8 Things to Know Before Your First Chemo Treatment

What, When, and Why

Every chemotherapy infusion includes a mix of drugs. Some are cancer-killing drugs, while others are medications that help ease side effects.

If you're not already clear about the answers to the following questions about all of the drugs you will receive, ask your healthcare provider:

• What is this medication?
• How does it help kill cancer cells?
• What side effects may it have?
• How will I feel after taking the medication?
• How should I cope with it?
• Who do I call if I have problems?
  

While some infusions take minutes, others take hours. A course may take days or weeks. Ask how you should plan for the treatments that await you.

It's Helpful to Bring a "Chemo Buddy"

You definitely don't have to go to your first chemo appointment alone. In fact, there are many reasons to have a "chemo buddy" with you for this session and future ones.

First, you might also be prescribed medication to take before chemo. Having someone drive you to your session can be helpful if the medication makes you tired.

Bringing a friend or family member means you have someone there who can focus on taking notes on instructions you are given and remembering questions you wanted to ask. (It's easy to become overwhelmed or distracted, particularly when chemo is new to you.)

They can also help you pass the time, which can be particularly helpful for lengthy treatments.

And while you will be monitored throughout your treatment, the team won't have eyes on you the entire time. A chemo buddy can keep a close eye out for reactions, like a rash or facial flushing, and inform healthcare providers immediately should they occur.

Hydration Is Essential

Chemotherapy drugs are very drying to your body's tissues. Becoming dehydrated may cause you to feel worse overall.

Staying well-hydrated can help your body purge waste while reducing the likelihood of problems, such as fatigue and headaches.

Right after an infusion, it's best to drink 8 ounces of water every hour until bedtime. Avoid caffeine as it can be dehydrating.

In rare cases, such as severe kidney disease or heart failure, it can be detrimental to drink too much water. So get specific hydration guidance from your oncologist if you have any other serious medical conditions.

Eat Light Ahead of Time

Two to three hours before an infusion, eat a light, high-fiber snack.

Chemo drugs tend to slow the movement of your digestive tract (peristalsis), so whatever you eat may be in your system for longer than usual. This often causes difficult bowel movements.

The drugs commonly used to prevent nausea and vomiting due to chemotherapy can also be constipating. Between staying hydrated and eating fiber, you should gain the upper hand on constipation.

There Will Be First Chemo Treatment Side Effects

You may feel side effects of your first chemo treatment in the hours after your session. Most are temporary, but plan on resting so your body can begin the recovery process.

Chemo treatment side effects—some of which you may experience after your first treatment, others not until several sessions—can include:

• Fatigue: You may feel tired or very fatigued the day after your first treatment. This differs from tiredness that can be cured with sleep. It may feel like profound lack of energy you can't seem to shake.
• Nausea and vomiting: It is normal to experience nausea and vomiting after chemo.
• Gastrointestinal symptoms: You may be constipated or have diarrhea after chemo.
• Sore mouth: Sometimes chemo can make your mouth feel dry and sore.
• Flu-like symptoms: You may have aches and pains a few days after your first treatment that feel similar to flu symptoms.
• Insomnia: It's common to have trouble falling asleep or to wake often at night when you're on chemo.
• Hair loss: Hair loss is a common side effect of chemotherapy, but you won't experience it immediately after your first treatment. It usually begins 2 to 4 weeks later.
• Memory problems or problems concentrating: Chemotherapy can cause cognitive problems like short-term memory loss or trouble concentrating.

If you feel ​​mentally foggy from the medications you've taken, let your healthcare provider know.

You Will Need Pre-Chemo Blood Tests

Before each round of chemo, you will have a blood test called a complete blood count (CBC). This is done to get the levels of blood cells produced by the bone marrow that can be affected by chemotherapy.

Tests are a normal part of the entire chemo process, and results give your healthcare team important information about your health status.

For example:

• Red blood cells and hemoglobin will be measured to see if you have anemia, which can lead to fatigue and lightheadedness.
• Your white blood cell count will tell your healthcare provider if you have neutropenia, a deficiency of white blood cells known as neutrophils. This can put you at risk for infection.

Depending on your results, your oncologist may recommend delaying chemotherapy or using specific treatments to improve your values before starting.

Results also factor in calculating the strength of your chemo doses.

You May Need Post-Chemo Medications

You may need to take post-chemo medications. If you can, have those prescriptions filled before your first chemo session to ensure you have them when you need them.

Medications used to control nausea and vomiting differ. Some are taken on a schedule to prevent chemotherapy-induced nausea. To be most effective, take these medications before you feel sick.

Other nausea medications are used on an as-needed basis when you are already feeling nauseous or vomiting.

Make sure you get clear instructions on how and when to take your medications.

Tracking Your Side Effects Is Helpful

If you have side effects from chemotherapy that are bothersome—such as nausea, vomiting, fever, diarrhea, rash, swelling, or unusual pain around the injection site—your healthcare team should be aware of them as soon as possible.

They will want to know how often you're having problems, how severe they are, and how you're coping with them.

It can be helpful to write down any symptoms you experience right after a treatment. Have a dedicated note in your smartphone or a notebook you can keep on hand for this purpose.