Chemotherapy

Nausea / Vomiting

Uncommon these days with good anti-emetic medicines. Tips: relax during chemo; avoid fried/fatty food; eat easy-to-digest food slowly; avoid bothersome odours; maintain fluid intake.

Lethargy & Tiredness

• Get plenty of rest; sleep longer at night and take naps
• Exercise between rest according to tolerance
• Get help in daily activities; eat well-balanced diet
• Drink plenty of fluids — minimum 2 litres a day

Mouth Ulcer

• Good oral hygiene; rinse after each meal
• Soft bristled toothbrush; adequate fluid intake
• Avoid food that is too cold, hot, spicy, rough or dry
• Choose soft, soothing food such as porridge and soft fruits

Hair Loss

Some drugs cause no hair loss, some thinning, others complete loss. Hair usually grows back, sometimes with different texture.

Preventing hair loss: mild unperfumed shampoo; don't wash too frequently; dab dry; soft brush; avoid elastic bands, dyes, perms, alcohol products, excessive heat.

When you lose hair: consider short cut or shave; soft hat in bed; sunscreen/scarf; wig/scarf/cap if desired. Avoid perming/colouring for at least 6 months after treatment ends.

Bone Marrow Suppression

Chemotherapy can affect production of red cells, white cells and platelets.

Anaemia: check Hb regularly; iron-rich diet; rest; light exercise.

Thrombocytopenia: report unexpected bruising, petechiae, bleeding gums/nose, reddish urine or black stools; avoid invasive procedures and sharp instruments; pressure on injection sites >10 minutes.

Neutropenia: high hygiene; wash hands; avoid crowds and uncooked food; no flowers/plants in room; check temperature — if >38°C inform nurse/doctor immediately. See Neutropenia page.

Diarrhoea & Constipation

Diarrhoea: adequate fluids; low-residue lactose-free diet; avoid spicy/fatty foods, alcohol, tobacco; keep perianal region clean (wash with water after defecation) to prevent infection.

Constipation: high-fibre diet if appropriate (fruits, vegetables and cereals); drink plenty of fluids; warm fluids and prune juice are helpful; physical activity as tolerated.

Loss of Appetite

• Try a variety of food
• Drink liquids at least an hour before or after meal time instead of with your meals
• Take advantage of “good” days to increase your food intake
• Eat small amounts throughout the day if large meals are difficult
• Eat a well-balanced diet; chew food well and eat slowly

Nausea — practical tips

• Try to relax during chemotherapy
• Stay away from fried or fatty food
• Take food that is easy to digest; chew well and eat slowly
• Try to avoid odours that bother you (e.g. smoke or perfume)
• If you experience nausea even before chemotherapy starts, try to avoid heavy meals or you may choose not to eat during chemotherapy — but remember to maintain fluid intake
• Anti-emetics (e.g. Maxolon, Kytril/granisetron, Aloxi, Emend) are commonly used to prevent this side effect