporary changes to your sexual function. If you are affected by low sex drive or erectile dysfunction, it should improve on completion of chemotherapy.

Sometimes chemotherapy can cause testosterone levels to fall. This is more common in men who are being treated with high dose chemotherapy. Testosterone levels usually go back to pre-treatment levels a few weeks after chemotherapy ends.

Being honest with your partner and talking openly about your concerns regarding sex can bring you closer together and ease any worries you have.

Whilst on chemotherapy you may have to have investigations such as CT scan, Chest X-rays and others.

It can take up to 3 weeks to get the results of these investigations. If you have an out – patient appointment with your oncologist for these results, it is worth ringing the Lingen Davies Centre on 017430261000 ext 3421 to ensure the results are back. Your appointment can then be rescheduled if the results are not available which will save you any disappointment.