Preparing for Chemotherapy
How to Prepare for Chemotherapy
Chemotherapy is likely to disrupt your normal routine and family life. Preparing ahead of time can help relieve stress and minimize chemo's impact on your physical and emotional health.
By Mikel Theobald
Medically Reviewed by Niya Jones, MD, MPH
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Chemotherapy isn’t a one-and-done treatment — it’s a journey and, as with any journey, planning ahead can make the road less bumpy. “Chemotherapy encompasses a wide variety of medications and active chemical agents that work toward killing abnormal or cancerous cells,” explains Elizabeth Chabner Thompson, MD, MPH, a radiation oncologist and founder of Best Friends for Life, a company that focuses on supporting people with cancer.
While there’s no way of knowing what your individual experience with chemo will be like, there are practical steps you can take to prepare for the impact treatment might have on your day-to-day responsibilities as well as necessary tests to schedule to make sure your body is ready for the challenge.
Prep to Minimize Daily Living Disruptions
Anticipate downtime after chemotherapy treatments to give your body the rest you’ll need. By making arrangements for routine tasks prior to beginning chemo, you’ll have less to worry about once the effects of treatment sneak up on you. Create a list of tasks you do on a daily, weekly, and monthly basis, and create a support team to help you when you are not able to do them yourself. Here are more specifics when preparing for chemotherapy.
Plan ahead for healthy eating:
- Have meals as a family or with a friend so that you are more likely to eat something. When nothing sounds good, have soft, bland foods cooled to room temperature, such as eggs, mashed potatoes, and cooked cereals.
- Start eating healthy now to boost nutrition and set a pattern that can be followed for as long as possible once chemo begins.
- Cook and freeze meals for the future or create a schedule for friends and family who offer to bring meals to your home while you are undergoing treatment.
- Think about dividing meals you freeze into small portion sizes, since bigger meals may be harder to tolerate during treatment.
- Stock up on non-perishable, healthy food items for times you are unable to get to the grocery store.
- If you like bottled water, stock up so that you’ll be able to stay hydrated.
Plan ahead to avoid germs:
- Hire a service or housekeeper to come in on a weekly basis to keep your living space as clean as possible, especially the bathroom.
- If it isn’t already a habit, get used to washing your hands often. Start talking with family and friends now about the need for them to wash their hands any time they plan to be around you.
- Adopt a no-handshakes and no-kiss policy to further limit your risk of exposure.
- Keep anti-bacterial wipes in your pocket.
- If your doctor gives the all-clear for sexual activity, practice safe sex with condoms.
Get finances set up:
- Set up bills to be automatically paid from your checking account. Even if a specific company does not offer auto-pay, your bank may offer an online bill-pay service where they will generate the payment for you at a pre-determined time.
- If finances are going to be tight, make arrangements for payment plans prior to beginning treatment. No one wants to deal with bill collectors in general, let alone while going through chemo.
Make arrangements at work:
- Talk with your human resources representative or employer to let them know you will be taking time off. They can provide you with Family Medical Leave Act (FMLA) forms to complete. FMLA entitles eligible employees to take 12 weeks of unpaid job-protected leave from their jobs without losing their health insurance.
- If someone will be taking over your duties while you are away from work, plan to train her or discuss responsibilities before you leave to ensure continuity.
Caring for kids and your home:
- Make arrangements for someone to provide transportation to and from school for your children. If they are involved in after-school activities, ask a trusted parent with a child involved in the same activity if she would provide rides for your child.
- If you have family nearby, ask them to attend games and performances when you can’t — your body’s defenses against illness will be weakened by the chemo, making it necessary to stay away from situations where you could be exposed to illness-causing germs.
- Consider inviting a relative to stay with you to help care for your children. Even if another parent is in the home, chances are your spouse will be busy helping to take care of you.
- Plan ahead for lawn maintenance and trash days. If necessary, hire services.
Planning for Chemotherapy: Health Preps
Your doctor’s office will outline pre-chemo requirements, but, in general, these are the steps you’ll likely need to take.
Standard blood tests.Your doctor will order blood tests prior to chemo treatment in order to establish a baseline record and to ensure your body is ready for chemotherapy. “Knowing certain blood levels of cancer markers before chemotherapy will help measure how the treatment is working — Is it effective or not? Do we need to change drugs to kill more cancer cells?” explains Dr. Chabner Thompson.
As treatment progresses additional blood tests will measure how your body is responding to chemo. “Chemotherapy can cause changes in blood cell counts and in blood chemistries, and the effect on the cancer cells dying can also lead to secondary effects that can be measured in the blood. Doctors can look for changes in liver, kidney, and heart function as the treatment progresses,” she adds.
Radiologic tests.X-ray, MRI, CT, PET, and ultrasound are all types of radiological imaging tests that may be used by your doctor before, during, and after chemo. Chabner Thompson says that these tests can be long and involve a lot of waiting room time. She recommends bringing something to keep yourself occupied during your wait. “You may need repeat tests after several cycles,” says Chabner Thompson. “This is normal. The physicians are measuring response to treatment.”
Dental exam.It is critical to see your dentist prior to beginning chemo in order to check for signs of infection that could lead to complications, Chabner Thompson urges. Begin using a baking soda and warm water rinse as part of your nightly oral care routine in order to ward off mouth sores once chemotherapy begins. The National Cancer Institute recommends adding 1/4 teaspoon baking soda and 1/8 teaspoon salt to 1 cup warm water, and then taking small sips and swishing around your mouth before spitting and rinsing with plain water. It is also recommends to use toothpaste that does not contain sodium lauryl sulfate, which can cause mouth irritation.
During chemotherapy many people experience dry mouth. Chabner Thompson recommends having Biotene mouthwash on hand to help relieve this uncomfortable sensation.
Podiatric evaluation. Chemotherapy can affect nails and skin and lead to infection if any existing health concerns aren’t addressed before starting chemo, warns Chabner Thompson. If you have problems with poor circulation, diabetes, or other health conditions that cause issues with feet or wound healing, schedule an evaluation with a podiatrist before beginning chemo.
Rest.Chemotherapy can leave you feeling wiped out. Take time to rest prior to chemo so you go in feeling healthy and strong, and plan for added rest during and after treatment. Fatigue also results because chemo drugs can cause blood counts to drop. When blood counts are at their lowest point, you’re at risk for infection and must rest to rebuild strength. This is when your living space needs to be as clean as possible, and you need to be separate from anyone who may have an infectious disease. When your blood counts are low, simple viruses can have serious and life-threatening implications.
Planning for Chemotherapy: Your Emotional and Mental Health
The effects of chemotherapy aren’t all physical. “One of the first things I tell my patients who are going to start chemotherapy is to prepare themselves intellectually, emotionally, and physically,” says Paul Hokemeyer, PhD, JD, a licensed family therapist based in Manhattan.
From a physical aspect, rest, a healthy diet, and exercise can help to ensure you begin chemotherapy treatments with the strongest, most resilient body possible. Intellectually, train your mind to focus on health and recovery, not on illness and death, says Dr. Hokemeyer. “This requires considered practice.” Guided meditation is a helpful tool for maintaining a positive outlook.
Emotionally, look for a support group where you can go to express your fears and anxiety about the process, Hokemeyer encourages. The love and support of family and friends is a crucial element of healing, but it can be difficult to share your true emotions if you feel like you have to put on a happy face to keep loved ones from worrying about you. Hearing friends and family tell you “everything is going to be fine” may be comforting, but seeing and hearing from people in an outside support group, who have recovered from similar circumstances as yourself, can be valuable to your emotional health.
Video: Cancer Treatment: Chemotherapy
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