Starting chemotherapy? 6 questions to ask

Finding out that you need chemotherapy can be overwhelming. But as I’ve
learned from working with cancer patients as a nurse over the past 18
years, it’s a little easier to manage when you know what to expect.

And knowing what to expect requires asking the right questions.
Below are six questions you and your caregiver should ask your care
team before you start chemotherapy.

What is my treatment plan?

There are many different chemotherapy drugs. Your chemotherapy
treatment may use one drug or a combination of drugs. So, ask for the
name of each drug you will be receiving. At MD
, we give our patients a printout for each medication
they’ll be receiving. It describes how the medications work, as well
as side effects and ways to manage them.

It’s also important to ask how long you’ll be receiving
chemotherapy. Chemotherapy is often given in “cycles.” This means the
treatment is repeated on a regular schedule with days or weeks of rest
in between. For instance, you may receive a dose of chemotherapy on
days 1, 5 and 9 every 21 days (3 weeks) for a total of 6 cycles. This
means your treatment would last approximately 18 weeks (multiply 6
cycles by 3 weeks). Knowing this information will help you plan ahead.

What side effects may I experience?

Many patients experience side effects such as hair loss, fatigue, nausea and chemobrain during and after chemotherapy. But the
side effects you experience will depend on the specific type of
chemotherapy drugs you’re taking. So ask your doctor what you can
expect, though it’s important to remember that the length, severity
and specific side effects vary from one patient to the next.

How can I manage side effects of my chemotherapy?

Discuss any possible side effects that you’re concerned about with
your oncology nurse. Request medications to treat the more common side
effects, such as nausea, before starting chemotherapy so that you have
them if necessary. If your chemotherapy regimen causes hair loss and
you want a wig, request a prescription before starting chemotherapy so
you will be prepared. Many insurance companies offer wig reimbursement
for patients on chemotherapy.

Communicate with your oncology team if you are having side effects
that aren’t well controlled. Your oncology nurse is an expert at
reviewing your symptoms and formulating a comprehensive plan for
managing them.

How will my chemotherapy be administered?

There are several ways we administer chemo. The most common method
is through an IV, where we insert a needle into a vein and use tubing
to attach to a plastic bag holding the drug. Other methods may include:

  • Oral chemotherapy, which means you’ll take a pill or drink the
    medication in liquid form
  • Injections administered into the
    muscle, under the skin or directly into a cancer lesion
  • Hepatic arterial infusion, where a tiny pump is surgically
    inserted under the skin and connected to the hepatic artery,
    administering drugs through the pump over about two weeks. This
    method is used to treat liver cancer.

If you’re receiving more than one chemotherapy drug, each drug may
be administered in a different way depending on your specific
treatment plan. Ask your doctor to review this with you.

Whom should I contact if I have problems — and when and how
should I contact them?

Before starting chemotherapy, find out whom to contact — and when
— if any issues arise. There may be some situations when you should
contact your oncologist, but in many cases, a physician assistant,
nurse or medical assistant can help.

If you’re a patient at MD Anderson, you
should contact your care team through myMDAnderson,
our secure patient portal, for most issues, such as scheduling, new
side effects you’re experiencing, questions about your treatment plan
and prescription refills. But you should also find out how to get in
touch – and whom to contact — if you have an urgent issue that can’t
wait, such as worsening or uncontrolled side effects or an adverse
reaction to a medication.

When should I go to the emergency room?

During chemotherapy, there are certain scenarios where your doctor
may recommend you go to the emergency room. These may include if you:

  • have a fever over 101 F,
  • can’t keep fluids down due
    to nausea and vomiting, and/or
  • have unexpected bleeding,
    such as a bloody nose, that won’t stop.

Ask if your doctor prefers that you visit a certain emergency room.

Once you have all of this information, be sure to share it with
those who will be helping with your care at home. That way, if you
aren’t feeling well, others will know what to do.

Misti DeMargel is a clinical nurse at MD Anderson in The Woodlands.

Request an appointment at MD Anderson online or by
calling 1-877-632-6789.