Before You Begin Chemotherapy

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Some of the side effects of chemotherapy can make it hard to keep up your daily routine, so you might want to take care of a few things before you start chemo. There are also some things that you may want to discuss with your doctor.

Get your teeth cleaned and have a complete dental check-up. Your mouth contains bacteria, which can get into your bloodstream during teeth cleaning or other dental procedures, such as having a root canal. Chemotherapy weakens your immune system, so you may be more susceptible to infections caused by these bacteria. Because of this, many doctors recommend having a dental check-up before chemotherapy starts. If you can't have a dental check-up before you start treatment, tell your doctor.

Get any heart tests (echocardiogram, for example) your doctor recommends.

Get a Pap smear. Chemotherapy can make the results of your Pap smear (the test for cervical cancer) temporarily abnormal.

Ask for help around the house. The most common side effect of chemotherapy is fatigue/feeling tired. Ask someone close to you to help organize the chores you normally do, such as cleaning, grocery shopping, cooking, and carpooling. It can be hard to ask for and accept help from others, but in most cases your loved ones will be happy to do something that helps you in your fight against breast cancer.

Join a support group if you think it might help you. Your doctor or nurse can help you find one. You also can check out the Breastcancer.org Discussion Boards to connect with others dealing with the same issues you are. It's been shown that both online and in-person discussion groups boost quality of life and may ease anxiety and depression.

Check with your doctor on what you should and shouldn't eat or drink on the day you're getting treatment. Some medicines have restrictions and requirements and others don't.

Talk to your doctor about any vitamins, supplements, and over-the-counter and prescription medicines you're taking. You may have to stop taking some vitamins, supplements, and allergy medicines while you're getting chemotherapy, since some of these can interact with chemotherapy. Tell your doctor about ALL the medicines, supplements, and vitamins you take, including laxatives, cold medicines, herbs, and pain relievers, such as aspirin or ibuprofen. Your doctor needs to know how much you take, how often you take it, and why you take it. You may want to bring in the bottles of everything you take so you don't forget anything.

Talk to your doctor about hair loss. Most chemotherapy medicines will cause some type of hair loss (a condition called alopecia). Your doctor will probably be able to tell you if you're likely to lose your hair. Besides the hair on your head, you'll probably lose the hair on your face, arms, legs, and pubic area. If you plan to buy a wig, you might want to get it before you start chemotherapy so you can match it to your hair color and style. You can also take the wig to the person who does your hair so it can be styled like your own hair. Some women decide to cut their hair short or shave their heads when they start chemo to be more in control of the hair loss process.

Talk to your doctor about maintaining your routine while on chemotherapy. How much of your regular routine you can keep up while on chemotherapy will be different for every person and depend on your unique situation. Some people continue to work while others need to take time off. Your doctor and oncology nurse can help you figure out how you're going to feel and how much you may or may not be able to do based on your regimen and health history. It can help to mark all your treatment days and any follow-up appointments or lab tests on a calendar. For example, if you're having treatment every 3 weeks:

  • The first week after treatment, you may not have much of an appetite. If possible, try to avoid business lunches or big dinners.
  • At some point in the first 2 weeks after chemotherapy, you may feel tired and you may be more susceptible to infections. Try to avoid large groups of people (including business meetings), hotels, airplanes, and other crowded places. Be extra careful about washing your hands and watching for any signs of infection or fever.
  • The third week after chemotherapy you'll likely feel pretty good. This is the best time to plan business meetings or travel.

Once you go through the first treatment cycle, you'll have a better idea of how to plan.

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