1-888-WINSHIP Going through Chemotherapy Chemotherapy drugs may be taken in pill form or infused into a vein (intravenous).

Sometimes a combination of the two is used. Intravenous medications are given in the clinic's ambulatory infusion center, or in a doctor's office. Each chemotherapy session typically last from 2 to 6 hours, not all of which involves administration of the medications. Labs are drawn prior to chemotherapy to ensure adequate blood counts (white blood cells, hemoglobin, hematocrit, are some of several). Typically then a visit with your oncology provider follows, and only then, with approval from the team, will your particular chemotherapy combination be mixed for you. At each visit an IV catheter is inserted into a vein in the arm, allowing medications to drip slowly into the blood stream. In some case a woman may have a Port-a-cath inserted that remains under the skin of the chest for the duration of treatment. This allows the medications to be administered without the need for a new IV start each visit. However, one must keep in mind that the insertion of a Port-a-cath is a surgical procedure. Patients may bring along a family member or friend during their chemotherapy session. Television and various activities are usually available. It is advised that one dress warmly, in layers, as it is always cool in the treatment areas. Plan to bring along a favorite water based beverage and a snack or two, keeping in mind that strong odors may be bothersome to others in the treatment area. Side Effects of Chemotherapy As most people are aware, chemotherapy has several side effects. Some are short term that may develop during treatment and start to go away soon after treatment ends. Even though many side effects are common during therapy, there is no need to suffer in silence. There are many ways to address adverse effects so it is important to let your oncology team know of any bothersome symptoms. Fatigue: anemia (a decrease in the oxygen carrying red blood cell count) and chemotherapy may cause fatigue. Infection: Chemotherapy will cause your white blood count to fall, leaving you potentially open to serious infections. It is most essential to let your oncology team know if you develop a fever over 100.5, especially after your first week of treatment. Treatment may include antibiotic therapy by mouth, or may require hospitalization to administer IV antibiotics. Gastrointestinal Irritation: Nausea, vomiting, diarrhea or constipation are common side effects of chemotherapy and may be prevented/treated. Let your oncology team know of any symptoms. Our registered dietitian is available for personal consultations at 404-778-5646. Sore Mouth: often called "stomatitis," is another possible side effect of chemotherapy. Your nurse educator will provide you with mouth care information and education re: appropriate oral care. Hair Loss: Depending on the therapy chosen, hair loss may be minimal, or may completely fall out. In most cases, hair grows back usually within 3 to 6 month after the completion of chemotherapy.

1-888-WINSHIP What Else You Need to Know Exercise: The importance of exercise, especially if you are accustomed to routine exercise, cannot be stressed enough. Not only does it maintain muscle tone, circulation, and respiration, but it also encourages a more positive outlook. If you are not accustomed to a regular exercise routine, a physical therapist is part of your Oncology Team and will be available to discuss exercise options. Intimacy: Physical intimacy with your significant other may be affected by numerous factors, both physical and psychological, during treatment. It will depend on how you feel, both mentally and physically, your energy level and the comfort level of your relationship. Don't be surprised if your energy level is low and your desire is just not there. Sometimes it takes time. Talk through anxieties you and your partner may be feeling -- communication is so important. Here are some things you and your partner may want to consider as you feel up to resuming sexual activity: Pick occasions when both of you have time and energy; after naps may be right. Set the scene for romance -- this may keep you relaxed For women, the treatment you are undergoing/went through, may cause vaginal dryness. There are several product, ie. Astroglide, that may ease this discomfort. Discuss this with your oncology team -- they will have several suggestions! Most importantly, it is important for both of you to know that, from a medical standpoint, sexual activity is not contraindicated. It is important to keep the closeness viable, especially during times as challenging as undergoing treatment for breast cancer.

Contraception: While undergoing chemotherapy, it is important to realize that even though your menstrual cycle may be absent or irregular, you may still ovulate. Conceiving during chemotherapy could be harmful to a fetus. It is most important to discuss contraception with your medical oncologist. Fertility Issues: If future pregnancies are a possibilty, you should discuss fertility issues with your medical oncologist. Emory Healthcare offers a full-service Reproductive Center. Depression: From diagnosis, through treatment, to recovery and assuming life as a "cancer survivor", this will be one of the most challenging times for you and your significant others. It is helpful to realize that feelings of sadness, depression, anxiety , and being overwhelmed, are all expected throughout your breast cancer journey. It is important to share your emotional challenges with your oncology team. There are members of your team trained to help you deal with the emotions brought on by your cancer diagnosis. Our social workers/therapists are available at any time during your visits to Winship Cancer Institute.