After chemotherapy - discharge

What to expect at home

You had chemotherapy treatment for your cancer. Your risk of infection, bleeding, and skin problems may be high. You may have mouth sores, an upset stomach, and diarrhea.

You will probably get tired easily. Your appetite may be poor, but you should be able to drink and eat.

Oral care

• Brush your teeth and gums 2 to 3 times a day for 2 to 3 minutes each time. Use a toothbrush with soft bristles.
• Let your toothbrush air dry between brushings.
• Use a toothpaste with fluoride.
• Floss gently once a day.

Rinse your mouth 4 times a day with a salt and baking soda solution. (Mix one half teaspoon of salt and one half teaspoon of baking soda in 8 ounces of water.)

Your doctor may prescribe a mouth rinse. Do not use mouth rinses with alcohol in them.

Use your regular lip care products to keep your lips from drying and cracking. Tell your doctor if you develop new mouth sores or pain.

Do not eat foods and drinks that have a lot of sugar in them. Chew sugarless gums or suck on sugar-free popsicles or sugar-free hard candies.

Take care of your dentures, braces, or other dental products.

• If you wear dentures, put them in only when you are eating. Do this for the first 3 to 4 weeks after your chemotherapy. Do not wear them at other times during the first 3 to 4 weeks.
• Brush your dentures 2 times a day. Rinse them well.
• To kill germs, soak your dentures in an antibacterial solution when you are not wearing them.

Preventing infections

Take care not to get infections for up to 1 year or more after your chemotherapy.

Practice safe eating and drinking during cancer treatment.

• Do not eat or drink anything that may be undercooked or spoiled.
• Make sure your water is safe.
• Know how to cook and store foods safely.
• Be careful when you eat out. Do not eat raw vegetables, meat, fish, or anything else you are not sure is safe.

Wash your hands with soap and water often:, including:

• After being outdoors
• After touching body fluids, such as mucus or blood
• After changing a diaper
• Before handling food
• After using the telephone
• After doing housework
• After going to the bathroom

Keep your house clean. Stay away from crowds. Ask visitors who have a cold to wear a mask, or not to visit. Do not do yard work or handle flowers and plants.

Be careful with pets and animals.

• If you have a cat, keep it inside.
• Have someone else change your cat's litter box every day.
• Do not play rough with cats. Scratches and bites can get infected.
• Stay away from puppies, kittens, and other very young animals.

Ask your doctor what vaccines you may need and when to get them.

Other self-care

• If you have a central venous line or PICC line, know how to take care of it.
• If your doctor or nurse tells you your platelet count is still low, learn how to prevent bleeding during cancer treatment.
• Stay active by walking. Slowly increase how far you go based on how much energy you have.
• Eat enough protein and calories to keep your weight up.
• Ask your doctor about liquid food supplements that can help you get enough calories and nutrients.
• Be careful when you are in the sun. Wear a hat with a wide brim. Use sunscreen with SPF 30 or higher on any exposed skin.
• Do not smoke.

Follow-up

You will need close follow-up care with your cancer doctor and nurse. Be sure to keep all your appointments.

When to call the doctor

Call your doctor if you have any of these symptoms:

• Signs of infection, such as fever, chills, or sweats
• Diarrhea that does not go away or is bloody
• Severe nausea and vomiting
• Inability to eat or drink
• Extreme weakness
• Redness, swelling, or drainage from any place where you have an IV line inserted
• A new skin rash or blisters
• Jaundice (your skin or the white part of your eyes looks yellow)
• Pain in your abdomen
• A very bad headache or one that does not go away
• A cough that is getting worse
• Trouble breathing when you are at rest or when you are doing simple tasks
• Burning when you urinate

References

Freifeld AG, Kaul DR. Infection in the patient with cancer. In: Niederhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2013:chap 36.

National Cancer Institute. Chemotherapy and you: support for people with cancer. http://www.cancer.gov/cancertopics/coping/chemotherapy-and-you. Accessed May 7, 2014.

Perry MC. Approach to the patient with cancer. In: Goldman L, Schafer AI. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 182.

Sideras K, Hallemeier CL, Loprinzi CL. Oral complications. In: Niederhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2013:chap 43.

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