* Have any dental work that you may need taken care of before you begin your treatment.

* Take good care of your teeth and gums.  Buy a new toothbrush after each monthly cycle of chemotherapy. (This will ensure that your toothbrush is clean and free of any bacterial/chemical residue.) If you wear dentures, clean them after each meal.  Brush your teeth with gentle strokes and use care when flossing. If bleeding occurs, do not panic and stop flossing for a few days.  If this persists or you are concerned about it, let your doctor know.

* If you are told that you will probably lose your hair, consider a new, shorter  haircut before you begin treatment to get you used to having less hair.

* Ask about participating in the American Cancer Society's Look Good...Feel Better Program to help you learn skin care techniques and ways to use hats, scarves and wigs while you are in treatment.  You will also receive a free make-up kit!  Call 1-800-395-LOOK for more information.

* Go shopping for a wig before you begin your treatment to get an idea of the color and style of wig that you would like.  If you have always wondered what it would be like to be a blonde, brunette or redhead, now is your chance!

* Remember that chemotherapy is another tool in the arsenal to get you well.  Instead of thinking "I will never get through the next three to six months of treatment.", break this period of time into manageable steps.  Countdown each treatment (e.g., "10, 9, 8...").  Before you know it, you will be half-way through treatment saying; "Six down, six to go!" Keep the following in mind: "Short-term sacrifice, long-term gain".

* Arrive at your appointments in plenty of time to get your blood work done so that your doctor can get the results in time for your scheduled treatment.

* Bring a book or a portable tape recorder with you to treatment. You can play relaxation tapes or your favorite music while you are waiting for treatment and when you are receiving chemotherapy.

* Bring mints or some sugar-free hard candy with you to treatment and keep them on-hand at work and at home. Bring a bottle of drinking water with you to treatment -- taking in plenty of fluids is always important. Popsicles and ice cubes made from your favorite fruit juices can also help to keep your mouth refreshed.

* Consult with your oncologist prior to getting a vaccine or flu shot while you are in treatment.

* Wear clothing that is soft, loose fitting and comfortable.

Hair, Skin and Nail Care Tips to Help Get Through Chemotherapy

* Some women shave off all their hair when it starts coming out.  Make a date with a friend or your partner, light some candles, buy some massage oil and make an evening of it; and always remember...your hair will grow back and often times better than it was before you lost it!

* Be gentle with your hair.  Use a mild shampoo such as Neutrogena, a soft brush and keep blow drying and teasing to a minimum.  Restrict the use of hair spray, which can tend to dry out your hair.

* To avoid infection, use care when clipping your nails and cuticles.  Treat yourself to a professional manicure.  If you wear acrylic or porcelain nails, discuss this with your doctor and keep them clean and dry.

* Avoid excess exposure to sunlight and use a good sunscreen with an SPF of 15 or more.  Wear sunglasses to protect your eyes, which may be more sensitive to light.

* Chemotherapy can sometimes cause your skin to break out, so keep your face and body clean and dry.  Over-the-counter products such as Clearasil can help.

* Chemotherapy can dry your skin, eyes/eye lids and vagina.  Products such as moisturizers, artificial tears, vaginal re-moisturizers such as Replens, A & D Ointment, Vitamin E oil or cream used on a regular basis (once or twice a day) can help.  Only using soap in the arm pits (axillae) and surrounding areas (unless there is visible dirt) can also alleviate these symptoms.

Self-care Tips to Help a Patient Through Chemotherapy

* Try to stay away from people with colds, infections or the flu.

* Avoid changing cat litter if you can or use care when you do.

* Depending upon the drugs that you are taking, chemotherapy may cause you to have burning urination and/or red-colored urine.  Do not panic!  This can be a normal reaction, but, if you are worried about it or experience painful urination, notify your health care team.

* If you experience flu-like symptoms, this may be a reaction to your treatment.  If these symptoms persist or become severe, inform your doctor.

* Prioritize your activities so that you will have enough energy for the important things you would like to get done.

* Chemotherapy may cause you to have irregular menstrual periods or your periods may stop while you are in treatment.  You may even experience symptoms such as hot flashes, vaginal dryness and headaches, which may indicate the early onset of menopause. Discuss any concerns that you have about this with your gynecologist and continue to use a form of contraception even if your periods stop.

* Always remember to take time out to be good to yourself -- get plenty of rest to conserve your energy.

* Chemotherapy can cause you to be more moody than usual.  Share your feelings with your partner, other family members, friends and co-workers.  This will help them to understand what you are going through.

* If you are having problems getting to sleep or getting a good night's sleep, try listening to relaxing music, reading a good book or taking a relaxing bath before you go to bed.  Physical activity and exercise during the day such as housework, walking or riding a bike can also help you rest better at night.
 

Nutrition and Eating Tips to Help a Patient Through Chemotherapy

* Eat small, frequent meals as opposed to three large meals each day.  Eat slowly and sit up or walk after each meal.

* Keep a variety of healthy (i.e., low fat, low sugar) and convenient snacks readily available.

* Chew your food slowly and thoroughly to help with digestion. Try taking a natural digestive enzyme (a supplement found in most health food stores) to help with digestion.  Always remember to discuss supplements that you are taking with your health care team.

* If you experience a loss of appetite, maximize the value of the food that you eat by choosing foods high in protein such as nuts, eggs, cheese or peanut butter.

* If you experience a metallic, bitter taste in your mouth, using plastic eating utensils may help to reduce it.  (Keep in mind that plastic utensils are meant to be disposable and may not wash or stay clean like your regular flatware does.)

* Eat a variety of foods with different textures and odors to find the foods that work best for you.

* Avoid spicy foods or foods that tend to be acidic.

* If you find that certain food odors or working with food are bothersome, ask someone else to do the cooking.

* Eat plenty of green, leafy vegetables.

* Include foods that are high in potassium such as bananas, mushrooms, potatoes, broccoli, asparagus and apricots in your diet.

* Avoid fatty, fried or greasy foods. Weight gain is fairly common.  Patients may diet and should consult with their health care team for advice.

* Avoid carbonated beverages to prevent excess bloating.

* Using nonfat dry milk and pasteurized liquid eggs such as Egg Beaters in your baking or cooking will add extra nutrients to the food you prepare/eat.

* If you experience problems with diarrhea, foods such as applesauce, cottage cheese, yogurt, melba toast, Jell-O and rice may be tolerated better than other foods.  If this problem persists or becomes severe, let your doctor know about it.
 

A Tip to Help a Patient Deal with Nausea

* If you are experiencing nausea, try to get your mind off the feeling by listening to calming music, watching a good movie or doing other activities that you find pleasant and relaxing.  Get some fresh air if you are cooped up in your office or home.  If nausea is not easily controlled, check with your doctor and ask about antinausea medications such as Zofran to help reduce or prevent nausea.
 

Nutrition - Changes in Body Weight During Treatment

Many people assume that while they are on chemotherapy they will be sick and lose weight.

With the new antinausea (antiemetic) drugs (e.g., Zofran, Compazine) available to breast cancer patients, nausea and vomiting are no longer a given.  In fact, many patients actually gain weight.  If this is the case, patients are allowed to diet.  (It is always important to discuss dietary changes with the medical team.)
 

Weight Gain - Three contributing factors:

1. Nibbling and snacking more than usual to help ease queasiness.

2. Eating as a means of dealing with anxiety.

3. Reduced levels of activity.
 

Suggestions for Patients Undergoing Chemotherapy

* Schedule five small meals a day as opposed to three large meals a day.   It is easier on the digestive system and will help keep snacking in between meals to a minimum.

* Drink more water -- it is filling and invigorating.

* Remain active.  Choose activities that you will enjoy.

 This will:
_ Get you out of the house.
_ Help relieve anxiety and depression.
_ Help burn excess calories.

Suggestions for Patients Having Trouble with Nausea, Vomiting, Loss of Appetite and Weight Loss

1. Ask the doctor to increase the antinausea medication (e.g., Zofran, Compazine) if vomiting continues.

2. Drink enough fluids to avoid dehydration and the imbalance in electrolytes that can result from vomiting and diarrhea.  This can be done by keeping your urine as lightly colored as possible.

3. Add a liquid milkshake-like supplement such as Ensure (available in most drug stores, grocery stores and Kaiser Permanente pharmacies) to the diet. This will help boost energy and supply a portion of the nutrients and calories the body needs throughout the course of treatment.

4. Ask someone else to cook the food.  Some patients feel that it is easier to eat certain foods if they do not have to prepare them.

5. Choose foods high in protein such as eggs, cheese or peanut butter.  This will help to maximize the value of the small amount of food that will be eaten.

6. Some patients undergoing chemotherapy complain about a metallic or bitter taste; switching to plastic eating utensils may alleviate the problem.

7. Avoid using favorite foods to stimulate appetite.  Some patients associate them with treatment and find that they can never eat them again.

*Always discuss any problems such as a severe loss of appetite or nausea and vomiting with members of the health care team.
 

Changes in Digestion During Treatment

Some anticancer drugs may cause problems with diarrhea.  As chemotherapy drugs work to fight and kill unhealthy cells, they also affect healthy cells and bacteria in the digestive tract such as lactobacillus acidophilus -- known as the "friendly bacteria".  Diarrhea is often associated with a decrease in the numbers of these bacteria.   Increasing lactobacillus acidophilus intake can restore a proper balance in the digestive system.

How to Restore the Proper Balance

1. Eat foods rich in lactobacillus acidophilus such as yogurt and many cheeses (check labels).

2. Drink acidophilus-fortified milk.

3. Take acidophilus supplements (available in health food stores).