8 Things to Expect on Your First Day of Chemotherapy
Throughout this series, we have talked about things leading up to this day, your first day of chemotherapy. I will leave a list of previous articles at the end of this post related to chemotherapy for you to review. But now the big day is here. Are you nervous? I know I was. I didn’t know what to expect, how I would feel, or even when I would start noticing any side effects of the chemo medicine. That’s why I wrote this article for you. Hopefully, after reading this article, you will be better prepared than I was for your first day of chemotherapy.
How Chemotherapy is Given
Chemotherapy can be given in several different ways including:
Oral – tablet, capsule, liquid
Liquid inserted into an organ
Liquid infused into an IV or chemo port
Liquid injected into a muscle (intramuscular or IM)
Liquid injected under the skin (subcutaneously or sub-Q)
Liquid injected into the spinal canal (intrathecal)
Liquid infused into a body cavity (intracavitary)
Liquid is inserted into the pleura which is the linings of the lungs (intrapleural)
Liquid injected directly into the tumor (intralesional)
Cream applied to the skin (topically)
Your oncologist will decide which route is best for you depending on what type of cancer you have, where the cancer is located, what stage the cancer is, and other considerations.
We will talk about three common ways chemotherapy can be given:
Oral
Intracavitary
IV/chemo port
Why This Route is Chosen
Oral: Convenience. You do not have to take time away from your work schedule to attend chemo sessions.
Liquid inserted into an organ: chemotherapy is given in a very high dose to the tumor through a tube inserted into an organ such as your bladder, but little effect on the rest of your body.
Liquid injected or infused into an IV/chemo port: the cost of IV chemotherapy is much lower than oral chemo. Your insurance company may not cover the cost of oral medication if a cheaper IV drug is available to you.
Types of Chemotherapy
Pill, tablet, capsule, liquid
Liquid inserted into an organ
IV liquid infused through the veins or a port that has been inserted into your chest
How to Prepare for Chemo
Pill – No specific preparation is necessary to take a pill other than having the medication on hand. Do avoid grapefruit/juice in your diet. A substance in grapefruit and grapefruit juice prevents your body from absorbing oral chemo medicine properly.
In an organ – If you are having chemo inserted into your organ, such as the bladder for bladder cancer, you may have this done in an operating room or an outpatient surgery center. If so, you will need to prepare for surgery by eliminating food and water according to your pre-surgery instructions. You will also need to take showers with antibacterial soap the evening before and the day of your procedure. This helps prevent infection following the procedure. If you are prohibited from showering, then clean your skin as best you can. Arrange for someone to drive you home and stay with you.
IV: If you will be receiving IV chemo regularly, your oncologist may have you get a chemo port. Your chemo nurse will “access” your port each time you go for chemotherapy treatment. “Access” means that a special IV needle will be inserted into the port which sits under the skin of your chest. (Read:Access to Chemo Port Information)
IV: Instead of getting a chemo port, you might receive intravenous chemotherapy through a needle in your arm. Your chemo team will let you know which route is best for you and why. Be sure to shower with antibacterial soap before each chemotherapy session to help reduce the number of bacteria on your skin which will help decrease the chance of infection from a needle poke.
What to Take with You on Your First Day of Chemotherapy
Pill: Prescription; insurance card; ID. You may need to get your medicine from a specialty pharmacy. If you don’t have one in your area that can supply your specific medication, you may need to have your medicine shipped to you from a mail-order service. Provide your pharmacy with your insurance information and proper identification. Your oncologist will send the prescription to the pharmacy.
In an organ: Since this will be done in a surgery center or the operating room at the hospital, you will need to take your insurance card and photo ID for check-in. Also, you will be given either sedation or anesthesia. Because of the effects of these medications, you will need an adult driver to drive you home and an adult to stay with you for the length of time stated by your doctor.
IV: Prepare a bag of items you will need to take with you for each visit, then restock whatever you need after your treatment to have your bag ready for your next chemo session.
I recommend you take a few things with you for your chemotherapy treatments. Some of these items include:
A light blanket. It can be chilly in the infusion room.
A small pillow. You might want to take a nap during your treatment if it is scheduled to last several hours.
A light jacket. It’s nice to have a jacket on when you get up to use the restroom if the room is chilly.
Warm socks or footies
A hat, especially if you have already lost your hair. Airconditioned breezes can be quite chilly on a bald head.
Bottled water or another beverage
Light snack
Notebook and pen to take notes during your appointment
Book to read
Coloring book and crayons or colored pencils
Puzzle book and pen or pencil
Laptop computer or tablet
Your phone and earplugs so you can listen to music
A companion if you can. The long sessions can be very tiring.
What to do Before Your First Chemotherapy Session
Pill: wash your hands thoroughly with soap and water for 15-20 seconds. Take your medication on time.
In an organ: Follow your doctor's instructions including showering, when to quit eating and drinking, and any other instructions. Arrive at your appointment on time.
IV: Shower according to your provider’s instructions. Do not apply any lotions to your arm if the IV will be started in your arm, or over your chemo port site if your port will be used for your chemotherapy.
What to do During Your First Chemotherapy Session
Pill: Read the medication label carefully. Make sure you are taking the correct dose. Put on gloves so the chemo med will not be absorbed through the skin of your hands. Take the exact amount of medication you are prescribed. Be sure to swallow the medication completely.
In an organ: You will be under the effects of either sedation or anesthesia for your procedure, so there is nothing you need to do during the insertion. Your care team will complete the procedure and then send you to the recovery area.
IV: It can take several hours to infuse chemotherapy medicine into an IV or through a chemo port. What you may choose to do during your infusion can vary from taking a nap, to watching a video on your phone, reading a book, or even talking with your companion. Your chemo session might be quite short or linger for hours depending on what medication you are receiving and many other factors. To help you pass the time while you receive your medicine, I have made some free coloring pages for you. Just click here. This is completely free for you to download and even share with others at your chemo clinic.
What to do After Each Chemotherapy Session
Pill: Remove your gloves and dispose of them in the garbage can. Be sure the gloves are placed completely into the trash container and are not able to fall onto the floor. Wash your hands thoroughly with soap and water. Make sure you have enough medication for your next dose. If not, get a refill in plenty of time before you need to take your next dose. Lock your medication up so young children or persons with memory issues do not accidentally get into your medicine.
When you use the toilet, flush the toilet twice with the lid down. If you have a spare bathroom, it would be advisable to use a separate facility from the rest of the household if possible.
If you are assisting a family member with a bedpan or bedside commode:
Wear gloves when emptying the bedpan or commode.
Carefully pour the waste into the toilet. Avoid splashing the contents as much as possible.
Pour water into the waste receptacle to rinse it then pour this into the toilet.
Close the toilet lid and flush it twice.
Wash your hands thoroughly with soap and water.
Follow these instructions to dispose of emesis (vomit) as well.
Watch for side effects from chemotherapy medicine.
Notify your care provider of any new side effects or if you have an increase in side effects.
Get lots of rest and drink plenty of low-sugar, non-alcoholic beverages.
In an organ: Follow your discharge instructions
Close the toilet lid and flush it twice if you received chemotherapy into your bladder.
Wash your hands thoroughly with soap and water.
Watch for side effects of chemo.
Notify your care provider of any new side effects or increase in side effects.
Get plenty of rest and drink plenty of low-sugar, non-alcoholic beverages.
IV: Watch for side effects of chemo.
Notify your care provider of any new side effects you experience or if you have an increase in side effects.
Get lots of rest and drink plenty of low-sugar, non-alcoholic beverages.
We have discussed eight things to expect on your first day of chemotherapy, whether you take a pill at home, go to a surgical center to have medicine inserted into an organ, or go to a chemo clinic to receive medication through an IV or port.
No matter by which route you receive your chemotherapy, it is important to be consistent and prompt to take each dose. If you experience any side effects which would prevent you from taking your next scheduled chemotherapy medicine, let your oncologist know right away.
Thank you for taking the time to read this article. I hope it has helped prepare you and your loved ones for eight things to expect on your first day of chemotherapy.
Please comment below on how this article has helped you better prepare to receive chemotherapy.
Wishing you all the best,
Kelly
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Yes, I am a nurse. No, I am not your nurse. The medical topics discussed in this, or any article on this site, are intended to be issues for you to discuss with your medical team if you feel they apply to you. None of the information you are about to read in this article is treatment advice for you from me. I do not have that authority.Additional articles to read:
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Hi, I’m Kelly. I am here to help you and your loved ones navigate your cancer journey with information and encouragement.
I have been both a cancer patient and a cancer patient supporter. I get what you, the cancer patient, are going through. But I also get what you, the cancer patient supporters, are going through.
I wish I could take this nightmare you are experiencing and turn it into a pleasant dream.
But I can’t.
So, what I can do instead is infuse as much hope and determination as is possible into this website for you. Here you have a place to find inspiration and support. A place to turn the chaos of cancer care into clarity.
Yes, I am a nurse. No, I am not your nurse. The medical topics discussed in this article are intended to be issues for you to discuss with your medical team if you feel they apply to you. None of the information you read in this article is treatment advice for you from me. I do not have that authority.