After chemotherapy - discharge



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

You will probably get tired easily, and your appetite will be poor. You should be able to drink and eat food.

Oral Care

Brush your teeth and gums 2 - 3 times a day for 2 - 3 minutes each time. Use a toothbrush with soft bristles.

Let your toothbrush air dry between brushings.
Use a toothpaste with fluoride.
Floss gently one time a day.

Rinse your mouth 4 times a day with salt and baking soda solution (mix one half teaspoon of salt and one half teaspoon of baking soda in 8 ounces or 1 cup of water).

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 mouth pain.

Chew sugarless gum or suck on sugar-free popsicles or hard candies. Do not eat foods and drinks with a lot of sugar.

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

If you wear dentures, put them in only when you eat. Do this for the first 3 - 4 weeks after your transplant.

Preventing Infections

You need to be careful not to get infections.

Practice safe eating and drinking during cancer treatment.

Be careful what you eat. 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, or fish, or anything else you are not sure is safe.
Wash your hands with soap and water often:

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 the 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.

Self-care

Know how to care for your central venous line or PICC line.

If your doctor or nurse tells you your platelet count is still low, learn how to prevent bleeding during cancer treatment.

Start to walk. Slowly increase how far you go based on how much energy you have.

You need to eat enough protein and calories to keep your weight up.

Ask your doctor about liquid food supplements. These can help you get enough calories and nutrition.

Be careful about being in the sun. Wear a hat with a wide brim. Use sunscreen with SPF 30 or higher on any areas of exposed skin. Do not smoke.

Follow-up

You will need close follow-up care with your cancer doctor and nurse.

When to Call the Doctor

If you have any of these symptoms, call your doctor:

Fevers, chills, or sweats. These may be signs of infection.
Diarrhea that does not go away or is bloody
Severe nausea and vomiting
Being unable to eat or drink
Extreme weakness
Redness, swelling, or drainage from any place where you have an IV line inserted into your body
A new skin rash or blisters
Jaundice (the white part of your eyes or skin looks yellow)
Pain in your stomach area
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

National Cancer Institute. Chemotherapy and you: support for people who have cancer (PDQ). Accessed May 11, 2012.

Perry MC. Approach to the patient with cancer. In: Goldman L, Ausiello D. Goldman: Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 182.

Update Date: 6/7/2010

Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospi

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