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Colorectal Cancer: In Treatment: Chemotherapy

During Chemotherapy Treatment

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On Treatment Days

Before you go to treatment:

  • Eat at least an hour before treatment if you are experiencing nausea after treatment.
  • Take with you any medications (including stool softeners and anti-diarrheal agents) that you may need later.
  • If prescribed, take your anti-nausea pills before leaving home.
  • Line up someone to drive you to and from treatment if the medication causes drowsiness.
  • Store a bucket in your car “just in case” you become nauseous during the ride home.
  • If your chemotherapy will be administered by an IV drip or syringe rather than by a take home infusion pump:
    • Wear comfortable, layered clothing with easy access to your chemoport
    • Bring something that you find relaxing and enjoy doing, you may be there for several hours.  If you bring music bring earbuds so you do not disturb your neighbors.  Some people find this an ideal nap time.

Keep in mind that often treatment does not start until a doctor, nurse or medical technician does the following:

  • Weigh you
  • Take your blood pressure and temperature
  • Do a brief physical
  • Ask about symptoms and side effects you may have experienced (our Symptoms Diary can help you keep track) 
  • Draw blood to check blood counts to do a standard complete blood count (CBS). If your blood counts are too low, treatment may be delayed a few days or a week. A delay of a few days or a week is not likely to affect the success of your treatment. To avoid a long delay, you may be given drugs to bring your blood counts up to safe levels. These drugs are man-made copies of natural body products that cause bone marrow to produce more new blood cells than it otherwise would.
  • If you had a high level of CEA, part of the blood draw will be used to test for CEA. To learn about CEA, click here.

Try to make friends with the oncology nurses (who are generally friendly as well as knowledgeable) and fellow patients. Both can give you insights about the chemotherapy experience and practical advice – as well as help to pass the time while undergoing treatment. (Who knows? You may even make a new friend. Social support is important to health.)  Due to the federal law known as HIPAA, as a general matter, patients no longer sit in communal circles they usually have private treatment areas which make it difficult to talk with other patients during treatment.

Do not leave the treatment area if you are not feeling well. If you don’t feel well, tell the medical staff.

If you received treatment through an IV line, consider using the bathroom before leaving. IV drugs are often given with a saline drip which can fill  our bladder and surprise you with an urgent need to urinate before you get home.

In General

  • When you meet other people going through chemotherapy, don’t be surprised if their treatment schedule is different from yours. Chemotherapy schedules are tailored to the individual situation.
  • Understand that treatment decisions may change as treatment goes along. A change does not mean that the original treatment was wrong. Medicine is a combination of science and art.
  • Think about your treatment goals and keep them in mind. Don’t live in the future. Live in the here and now. Setting goals can help. As you move toward your goals you are likely to feel happier and stronger, more energized and effective. You feel more competent and confident in yourself and your abilities. Setting goals recognizes that you can’t make changes overnight, and you can’t heal faster than nature allows. Writing goals down somewhere you are likely to see can be a reminder that helps get through any dark times. 
  • Before taking any supplements or over the counter vitamins or herbs check with your doctor.  
    • Do not take vitamins, minerals, herbs, antioxidants or other dietary supplements without first asking your medical oncologist or other members of your cancer treatment team whether it is okay. Some of these substances such as St. John’s Wort can be harmful when mixed with chemotherapy. Some may reduce the effectiveness of the chemotherapy.
    • All cancer survivors should avoid high-dose vitamin A and C supplements.
    • If medical personnel suggest or allow you to take vitamins, minerals, herbs, antioxidants or other dietary supplements, do not take more than is recommended without first checking with medical personnel.
  • Keep track of your symptoms so you can report them when you see your doctor. We provide a symptoms diary to help you keep track. When you are ready to see a doctor, you can change your diary into an easy to read graph with the push of a button.
  • Do your best to live a lifestyle that helps your body function at its disease-healing best. The same lifestyle may also help prevent a future recurrence. It may make it easier to adopt and continue a healthy lifestyle if you think of it as part of your medical regimen.
    • It is not worth spending even a minute  worrying about your previous habits. Focus on what you can do now to improve your lifestyle.
    • Do not expect to make big changes overnight. Start small, with one step at a time. 
  • Do your best to eat nutritiously. During treatment, you may need extra protein and calories. At times, your diet may need to include extra milk, cheese, and eggs. If you have trouble chewing and swallowing, you may need to add sauces and gravies. Sometimes, you may need to eat low-fiber foods instead of those with high fiber. Ask your oncologist about any diet changes you may need to make. If he or she doesn’t know, ask to be referred to a nutritionist/dietitian who helps people with colorectal cancer. (For information about what a nutritionist/dietitician does, choosing a nutritionist/dietitician, and insurance issues, click here.) 
  • Chemotherapy can wreak havoc with your appetite. Do your best. Be practical, not obsessive.
  • Take it easy. You may not have as much energy as usual, so try to get as much rest as you can. Let the "small stuff" slide, and only do the things that are most important to you.
    • Take a hot bath, with or without bubbles.
    • Get a massage.
    • Go to a movie.
  • Be active and exercise (yes, even during treatment subject to your doctor’s approval - though you may have to take it easier.) NOTE: If your blood counts drop to the point that you are at risk for infection avoid public places including gyms. Your doctor may suggest that you do not exercise at all until your cell counts return to a safe level. (For additional tips about avoiding infection, click here.)
  • Get appropriate rest and sleep. Keep in mind that while actively undergoing treatment, you may need more sleep than the average person.[i] For information about sleep, click here
  • Stay hydrated with safe drinking water. Chemotherapy is toxic. The chemical poisons are flushed out through your kidneys and bladder. If you do not drink enough liquids, your kidneys and bladder will be exposed to higher concentrations of toxic chemicals. This is the reason people are given beverages to drink during treatment and told to keep fluid intake high. Check your drinking water to be sure it is safe for people who are prone to getting infections. (To learn about safe water, click here.
  • Aim for a healthy weight.
    • If nausea and vomiting make it difficult to eat or to maintain weight, click here. 
    • While you may think only about weight loss during chemotherapy, it is not uncommon for people who undergo chemotherapy to experience weight gain. Do not attempt weight loss during treatment. Wait until the post treatment recovery phase.
    • A combination of psychological support, nutritional counseling and exercise can help to maintain or lose weight. 
  • If you are undergoing acupuncture as a complementary treatment:
    • As noted above, be sure your doctor knows.
    • Watch your white blood and platelet counts. If either are low, ask your doctor if it is okay to continue acupuncture. If the doctor says “yes”, be sure to tell the acupuncturist about your low count.
  • Pamper yourself. 
  • Spread the word among your friends that cooking may be difficult for you. Home cooked meals provided by friends have been said to have the taste of love in them.  It may also help if you let them know specifically what you can and cannot eat, friends are more than willing to accommodate you and help with food.
  • Reduce risk of infection in all aspects of your daily life. Infections slow recovery. For instance, avoid public places such  as gyms and spas as much as possible. To learn more, click here.  
  • Practice good oral hygiene.
    • If your dentist advised you to take additional precautions during treatment, take them. For instance, your dentist may recommend a fluoride mouth rinse or a fluoride gel in addition to daily brushing.
    • An infection in your mouth can lower your body's ability to fight your cancer. Keep your mouth clean. Brush at least twice a day. Floss at least once a day. (If you haven't had one lately, schedule a dental check up). 
    • Check your mouth every day. Call your dentist immediately if you notice any changes or problems. Any of the following symptoms may indicate an infection.
      • Bleeding or a sticky, white film in your mouth 
      • Lumps 
      • Soreness 
      • Swelling 
      • Ulcerations.
      • To learn more about oral care, click here.
  • Minimize alcohol consumption. For example, men should limit drinking to two drinks a day. Women should limit alcohol to one drink a day.
  • Minimize stress. To learn how, to avoid unnecessary stress, click here. To learn how to deal with stress, click here.
  • Deal with emotions that surface. To learn how, see: Tips To Help Feel In Control Of Your Emotions 
  • If you smoke, stop. 
    • Smoking may interfere with the effectiveness of cancer therapy. Cancer patients who smoke have a lower survival rate than nonsmokers. By quitting, you can improve the body’s response to treatments, lessen complications and side effects, decrease the risk of recurrence and enhance survival.
    • Quitting during treatment may be very uncomfortable. It may include a variety of symptoms such as difficulty sleeping, depression, anxiety and irritability. On the other hand, it may help keep your mind off of the treatment.
    • For information about quitting, click here.     
  • Keep in mind that your primary doctor is also part of your medical team. Ask your specialists to keep him or her up-to-date. Don't skip your regular appointments. 

For information about chemotherapy, see:

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