Discharge Instructions for Chemotherapy

You are getting a type of cancer treatment called chemotherapy. It's also called chemo. Chemo is a common cancer treatment. There are many types of chemo medicines that can be used. This sheet gives some general information on how you can take care of yourself after chemo. Talk with your healthcare provider about side effects, safety measures, and other details based on the chemo medicines you're getting.

Mouth care

Many people get mouth sores, dry mouth, or taste changes as side effects of chemo. Here’s what you can do to help care for your mouth:

• Keep your mouth clean. Brush your teeth with a soft-bristle toothbrush after every meal and at bedtime. Use a toothpaste with fluoride. Ask if you should floss.

• Use a mouth sponge swab or special soft toothbrush if your gums bleed during brushing. Ask your healthcare team about these swabs.

• Don't use mouthwash with alcohol in it.

• Use any mouthwash given to you as directed.

• Use salt and baking soda to clean your mouth. Mix 1 teaspoon of salt and 1 teaspoon of baking soda in 8 ounces of water. Swish and spit to keep your mouth soft and ease dryness.

• If you wear dentures, you may be told to wear them only when you eat. Ask your healthcare provider. Clean your dentures twice a day. Soak them in antimicrobial solution when you aren't wearing them. Rinse your mouth after each meal. 

• Check your mouth and tongue for white patches. This may be a sign of a type of yeast infection called thrush. This is a common side effect of chemo. Tell your provider if you get these patches. You might need medicine to treat them.

• Use lip balm to keep your lips from drying and cracking.

• Sugarless gum and hard candy can help ease dryness.

Upset stomach

Many people on chemo feel sick and find it hard to eat during treatment. Try these tips:

• Eat small meals many times a day to keep your strength up. Try to focus on high-protein foods.

• Choose bland foods with little taste or smell if you're reacting strongly to food.

• Be sure to fully cook all food. This kills bacteria and helps you prevent illness.

• Eat foods that are soft. They're less likely to cause stomach irritation.

• Try to eat a variety of foods for a well-balanced diet.

• Drink plenty of fluids.

• Ask your treatment team about supplements and shakes if you're having trouble eating.

• Eat foods with fiber unless your healthcare provider says not to. Fiber can help to prevent constipation.

• Take your antinausea medicine as soon as you feel nauseated. Don't wait until you're throwing up. Let your provider know if it's not working.

Infection

Chemo can affect your immune system and make it easier for you to get infections. Take these steps to stay well:

• Keep clean. Wash your hands often. Be sure to wash them before you eat and after going to the bathroom. Wash your hands with soap and clean, running water for at least 20 seconds. If soap and water aren't readily available, use hand sanitizer that contains at least 60% alcohol.

• Stay away from people who are sick with an illness you could catch. This includes people with colds, flu, measles, or chickenpox. This also includes people who've recently had a vaccine for any illness.

• Stay away from crowds. If you have to be around a crowd, it's a good idea to wear a mask.

• Let your healthcare provider know if you have any signs of infection. This includes a sore throat or a burning feeling when you pee. You may have an infection that needs treatment.

• Be careful with pets. Scratches and bites can lead to infection.

Other self-care

Here's what else you can do:

• Be ready for hair loss. This often starts a few weeks after chemo begins. You can lose hair anywhere, including pubic hair, eyebrows, and even eyelashes. You may want to cut your hair short or buy hats or wigs ahead of time.

• Try to exercise. Exercise keeps you strong and keeps your heart and lungs active. It helps you feel less tired and helps you eat and sleep better. Walking and yoga are good types of exercise.

• Keep your skin moisturized. Chemo can make your skin dry. Use moisturizing soap. Apply lotion several times a day to help ease dry skin. Wash with cool or warm water, not hot water. Hot water dries your skin.

• Know what changes to expect with chemo. Some medicines can cause your skin to change color and peel. This most often happens on the hands and feet. Your nails may turn yellow or become brittle. They may fall off.

• Protect your skin from the sun when you're outside. Some chemo medicines make your skin more sensitive to sun damage.

• Don't smoke or use any form of tobacco.

• Close the lid and flush twice after using the toilet for the first 3 days after treatment.

• Don't get pregnant during chemo. Talk to your provider about using birth control during treatment.

When to call your healthcare provider

Know how to get help any time, even after office hours and on weekends. Call your healthcare provider right away if you have:

• Unexplained bleeding

• Trouble focusing

• Tiredness that gets worse or keeps you from getting out of bed or taking care of yourself

• Shortness of breath, wheezing, trouble breathing, or bad cough

• Rapid, irregular heartbeat or chest pain

• Dizziness or lightheadedness

• Constant feeling of being cold or shaking chills

• New hives or a cut or rash that swells, turns red, feels hot or painful, or starts to ooze

• Burning feeling when you pee

• Bloody or cloudy urine

• Fever of 100.4°F (38°C) or higher, or as directed by your provider

• Diarrhea

• Yellowing of your eyes or skin (jaundice)