Disease Information and Treatment Plans

Chemotherapy drugs are used to treat conditions where body tissues grow abnormally. They work by destroying such tissues, and in some cases, patients may receive chemotherapy along with surgery and radiation therapy.
Each chemotherapy treatment involves continuous drug administration to reduce and eventually eliminate abnormal tissues. Each session is spaced out in cycles to allow the body to rest and reduce side effects caused by the drugs.
Patients may receive multiple drugs together to enhance the treatment effect.
After completing the prescribed chemotherapy, doctors will schedule periodic follow-ups to evaluate treatment results or check for side effects from chemotherapy. Blood tests may be done to monitor blood cell counts because many chemotherapy drugs suppress bone marrow function, which is responsible for producing various blood cells.
To ensure effective treatment and disease control, patients must receive chemotherapy on schedule and complete the treatment plan. This also allows for treatment evaluation and monitoring of side effects, as treatment plans may need adjustment to provide the best outcomes for patients.

Common or Possible Adverse Effects from Chemotherapy

and Self-Care, divided into 3 systems as follows:

1. Gastrointestinal Symptoms

1.1 Nausea and Vomiting

Drugs may cause nausea and vomiting both before and after chemotherapy. Patients should not worry as doctors have prescribed medications to prevent and relieve these symptoms.
Eat light and easily digestible foods such as rice porridge or boiled rice on the day of chemotherapy treatment.
Eat small amounts more frequently and eat slowly, chewing thoroughly before swallowing to aid stomach function and prevent overeating.
If experiencing nausea and vomiting, drink clear, cold, mildly flavored beverages such as lemon water, orange juice, or carbonated drinks using a straw, sipping slowly to help improve symptoms.
Avoid high-fat foods or fried foods as they are hard to digest and the smell of oil may trigger nausea and vomiting.
Avoid strongly flavored foods such as spicy, heavily seasoned, or very sweet foods and foods with strong odors. Patients should eat cold foods like fruits or ice cream, which are easier to eat and less odorous.
After eating, do not exercise immediately and avoid lying flat for at least 2 hours. Instead, sit or rest.
Wear comfortable clothing that is not too tight and ensure fresh air exposure to help increase appetite.
Consult a doctor about anti-nausea medications if feeling unwell or symptoms worsen.

1.2 Loss of Appetite

Eat small amounts more frequently to ensure adequate daily nutrient intake.
Clean your mouth and teeth before eating to enhance food taste.

1.3 Inflammation of the Gastrointestinal Mucosa

Mouth and throat ulcers may occur during or after chemotherapy. If these symptoms interfere with daily life, inform your doctor.
Use a soft-bristled toothbrush to reduce irritation of the oral mucosa.
Brush teeth after every meal and before bedtime, or if not possible, rinse the mouth with clean water after eating.
Avoid mouthwashes containing alcohol as they may increase irritation. Use alcohol-free formulas instead.
Avoid foods that increase irritation such as spicy foods, dry foods, hard foods, or sour fruit juices.
Eat warm or cold foods rather than hot foods.
Eat easily swallowable foods such as rice porridge or boiled rice and drink plenty of water.
Doctors may prescribe lozenges to reduce pain from oral mucosa ulcers.
Regular oral hygiene care helps prevent infections and abnormal bleeding.

1.4 Diarrhea

If diarrhea occurs more than 3 times within 24 hours or is accompanied by abdominal cramps, inform your doctor immediately and do not self-medicate with anti-diarrheal drugs.
Drink plenty of fluids such as oral rehydration solutions or water to prevent dehydration.
Eat soft, low-fiber foods such as warm rice porridge or boiled rice and avoid high-fiber foods like vegetables and fruits during symptoms.

1.5 Constipation

Eat high-fiber foods such as fresh vegetables, fruits, and whole grains to prevent constipation.
If symptoms occur, consult a doctor as laxatives may be needed. Do not self-medicate or use enemas without medical advice.

2. Bone Marrow Suppression

2.1 Low White Blood Cell Count

White blood cells fight infections. Low white blood cell counts increase the risk of infection compared to the general population. Patients should follow these precautions:

Avoid close contact with infected individuals such as those with colds or being in crowded places.
Maintain personal hygiene by washing hands frequently, avoid touching eyes or nose with dirty hands, and maintain good oral hygiene.
Do not receive any vaccinations without consulting your treating physician.
Avoid using rectal suppositories as they may cause wounds that allow infections to enter the body easily.
If you have high fever, chills, cough, sore throat, or painful urination, seek medical attention immediately at the nearest healthcare facility.

2.2 Low Red Blood Cell Count or Anemia

Low red blood cell count may cause fatigue and weakness. Rest adequately and eat nutritious food. If you experience difficulty breathing, rapid breathing, or chest pain, seek medical attention immediately at the nearest healthcare facility.

2.3 Low Platelet Count

Low platelet count may cause easy bruising or bleeding. Avoid sharp objects and be cautious to prevent injuries or accidents.
Use a soft-bristled toothbrush to prevent wounds and bleeding. Consult your doctor or pharmacist before dental procedures.
If abnormal bleeding occurs, such as bruises or bleeding spots on the skin, or blood in urine or stool, seek medical attention immediately at the nearest healthcare facility.

3. Skin Symptoms

3.1 Hair Loss

Some drugs may cause hair loss, indicating the drug is working. Hair will regrow normally after treatment, so patients should not worry.
Cut hair short to reduce the feeling of hair loss.
Use mild shampoo, comb hair gently, and avoid heat treatments such as hair drying or perming.
Wigs or hats can be worn during chemotherapy treatment.

3.2 Skin Changes

During chemotherapy with some drugs, patients may experience rashes, dry skin, or increased sensitivity to sunlight. Patients should:

Use fragrance-free soap and apply creams or lotions to prevent dry skin.
Avoid direct sunlight exposure, wear hats, or apply sunscreen before going outdoors.

Information provided by Pharmacy Department Tel. 02-4671111 ext. 3174
MeeSuk Center (Cancer and Blood Disease Center) Phyathai 3 Hospital

General Guidelines for Patients Receiving Chemotherapy