It is important to know that not all medicines and drugs work to treat cancer in the same way. There are a lot of different treatments for cancer with many more being studied. Drug treatments such as chemotherapy, immunotherapy, or targeted therapy are often referred to as systemic or a way to treat the entire body. There are three different goals of treatment: curative intent, control, palliation.
- Curative intent: This term is used when a treatment is given that has a chance of curing a person's cancer.
- Control: If cure is not possible, the goal of control is to give treatment so the disease is stable. The cancer can then be managed as a chronic disease and controlled with treatment.
- Palliation: The goal of palliation is to relieve symptoms caused by the cancer. When cancer reaches advanced stage, no longer able to control and continues to progress the goal of giving treatment is to improve quality of life.
Chemotherapy can also be used with other treatments such as surgery, radiation, or both. It can also be used with other drugs such as targeted therapy, immunotherapy, and hormone therapy.
In this health unit:
- What chemotherapy is.
- Oral chemotherapy.
- Infusion chemotherapy.
- Common side effects of treatment.
- Palliative care.
- What to do in the first 48 hours after treatment.
- Managing symptoms of chemotherapy.
More information can be found at cancer.org.
The CMH Infusion Center is a warm and homelike environment featuring natural light, Columbia River views and artwork provided by local artists. While receiving infusion services, our friendly and compassionate caregivers do all they can to ensure your comfort.
- Complementary therapies such as music, massage and aromatherapy.
- Wireless internet.
- Warm blankets and pillows.
- Complementary light refreshments and snacks.
- IPADs are available to use during your infusion.
Infusion chemotherapy is when cancer fighting medication is delivered into your blood through a needle in your arm or a central line. This infusion may take a couple hours or all day.
Your oncologist may recommend immunotherapy as part of your cancer treatment plan. Immunotherapy helps to boost your body's natural defenses against cancer.
Your oncology doctor may determine that an oral chemotherapy drug is the best way to treat your cancer. Oral chemo is a pill or liquid that you swallow and take at home.
Before you start, you will receive very clear instructions on how to take your medication and what side effects to expect. It is very important to take your oral chemo exactly as the doctor tells you.
Receiving oral chemotherapy
Your oral chemo will come from a specialty mail order pharmacy, which will coordinate your medication shipments. Your medication may be delivered to the clinic or to your home, depending on your preference and insurance requirements.
Sometimes your insurance copay may be very high, since these drugs are very expensive. Our team will work with you and the specialty pharmacy to find funding assistance to make your medication affordable.
Working with your care team
Even though you will be taking your chemotherapy at home, you will still be followed closely by your oncology team, with lab work, scans and doctor visits.
At the CMH-OHSU Knight Cancer Collaborative we have a designated oral chemotherapy pharmacist. The oral chemotherapy pharmacist will meet with you to provide education and assistance.
If you have any questions please call our clinic or contact the oral chemotherapy pharmacist at 503.338.4646.
Chemotherapy drugs are designed to kill fast-growing cells in the body. Because of this, healthy tissues made of fast growing cells can also be affected. Healthy tissues that may be affected include:
- Hair follicles
- Cells in the bones that form blood
- Cells in the mouth and digestive tract
- Reproductive cells
We experience side effects when chemotherapy harms healthy tissue. Please let your care team know about any side effects you're experiencing. In some cases, we can help alleviate them.
When to call your provider
Some side effects are more serious than others and may be a sign of infection. Call your doctor immediately if you have any of these:
- Fever of 100.4F or greater.
- Unexplained bleeding or bleeding that does not stop.
- Chest pain, shortness of breath, wheezing or trouble breathing.
- Rapid, irregular heart rate.
- Dizziness, lightheadedness.
- Hives, a cut or a rash that swells, turns red, feels hot, painful or beings to ooze.
- Nausea or vomiting for several days.
- Diarrhea for several days, despite Imodium.
- Frequent or painful urination.
- Feeling confused, having frequent headaches or trouble seeing.
After a chemotherapy treatment you should take extra precautions to protect people around you from the powerful drugs in your system. Chemotherapy agents will be in your urine, stool and vomit for the first 48 hours (two days) after treatment. Trace amount can be found in your saliva, vaginal fluids and semen. It is safe for you to be with your family, but follow these guidelines to keep them safe.
- Handling waste: Always wear gloves when working with soiled linen, equipment and waste. Pregnant women should avoid all contact with contaminated waste.
- In the bathroom: When using the toilet, flush it twice with the lid down. Clean the toilet with a cleaner daily. If using a bed pan, urinal, commode or vomit basin, rinse it after each use. Wash it with soap and water daily.
- Incontinence: If incontinence of stool or urine occurs, change soiled clothing immediately. Wash the skin well and pat dry. Applying protective ointment may prevent the skin from irritation. Immediately place soiled linen in the washer and wash it twice with hot water and regular detergent. Do not wash any contaminated linen with other items.
- Sex: A condom should be worn during sexual activity.
- Zofran 8mg (Ondansetron) take every 8 hours as needed for nausea, may cause constipation.
- If still nauseated after 30 minutes of taking Zofran, take Compazine (prochlorperazine) 5-10 mg every 6 hours as needed for nausea (maximum 40 mg per day).
- Use Imodium (Loperamide) over the counter for diarrhea.
- On the 1st episode of diarrhea, take 2 tabs of Imodium, then 1 tab every 2 hours until diarrhea free for 12 hours. Maximum 8 tabs per day.
- Call the clinic for 3 or more episodes of diarrhea not controlled with Imodium.
- Drink plenty of fluids—12 (8 oz.) cups of fluids daily. Avoid caffeinated products.
- Eat small frequent meals that are low fiber such as: Banana, Rice, Applesauce and Toast (BRAT diet).
- Keep rectal area clean and dry.
- If above isn't enough, please call the clinic.
Constipation, prevent and treat
- Try eating lots of high-fiber foods, such as fruit, vegetables and whole grains (aim for 4 to 5 cups).
- Drink plenty of fluids (at least 8 cups or 64 oz. per day) and get as much exercise as you can. Being physically active helps the GI tract function optimally.
- Try relaxation techniques, such as meditation, yoga or light stretching.
- If the above isn't enough, please call the clinic.
It's not uncommon for people to experience a loss of appetite, difficulty swallowing, dry mouth, nausea or vomiting as a result of cancer treatment. This can lead to weight loss. Contact the dietitian at 503.338.4085 for help if your weight loss increases to more than 5% in a month or 10% in the last 6 months. There is a dietician available to meet with during your treatment.
Palliative care is medical care focused on relieving physical, mental and/or emotional suffering that results from serious illness or injury. Your palliative care providers work together with the rest of your medical team with the goal of improving your quality of life during and after treatment.
In common language, the term "palliative care" is often mistaken for "hospice care," but they have different intentions. While hospice care is focused on providing comfort at the end of a person's life, after any disease treatment has ended, palliative care is focused on reducing suffering and improving quality-of-life during treatment and recovery.