Managing Patients On Chemotherapy

Before Chemotherapy

Dental

A complete dental check-up including teeth cleaning is recommended before chemotherapy. The mouth contains bacteria which can get into the bloodstream during teeth cleaning or other dental procedures such as a root canaling. If a complete dental check-up is not possible before chemotherapy, it is important to inform the doctor. As chemotherapy weakens the immune system, patients are susceptible to infections caused by bacteria.

Clothing

The following clothing should be worn during chemotherapy:

  • Port or arm accessible clothing on treatment days.

  • Pants which can be opened one-handed if patient is receiving intravenous treatment in the arm

  • Medic Alert wristband, bracelet, necklace, dogtag to highlight allergies, drugs, conditions e.g. "No taking blood pressure or inserting needles on the arm which is at risk for lymphedema".

  • If the chemotherapy drug causes increased sun sensitivity; sunblock, sun hats, dark colours and heavier woven fabric may be worn. This will prevent UV rays from reaching the skin

Vitamins and Antioxidants

Antioxidants have received heightened media attention in recent years in regards to cancer prevention. They can be found in a diet rich in fruits and vegetables, and larger amounts may be consumed through supplements. Vitamin E and selenium supplements have been proven to reduce the incidence of prostate and colon cancer. Antioxidants are used by some patients during cancer treatment to reduce the side effects of chemotherapy. Common antioxidants in dietary supplements

  • Alpha lipoic acid

  • Grape seed extract

  • Beta-carotene

  • Lutein

  • Vitamin A

  • Lycopene

  • Vitamin C (ascorbic acid)

  • Selenium

  • Vitamin E (alpha-tocopherol)

  • Zinc

Chemotherapy agents that are metabolized in the liver which can be affected by food supplements that are also metabolized by the liver are:

  • Taxol

  • Taxotere

  • Vincristine

  • Irinotecan

  • Etoposide

Food supplements metabolized in the liver and should be avoided when using the above chemotherapy agents:

  • Grape fruit juice

  • Milk thistle

  • Goldenseal

  • Cat’s claw

  • Cannabinoids

  • Licorice

  • Chamomile

Foods to Avoid

Chemotherapy damages mouth and stomach cells. An enhanced sense of smell may also occur creating an aversion to certain foods with strong odors and causing nausea. Spicy, fried, high fat and very sweet foods which upset digestion should be avoided.

Timing of Meals

Eating a light meal before treatment can stave off hunger and provide energy. To avoid developing an unwillingness to eat, patients are advised not to eat too close to the time of treatment. Eating 1-2 hours before and within three hours after treatment may lead to nausea, so it is advised to avoid eating within these time periods. Also the patient should avoid lying down for about an hour after eating.

During Chemotherapy

Maintaining a regular routine of activities while on chemotherapy is different for every person and depends on certain situations. Some people continue to work while others require time off. Doctors and oncology nurses can recommend what a patient is able to do based on their chemotherapy regimes and health histories. This can help the patient mark all treatment days and any follow-up appointments or lab tests on a calendar. For example, if having treatment every three weeks:

  • First week after treatment - patient may not have much of an appetite. Business lunches or big dinners should be avoided.

  • First two weeks after chemotherapy - patient may feel tired and could be more susceptible to infections. Large groups of people at business meetings, hotels, airplanes, and other crowded places should be avoided. Patient should diligently wash hands and watch for any signs of infection or fever.

  • Third week after chemotherapy - patient will likely feel good. This is the best time to plan business meetings or travel.

After Chemotherapy

Food recommended for patients after undergoing chemotherapy

Food Type

Example

Clear broths or light soups

Fresh fruits - soft, watery fruits such as watermelon

Cheese/yogurt

Bread (sandwiches/ toast)

Rice/potatoes (baked/steamed/ micro waved/ mashed)

Ice-cream

Crackers/biscuits

Yogurt


Yogurt is a good choice of food to eat after chemotherapy for several reasons. The Cancer Cure Foundation explains that Lactobacillus bulgaricus, the healthy bacteria found in yoghurt can boost the immune system. In addition, yogurt may help reduce nausea as it is mild and bland. It also contains protein and calcium, which helps keep bones and muscles healthy. Chemotherapy patients should eat only pasteurized yogurt as unpasteurized yogurt can cause food-borne illness.

Meat

Chemotherapy patients are encouraged to consume high protein foods. The cancer-based website ChemoCare.com explains that high protein food increase energy and help spare muscle tissue from being wasted. Protein found in beef also helps the body heal itself and fight infection. To help avoid nausea, meat roast with potatoes, carrots and a few spices are recommended.

Cooked Broccoli


Five or more daily servings of fruits and vegetables can increase energy levels and help fight cancer. Raw vegetables should be avoided after chemotherapy, as they may harbour dangerous food-borne illnesses. Cooking of vegetables eg. broccoli help to kill harmful microorganisms, and make these foods safer for chemotherapy patients to eat.

Bananas


Bananas contain antioxidants which help to fight cancer and are a better choice of fruit for chemotherapy patients. The Cancer Cure Foundation states that fruits with protective barriers, like bananas with peels have fewer microorganisms which could make a patient sick. Bananas go well with many foods including high-protein foods such as cottage cheese or peanut butter.