【Major points】

  1. Chemotherapy can be used to destroy cancer cells to control and slow the progression of cancer.
  2. Possible side effects include low blood cells, nausea, vomiting, oral mucositis, and hair loss.
  3. During chemotherapy, have small, frequent meals and consume high-calorie, high-protein foods.
  4. Focus on personal hygiene to avoid infection, move slowly and carefully to prevent injury and bleeding.

What is chemotherapy?
Chemotherapy is an anti-cancer treatment that uses drugs (chemotherapy agents) to destroy or inhibit the growth and division of cancer cells. These drugs enter the bloodstream and travel throughout the body to reach cancer cells in different tissues and organs.

What are the common side effects?
The main targets of chemotherapy are the rapidly dividing cancer cells. However, normal cells that also divide quickly, such as those in the blood, hair, and digestive system, can be affected as well, causing the following common side effects:
  1. Decreased blood cell counts: including anemia (due to reduced red blood cells), leukopenia (affecting the immune system), and thrombocytopenia (affecting blood clotting).
  2. Oral and gastrointestinal issues: Chemotherapy can damage the cells lining the oral cavity and digestive tract, leading to mouth sores, indigestion, nausea, vomiting, constipation, and diarrhea.
  3. Hair loss: Chemotherapy can impact the rapidly growing hair follicle cells on the scalp, resulting in temporary hair loss.

Principles of care:
  1. Avoid infection and pay attention to personal hygiene: 
    1. Wear a mask when going out and avoid going to public or crowded places.
    2. Keep the home environment ventilated and dry, avoid pets and indoor potted plants.
    3. Brush your teeth and clean your mouth after each meal, if you have any oral ulcers, please clean mouth frequently.
    4. Keep the genital and anal area clean and dry, and consider warm water sitz baths if needed.
    5. Wash your hands frequently with soap and bathe everyday.
  2. Prevent injury to avoid bleeding:
    1. Use caution when handling sharp objects.
    2. Keep your nails short and avoid scratching yourself.
    3. Use a soft-bristled toothbrush or oral swabs for brushing teeth.
    4. Check your skin daily for any bruising or small red spots.
    5. If you develop a fever, severe nausea/vomiting, diarrhea, blood in urine or stool, or any unexplained bleeding, contact your healthcare team or seek emergency care.
  3. Leisure and Activities:
    1. Maintain a regular sleep schedule and get sufficient rest.
    2. Engage in appropriate exercise and change positions slowly to prevent dizziness and falls. 
  4. Dietary considerations:
    1. During chemotherapy, you may experience decreased appetite, nausea, and vomiting. Opt for small, frequent meals and avoid heavy, oily, or spicy foods.
    2. Focus on high-calorie, high-protein foods, and consider consulting a nutritionist if needed.
    3. Avoid raw food and food that is too hot or too cold.
    4. Nutritional supplements may be beneficial; discuss with your healthcare team.
  5. Emotional support:
    1. Find ways to express and relieve your emotions, such as through talking to others.
    2. Use techniques like deep breathing, light exercise, and listening to music to divert your attention.
    3. If you have religious or spiritual beliefs, they can provide a sense of comfort and calm.
  6. Hair loss from chemotherapy is temporary, and your hair will typically regrow once the treatment is completed. You can use hats, scarves, or wigs, and gentle shampoos to avoid irritating the scalp.

  1. Eran, Ben-Arye., Lynda, G. B., Susan, Y., Bella, S., Orit, G., Yehudit, T., Ilanit, S. S., & Noah, S. (2023). Nurse- guided patient self-treatment in integrative oncology: A randomized controlled trial. Support Care Cancer, 31(4), 233. https://doi.org/10.1007/s00520-023-07689-4
  2. Fares, M. S. M., Bassam, A. R. H., Mahmathi, K., Hamza, K. I., Ali, H. M., & Egbal, A. (2023). Prevalence and Impact of Fatigue on Quality of Life (QOL) of Cancer Patients Undergoing Chemotherapy: A Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev, 24(3), 769–781.https://doi.org/10.31557/APJCP.2023.24.3.769
  3. Tayebeh, R., Siamak, N., Fakhry, J., Alireza, T. D. B., Fatemeh, M., & Ali, K. J. (2022). The effect of Orem-based self-care education on improving self-care ability of patients undergoing chemotherapy: a randomized clinical trial. BMC Cancer, 22(1), 770-779. https://doi.org/10.1186/s12885-022-09881-x
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