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Chemotherapy: Steps To Take Before Chemo Starts


Before starting chemotherapy, it is advisable to take the following steps. (If the list starts to become overwhelming, start with the steps that are most important to you. If you need help, ask a family member or friend for assistance.)

  • Be sure you understand all the information you need to know about the treatment, including:
    • The goals of the treatment.
    • How the treatment will be given.
    • How long each treatment will be.
    • Possible side effects, how long they may last and what you can do about them. For instance, if the chemotherapy drugs usually cause nausea and/or vomiting, discuss taking anti-nausea medication before chemotherapy starts. It is easier to prevent the problem than to get it under control after it starts. 
    • The course of your treatment. (Chemotherapy is usually a course of treatments instead of just one. The treatments are generally given in cycles).
    • Whether the treatment is recommended as part of a series of treatments (such as radiation and/or surgery). 
    • We provide a list of questions to consider asking in the document in Chemotherapy: Questions To Ask Before Agreeing To
  • Get a dental check up. 
    • Oral infections can worsen the effect of chemotherapy. 
    • Let your dentist know you are about to start chemotherapy treatment.
    • For information about good oral care, click here.
  • Increase your intake of calories and protein to help combat weakness that may occur during chemotherapy and to promote recovery.
  • Ask your doctor for a copy of the Medical Consent form you will be required to sign before treatment starts. Read the form carefully. Ask questions about anything you don't understand. Make changes as you desire.
  • Talk with your doctor about:
    • Any and all prescription and over-the-counter drugs, recreational drugs, vitamins, herbs and supplements you take. Include those you stopped taking recently and substances you may not think of as medicines. Your doctor will tell you if you should stop taking any of these substances before you start chemo. 
    • What you can do to be as healthy as possible during and after treatment. For instance:
      • Foods to eat or not eat, vitamins and supplements to take. For eating tips, National Cancer Institute has a publication Eating Hints for Cancer Patients Before, During and After Treatment available for free online at: offsite link or call for a copy: 800.4.CANCER
      • Consider speaking with a nutritionist/dietitian. 
      • If you smoke, stopping can help improve the body’s response to treatment, and lessen complications and side effects. If you quit permanently, stopping can decrease the risk of recurrence and enhance survival.
      • Consider complementary  therapies such as meditation and hypnosis. To learn about complementary treatments, click here.
    • What you should to do make up for any nutrients that may be removed from your system by the treatment. 
      • NOTE:Taking vitamin and mineral supplements or any other complementary and alternative medicine should never be done in place of medical care. You should not take any vitamins or supplements or engage in any complementary treatments without telling your doctor first. 
    • If  the drugs will be given through a port or catheter implanted under the skin, ask the doctor what choice you have about the specific location to make the appearance less noticeable and the device more comfortable. (For example, women may prefer the device below or above the bra line).
  • Learn about the side effects that frequently occur with the particular treatment and how to eliminate or minimize them.
    • Your doctor is a good source for this information. You can obtain additional information about side effects and particular treatments from such reputable web sites as The American Cancer Society offsite link or American Society of Clinical Oncologists, offsite link. Type in the name of the drug(s) that will be used. Be sure to ask your doctor any questions that come up from your research.
    • Articles in Chemotherapy: Side Effects And What To Do About Them provide practical information about each of the common side effects.  
    • Get prescriptions for medications that may minimize or help you cope with possible side effects. Prescriptions don't cost anything until you have them filled. If you have the prescriptions, you can fill them without delay if the need arises. 
  • If you are at risk for losing your hair:
    • Decide if you will want to wear a wig. If so, now is the time to get one to match your hair or at least to save a sample of your hair. Many insurance companies cover the cost of wigs. Free and low cost wigs are available.
    • Consider other ways of coping such as shaving your head or wearing hats and scarves or even sewing bangs into a scarf.
    • Instead of waiting for hair to fall out, consider cutting it off. Some people cut their hair in a ceremony with their partner or friends.
    • For information, see: Hair Loss From Treatment And What To Do About It.
  • If you smoke, quit. For tips about stopping, click here.
  • Stock up on comfort foods for those days when you may not feel well enough to shop and/or cook. 
    • Include some meal size portions in your freeezer that you can defrost as needed. 
    • When you freeze foods for this period, make the portions smaller than usual for those occasions when you don't feel like eating a lot.
    • Start learning about how to avoid infection relating to food - including purchase, storage, cooking and eating out. See: Food Safety: What You Need To Know About
  • Also stock up on a variety of beverages. It will likely be important to drink a lot of fluids. A variety may make it more likely that you will have sufficient intake of fluids.
  • Consider taking a tour of the area where chemotherapy will be administered and any other location where you will be spending time. This way you will know what to expect. You'll also get a better idea of what to bring with you to make yourself comfortable during a chemotherapy infusion.
  • Think about how you will get to and from chemotherapy treatments. If needed, American Cancer Society can help arrange transportation with its list of volunteer drivers. Call 800.ACS.2345. The more notice you give the Society, the more likely it can find a volunteer to fill your needs. The Society can also point you to available public transportation in your area.
  • Make appropriate arrangements at work if the treatment will interfere with your ability to work. For instance, arrange time off for chemo treatments - or even a break from work during chemo. To learn more, see: At Work
  • Understand the financial aspects of the treatment. 
    • If you have health insurance, you are still likely to have to pay some money depending on your particular policy.
    • If you do not have health insurance, start thinking about how to pay for the treatment. (Keep in mind that you may still be able to purchase health insurance despite your diagnosis.) If you have limited assets and income, you may qualify for Medicaid.
    • For information, see: Chemotherapy, The Financial Aspects
  • If you are considering having a child during or after completion of chemotherapy, explore your options now. For instance, sperm and eggs can be banked. To learn more, see: Chemotherapy: Preserving Fertility.
  • If you have underage children:
    • Give children some tasks to do so they feel helpful and included.
  • If you are a woman and take a PAP smear test periodically, consider getting a PAP smear before chemotherapy starts to avoid false abnormal results.Chemotherapy can affect the relevant cells for up to a year after the end of chemotherapy.
  • If there is time until the start of chemotherapy, talk with your specialist about "prehab" - basically exercise to strengthen the body's disease fighting ability. Prehab is generally covered by health insurance.
  • If your chemotherapy will lower your immune system (your infection fighting ability), learn how to avoid unnecessary infections now, For information about how to avoid infections on a daily basis, click here. For information about avoiding infection with good oral care, see above.
  • If you are likely to be fatigued or otherwise unable to your normal daily activities:
    • Consider setting up an online support network at a site such as offsite link  Family and friends can sign up on a calendar for chores that need to be done.
    • Speak with the person with whom you live about shifting some of your responsibilities for the duration or at least for days that are difficult for you.
  • If you have underage children:
  • It is likely safe to assume that you will not be able to do any unnecessary tasks or projects you've been planning to complete. 
  • Start thinking about how to reward ourself when treatment is over.

NOTE: This is a good time to start keeping your own copy of your medical records if you haven't already. Ask your doctors for a copy of your pathology report, test results and their records, and then start keeping your file to date. 

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