Chemotherapy FAQ

There are many different kinds of chemotherapy drugs available for treatment use. Your doctor will decide what kind of chemotherapy is best for you. The choice of drug used depends of a number of factors, including what type of cancer is being treated, what other illnesses or health problems you have, the expected side effects and what other treatments have been given in the past.

You may not have the same nurse at each visit. We have a team of highly qualified oncology nurses who are all equally capable of caring for you. All of our nurses receive continuing education and clinical development to provide you with quality, safe,and up-to-date care.

This depends on the type or combination of drugs that you are having. Many chemotherapy drugs do not cause hair loss, but others can cause hair thinning or even complete hair loss. Your Medical Oncologist and Nurse Specialist will be able to tell you how likely hair loss is with your treatment. If it is to happen, hair loss will usually start about 2-3 weeks after the first treatment, but will always grow back after you have finished your treatment. For some people, the thought of losing their hair temporarily is very upsetting. Some patients use scarves, turbans or colourful hats to help cope until their hair comes back, or if you prefer, we can organise a wig fitting for you.

In general, chemotherapy treatment is given in courses or cycles with rest periods in between. This allows normal cells to recover and your body to regain its strength. If your body needs more time to recover, the next cycle may be delayed.

The drugs may all be given on a single day, several consecutive days, or continuously as an outpatient or an inpatient. Treatment could last minutes, hours, or days, depending on the specific protocol, and this treatment may be repeated weekly, bi-weekly, or monthly. Your doctor will inform you of how long and how often your particular chemotherapy will be.

Depending on the drug/s being given, your visit to the day ward may vary from a few minutes to several hours. You will be advised of the time-frame for your chemotherapy when you are booked in.

Your specialist cancer doctor will have documented current medication at the initial examination. If there has been any modification of dose or drugs please let staff know prior to treatment. Occasionally you may be asked not to take a specific drug on the day of treatment due to possible interactions with the medication being given on the day. Please ask staff if you have any queries.

Eat and drink as you normally would on the day of treatment. Some people find it helpful to minimise excessively hot/spicy foods and alcohol prior to and initially after treatment to reduce heartburn/ gut irritation.

Not all chemotherapy drugs will make you feel sick or be sick. When we use the ones that do, we always give anti-sickness drugs to try and prevent the problem. Improvements in these drugs in the last few years means that many patients do not feel sick at all, or only have minor problems. If you are given anti-sickness tablets to take for a few days after your treatment, do make sure you take them as prescribed. It is much better to prevent sickness before it starts. If you still feel sick after chemotherapy, let us or your general practitioner know. We can often try another medication that can help.

Depending on the nature of your work and the individual situation it is still possible for a number of people to continue working whilst receiving chemotherapy. It is helpful to be aware that fatigue is a common side-effect of the treatment and that reduced hours/ flexible work arrangements are more realistic to allow optimal outcomes both from a treatment and a workplace viewpoint. Social work / Centrelink Services are available to assist you explore what financial options are available during treatment and beyond.

This depends on the chemotherapy drugs being given. Occasionally extra drugs are administered prior to the treatment to reduce the chances of reaction to the drug/s. Some of these “pre-medication” drugs may cause drowsiness, so it is advisable for the first treatment to have a designated driver and establish whether it is possible to drive yourself for subsequent treatments.

If you are planning to go on holidays shortly after completing your chemotherapy, please discuss this with your treating doctor

Many people who receive chemotherapy experience fatigue. This can sometimes be caused by anaemia. Your daily activities should be planned according to how you feel, and you should take rest periods throughout the day as often as you feel necessary. Some tips on managing your fatigue include:

• Maintain your usual lifestyle activities, as much as possible, but pace activities according to your energy level. Plan on doing your most important activities first or when you feel your best.
• Mild exercise such as walking, playing golf or stretching may actually increase your feelings of energy. Heavy exercise, however, generally should be avoided.
• Eat a well-balanced diet. Good nutrition will help with your energy level.

Your treatment team can suggest other ways to help you deal with fatigue

If you develop any of the following symptoms while you are on chemotherapy – and for four weeks afterwards – you should ring us for advice immediately:

• if you are feeling extremely hot or have a temperature above 38°C on two occasions one hour apart or 39°C on one occasion
• sore throat
• chesty cough
• stomach bug or upset stomach
• urine infection (cystitis)
• feeling generally unwell, achy or flu-like
• redness or discharge around a Hickman or other central line
• shivery episodes after flushing a Hickman

DON’T DELAY: It is very important to act immediately. Contact us on ph (03) 4215 2709 during business hours or ph (03) 4125 2264 after hours.

If you become unwell at night or on the weekend, or you cannot get out of bed, you should present to the emergency department via an ambulance or family member. If you have a neutropenia card, please take this with you and/or inform the triage nurse that you are having chemotherapy. They will need to put you into an isolation area so you are not exposed to possible infections in the waiting area.

Anaemia is a low red blood cell count.
Red blood cells carry oxygen throughout your body. When there are too few red blood cells, you have anaemia. Your body tissues don’t get enough oxygen to do their work, and you could feel weak, tired or even experience dizziness, chills or shortness of breath. Anaemia can be treated. If you have any of these symptoms, please let your treating team know.

Neutropenia is a low white blood cell count.
Because chemotherapy kills both cancerous cells and other normal cells that grow at a fast rate, white blood cells are often destroyed along with the cancerous cells resulting in a condition of low white blood cells in the circulating blood.
Because white blood cells play an important role in preventing infection, any time your white blood cell count drops you are at higher risk of getting an infection. This doesn’t mean that you need to isolate yourself from other people, though it is sensible to avoid close contact with those who have obvious coughs, colds, flu and so on.

Thrombocytopenia is a low platelet count
Platelet cells are the types of blood cells that help form blood clots. Platelet cells are made in the bone marrow and can be found in both the bone marrow and the circulating blood. Patients with certain types of cancer and those patients receiving chemotherapy or radiation may experience a reduction in the number of platelets in the circulating blood called thrombocytopenia. This condition may increase your risk of bruising and bleeding