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Guideline Department of Oncology AP.65.01E 1 (3) 29.4.2017 For patients receiving cancer drugs On XX/[Month] 20___, you started medical cancer treatment with the following medicines: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ General The reception and medical treatment visits at the outpatient clinic are mainly on different dates. Remember to show your certificates and prescriptions at your physician's appointment. If necessary, a nurse will provide you with a certificate for travel reimbursement to compensate for using your own car or a taxi. You are welcome to bring someone along with you to the reception. It is important to take good care of hand hygiene when you are receiving cancer drug treatments. Good hand hygiene prevents infections. Drink enough fluids for a couple of days before and after the treatment, and avoid alcohol and vitamin supplements. Cancer drug treatments prevent the growth and division of cancer cells in different ways. The side effects are caused by the drugs targeting not only the cancer cells but also healthy cells. The nature and severity of the side effects are different for different people. Nausea Some cancer drugs, but not all of them, cause nausea. Antiemetic drugs (which prevent nausea) can often be changed and tailored to suit your individual needs. There are several drugs available for alleviating or completely preventing nausea. If you experience nausea, see if the following tips help: • Eat little at a time and often, so that your stomach is never completely empty. • Eat and drink calmly and chew carefully. • Eat cold food whenever possible. • Drink between meals rather than during meals, if possible. Pirkanmaa Hospital District www.pshp.fi Guideline Department of Oncology AP.65.01E 2 (3) 29.4.2017 Foods containing a lot of fat or sugar, spicy foods, foods which have a strong smell as well as milk and dairy products may sometimes cause nausea. Smells from cooking may also increase it. Your sense of taste can sometimes change. If food you usually eat does not taste good, try new dishes. Your sense of smell can also change so that strong smells alone may cause nausea. Constipation Some pain medications and cancer drugs may cause constipation. Constipation can be prevented by: – exercising – eating lots of dietary fibre – consuming enough fluids – taking drugs that improve bowel movements. Diarrhoea Prevention of diarrhoea Avoid foods rich in fibre and make sure you drink enough fluids. If you start to have more than four bowel movements per day or if you have diarrhoea during the night, you should start taking loperamid (2 tablets = 4mg, e.g. Imodium or Imocur) immediately after the symptoms begin. The diarrhoea medication should be continued with 1 tablet every 6 hours until 12 hours have passed from the last bout of diarrhoea. If the symptoms are strong or if they continue for more than one day or if you have fever, contact your personal nurse. Other side effects Hair loss will begin at approximately 1–2 weeks from the start of treatment, but not in all treatments. Cancer drug treatments may increase the feeling of fatigue or tiredness and may also result in reduced libido. Mild exercise decreases fatigue symptoms. Sometimes a drug given as a subcutaneous injection under the skin is used in connection with strong cancer drugs. It boosts the production of white blood cells in bone marrow (known as a “white cell growth factor”). This may cause bone or muscle aches, which can be alleviated with pain medications. Drugs given via intravenous 'drip' treatment into a vein may cause local irritation at the site of the injection as well as the area around the vein (burning sensation, pain, redness). If this occurs, inform the nurse or the physician. Pirkanmaa Hospital District www.pshp.fi Guideline Department of Oncology AP.65.01E 3 (3) 29.4.2017 Tell both the nurse and the physician about any changes in your condition and the side effects of the treatment. Contact the outpatient clinic of the oncology department if you have any of the following symptoms: – a temperature of over 38 °C – bleeding symptoms: large bruises, bleeding from the gums, prolonged nasal bleeding, gynaecological bleeding, bloody cough, bloody vomit, black stool or blood in the urine. – severe stomach pain, prolonged constipation or diarrhoea – severe vomiting that continues for more than 2 days despite medication – extensive rash or some other hypersensitivity reaction – mental confusion, cramps – flu-like symptoms, fever, stomach pain, etc. before the next treatment. The telephone number for the oncology outpatient clinic medical treatment is +358 3 311 63468. Follow the instructions and we will call you back. If you have a problem during the weekend, in the evening or at night, contact: Oncology ward RS1, telephone +358 3 311 63311 Oncology ward RS2, telephone +358 3 311 63312. Tays emergency care Acuta, telephone +358 3 311 66411 Pirkanmaa Hospital District www.pshp.fi