Chemotherapy

Welcome to the Lingen Davies Centre.

What is Cancer?

Cells are part of the body which go through a process of growing and dividing to help our bodies develop, heal and repair.

Cancer can develop when this process goes wrong and the cells become abnormal. This causes the cells to grow and divide much faster than normal which will then form a lump which is known as a tumour.

For more information, including videos about how Cancer may develop, please visit the Macmillan website.

What is Chemotherapy?

Chemotherapy is a word used to describe anti-cancer treatments.

Chemotherapy drugs are toxic to cells which mean they will disrupt the growth and division. Chemotherapy can cause damage to normal wells as well as cancer cells. The difference is that normal cells can repair the damage caused by chemotherapy but cancer cells cannot and therefore are destroyed.

Chemotherapy can be used alone to treat cancers but in many cases it is used alongside other treatments such as surgery, radiotherapy, hormonal therapy and biological therapy.

For information about Clinical Trials within the Trust, please visit our Research and Innovation page.

Do’s and Don’ts

Do Do’s Dont Dont’s
  • Remember to have your blood test the day before chemotherapy.
  • Drive to your chemotherapy appointments unless you discussed with the chemotherapy nurses prior. If you are unable to get a lift there is hospital transport available.
  • Drink plenty of fluids – ideally 2 litres per day.
  •  Take any herbal therapies/medicine.
  • Eat a healthy balanced diet.
  • Have any complementary therapies unless agreed by your oncologist.
  • Have something to eat and drink prior to your chemotherapy appointment.
  •  Consume alcohol around the time of your chemotherapy.
  • Listen to your body and rest when you need to.
  •  Think anything is a ‘silly’ question or concern.
  • Call the 24 hour oncology helpline any time day or night with any worries or concerns.
  • Have your flu jab the week before you are due your treatment (during the winter months)

Help and Support

Hamar Centre Aug 2017

The Hamar Help and Support Centre provide counselling and support services to patients with a cancer diagnosis, their family and carers.

The Health and Wellbeing events have been set up to enable you to meet professionals who will aide your recovery and develop an individually tailored programme of care that can be designed around your specific needs.

If you have been diagnosed with cancer, please attend one of our Health & Wellbeing events.  The event will:-

  • Introduce you to the services that you may or may not need to access following your diagnosis
  • Introduce you to the services that you may or may not need to access during your pathway
  • Give you the opportunity to hear from the service leads
  • Allow you the opportunity to take away any relevant information of your choice
  • Give you the opportunity to meet some of our Clinical Nurse Specialists and ask questions or discuss any concerns

Speakers include: Macmillan Information & Support Centre Manager, Macmillan Welfare Rights & Benefits service, Macmillan Integrated Therapies team member, Chemotherapy advisor, Radiotherapy Manager, Macmillan Exercise Advisor, Research & Trials Sister, Counsellor, Lead Cancer Nurse and Hamar Help & Support Centre Manager

You will also have the opportunity to meet other patients who may be in a similar position to you thereby encouraging a sense of support. Your Key Worker/Clinical Nurse Specialist will also be able to advise you of other support groups that you may also be able to access.

For further information please feel free to call Jessica Greenwood, Lead Cancer Nurse, on 01743 261000 ext 3449.

Note: The Dinwoodie Theatre can be found at the Shropshire Education and Conference Centre (SECC) which is located within the grounds of The Royal Shrewsbury Hospital (RSH).

The Lecture Theatre at The Princess Hospital (PRH) is located within the hospital in the Education Centre which is on the first floor.

The Get Active, Feel Good programme helps support people living with and beyond cancer in Shropshire in becoming more active.

Being active during and after cancer treatment has many benefits including

  • Reduce fatigue (tiredness)
  • Reduce stress and anxiety
  • Help manage weight
  • Improve muscle strength
  • Maintain cardiovascular fitness
  • Help bone strength
  • Plus many more

The get active, feel good programme can support you in starting regular, sustainable physical activity. Our Get active, feel good advisor is an exercise specialist trained in working with people living with and beyond cancer, who will help you with safe and effective ways of being active that meet you own individual needs and lifestyle.  The programme provides on-going support to help keep you as active and help you to build your physical activity in a way that suits you.

If you are unsure about how to start or build up your physical activity levels and would like some advice then please contact the Get Active, Good advisor, Kim Davies on the details below to arrange a free consultation.

Tel: 07543827531

Email: getactivefeelgood@gmail.com

Chemotherapy Online patient forums

Forums are an online support group which give information about chemotherapy, being treated and side effects.  The benefits of using online forums is to talk to other people in a similar situation and share experiences. It is important to remember that your experience may differ completely to another patient who is on the same treatment.

For more information you can visit the Macmillan Forum or the Cancer Research Forum.

Macmillan Chemotherapy blogs

This is a good way to look at other patient’s experiences and their journey. It also gives you the opportunity to share your journey with other patients.

For more information please visit the Macmillan Blogs Pages.

Look Good, Feel better is a cancer support charity that helps women manage the visible side effects of cancer treatment (including free beauty products). Contact the Hamar centre on 01743 261035 for more information or visit the Look Good Feel Better Website.

Odyssey was created to help people with cancer regain their confidence and enjoyment of life. Creating a magical adventure through a unique blend of the unexpected, a variety of challenges and a lot of fun. And its free! For more information please visit the Odyssey Website.

Preparing for Your Chemo

If you’re about to start chemotherapy in the unit then we ask that you watch our “Introduction to Chemo” video.

Side Effects

Chemotherapy can cause your immune system to become low. It is important that you take precautions to minimise your risk of picking up an infection.  It is important to contact the 24 hour helpline number on 03332226646 if you are:

  • Feeling Unwell
  • Feel Shivery or Flu Like
  • Have a temperature of 37.5 or above

Professional Advice

  • Check your temperature every day and if you feel unwell check it even more regularly.
  • Avoid contact with people that are unwell where possible.
  • Avoid swimming pools.

Patient advice

  • Ask visitors to use antibacterial hand wash when they visit you.
  • Try and stay away from crowded areas when possible.
  • Understand how your thermometer works before you start chemotherapy.

Chemotherapy targets fast growing cells, which is why it can affect the lining inside your mouth. Your mouth can become dry, sore and occasionally ulcerated. Taste can also be altered.

Professional and Patient Advice

Sore Mouth

  • Contact the 24 hour helpline number on 03332226646 if you have an ulcerated mouth which is making eating and drinking difficult.
  • Use any mouth care products as prescribed
  • Avoid any drinks or mouthwash containing alcohol
  • Take pain killers 20-30 minutes before eating
  • Avoid salty or spicy food
  • Try luke-warm food and drinks, as very hot or cold food can cause irritation
  • Use a soft tooth brush

Dry Mouth

  • Frequent drinks, even if it’s just a sip
  • Avoid caffeine drinks
  • Avoid alcoholic drinks
  • Moisten meals by having plenty of sauce or gravy
  • Try ice cream

Taste changes

  • Eat strong flavoured food as long as your mouth is not sore
  • Avoid foods that taste unpleasant
  • Fresh pineapple can stimulate taste buds
  • Use mouth wash regularly
  • Think of food as fuel! It’s important to keep eating to give your body the nutrients it needs.

Diarrhoea

Diarrhoea is passing loose or watery faeces more than three times a day. It affects everyone from time to time, but can be caused by certain chemotherapy treatments.

Diarrhoea is treated by replacing the fluids, salts and minerals that are lost.

Professional Advice

  • Take Loperimide tablets as explained by the chemotherapy nurses. If you still have diarrhoea after taking loperimide please call the 24 hour helpline number on 03332226646
  • Increase your fluid intake to ensure you don’t become dehydrated
  • Avoid consuming foods high in fiber such as nuts, seeds, fruit or whole grain products
  • Take rehydration sachets if provided to you after chemotherapy.

Patient Advice

  • Avoid fatty and spicy foods
  • Eat binding foods such as potatoes, white rice, white  bread, rich tea biscuits and bananas

Constipation

Professional advice

  • If you have been supplied laxative medication, please take it as prescribed.
  • Increase your fluid intake
  • Contact the 24 hour helpline number for assistance if laxatives are unsuccessful
  • Eat high fibre food

Patient advice

  • Eat plenty of fresh fruit and veg
  • A little bit of exercise can encourage a bowel movement
  • Drink caffeinated drinks
  • Kiwi Fruit, prunes and beetroot can also help

Not all chemotherapy causes nausea or vomiting, and many patients don’t experience this at all. However, everyone is different and there are many medications which can relieve these symptoms.

Professional advice

  • Take your anti-sickness tablets as instructed, especially for the first 3 days after chemotherapy
  • Ring the helpline number on 03332226646 if you have nausea or vomiting to the point where your fluid and food intake are restricted
  • Avoid alcohol
  • Eat plain foods
  • Eat small meals often
  • Avoid preparing food if you feel nauseous

Patient advice

  • Drink ginger beer and eat ginger biscuits
  • Snack on jelly babies and crisps
  • Allow full fat fizzy drinks to go still, and drink through a straw
  • Avoid spicy or greasy foods
  • Avoid onions and mushrooms for the first few days as it bloats
  • Eat what you want when you want it

Not all chemotherapy treatments will cause your hair to fall out. Your oncologist will discuss this with you prior to chemotherapy.

If you are having chemotherapy that causes hair loss you have many options to consider.

After your first session of chemotherapy it will take around 2-3 weeks for the hair to start falling out.

You will receive a wig referral form after the appointment with your Oncologist. This will provide you with the option of which service you would like to choose. Ring the number and arrange an appointment for your wig consolation. If you have not been given a form, ask when chemotherapy day centre staff and we can arrange one for you.

Patient advice

  • Some people advise cutting your hair shorter before starting chemotherapy to get used to a shorter length
  • Be aware that the scalp becomes tender just before the hair starts to fall out
  • Some patients decide to shave their hair off before it falls out as they feel they have taken back some control
  • Have a head scarf as well as a wig, as sometimes you can feel too hot in the wig

Useful websites for wigs and headscarf’s

Some patients may be eligible to use the cool cap. Ask at your pre assessment if you are interested. For more information and aftercare advice about these please visit the Paxman Website.

Some chemotherapy treatments can cause the skin to become dry, sore and sensitive to the sun.

Capecitabine tablet chemotherapy can cause the skin to become sensitive on your hands and feet. Hand and foot syndrome or Palmar-Plantar (PPE) can affect the skin on the hands and feet. This can result in tenderness, redness, tingling and peeling of the skin on the palms and soles.

Many patients relieve this by using Udderly Smooth on their hands and feet to keep their skin moisturised and to prevent peeling and cracking of the skin.

Other chemotherapy types, especially Docetaxol, can cause changes to your finger and toe nails as well. This is not permanent and will get better after the completion of chemotherapy.

Professional advice

  • Apply moisturiser cream at least twice a day
  • Ensure you use fragrance free moisturiser cream
  • Avoid fragranced soap / body wash
  • Don’t spray body spray / perfume directly to the skin
  • Take pyridoxine supplements if you have been given them
  • If your hands/feet are red or sore try and keep pressure off them and keep cool
  • Use high factor sun cream to prevent burning
  • Stay in the shade when possible
  • Call the 24 hour helpline number if you have sore / feeling skin on your hands and feet which is preventing you carrying out normal daily activities

Patient advice

  • Use Udder cream available at udderlysmooth.co.uk
  • Rest if the skin on your hands or feet feel feels sore
  • Use un-fragranced moisturisers daily

Many patients experience some form of fatigue or tiredness during the course of their chemotherapy treatment. This is the most common side effect of chemotherapy. It is expected that you will feel tired after chemotherapy, but we do not expect you to be so exhausted that you have to spend more than 50% of the day sleeping or resting. If you are concerned that you have excessive fatigue levels please contact the helpline number on 03332226646.

Professional advice

  • Be honest about your fatigue level when seen by your Oncologist. You may need an alteration of your treatment
  • Light exercise is beneficial physically and psychologically, but only exercise to your limits.

Patient advice

  • Know your limits and don’t try to push past them, otherwise you will feel extremely tired
  • Be as active as you can, but ensure you rest and relax for a good amount of time to recover
  • Make the most of good points in your cycle as you need to rest more when you feel tired

Patients diagnosed with cancer and receiving chemotherapy have a greater chance of developing blood clots. It is important to stay as active as possible to ensure a good blood flow around the body as this will help reduce the risk.

Please contact the 24 hour oncology helpline number urgently on 03332226646 if you develop any of the following symptoms:

  • Swelling or pain in the leg or calf.
  • Warmth and redness of the leg.
  • Unexplained shortness of breath.
  • Chest pain (particularly when breathing in)
  • Blood being produced when you cough.

Blood Clots, Cancer and You from anticoagulation uk on Vimeo.

Women

Fertility can be altered after receiving chemotherapy. If you would like egg harvesting this should be discussed with your Oncologist prior to starting any chemotherapy. It is still possible to become pregnant naturally after receiving chemotherapy, but it is unlikely.

Being diagnosed with cancer and receiving chemotherapy treatments can alter your sexual function. This can be due to a combination of different factors such as hormone changes, possible body image changes and side effects like fatigue.

The hormonal changes caused by chemotherapy include:

Hot flushes and sweats, vaginal dryness and a lower interest in sex. It is common for women to develop vaginal thrush during chemotherapy – Please contact your GP for treatment.

Chemotherapy can affect the levels of the female sex hormones. If you have not had a natural menopause, you may notice changes to your periods. Sometimes periods stop altogether. Some women may have an early menopause. Your Oncologist will inform you if your treatment may affect your periods.

If your periods stop, it is still important to use contraception. This is because it may still be possible to become pregnant. You will need to use a reliable method of contraception during your treatment.

Being honest with your partner and talking openly about your concerns regarding sex can bring you closer together and ease any worries you have.

Men

Chemotherapy can reduce your sperm count. This could affect your ability to father a child after completion of chemotherapy. Sperm collection should be undertaken prior to the start of chemotherapy if you are thinking of starting a family in the future. This should be discussed with your Oncologist at your initial consultation.

Chemotherapy can cause side effects such as fatigue, which can then cause you to have less interest in having sex.

It is unusual for chemotherapy to cause erectile dysfunction, although a minority of treatments can cause some temporary changes to your sexual function. If you are affected by low sex drive or erectile dysfunction, it should improve on completion of chemotherapy.

Sometimes chemotherapy can cause testosterone levels to fall. This is more common in men who are being treated with high dose chemotherapy. Testosterone levels usually go back to pre-treatment levels a few weeks after chemotherapy ends.

Being honest with your partner and talking openly about your concerns regarding sex can bring you closer together and ease any worries you have.

Whilst on chemotherapy you may have to have investigations such as CT scan, Chest X-rays and others.

It can take up to 3 weeks to get the results of these investigations. If you have an out – patient appointment with your oncologist for these results, it is worth ringing the Lingen Davies Centre on 017430261000 ext 3421 to ensure the results are back. Your appointment can then be rescheduled if the results are not available which will save you any disappointment.