Patient Instructions

After chemotherapy - discharge

You had chemotherapy treatment for your cancer. Your risk for infection, bleeding, and skin problems may be high. To stay healthy after chemotherapy, you'll need to take good care of yourself. This includes practicing mouth care, preventing infections, among other measures.

What to Expect at Home

After chemotherapy, you may have mouth sores, an upset stomach, and diarrhea. You will probably get tired easily. Your appetite may be poor, but you should be able to drink and eat.

Mouth Care

Take good care of your mouth. Chemotherapy can cause dry mouth or sores. This can lead to an increase in bacteria in your mouth. The bacteria can cause infection in your mouth, which can spread to other parts of your body.

Brush your teeth and gums 2 to 3 times a day for 2 to 3 minutes each time. Use a toothbrush with soft bristles.
Let your toothbrush air dry between brushings.
Use a toothpaste with fluoride.
Floss gently once a day.

Rinse your mouth 4 times a day with a salt and baking soda solution. (Mix one half teaspoon, or 2.5 grams, of salt and one half teaspoon, or 2.5 grams, of baking soda in 8 ounces or 240 mL of water.)

Your doctor may prescribe a mouth rinse. 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 pain.

DO NOT eat foods and drinks that have a lot of sugar in them. Chew sugarless gums or suck on sugar-free popsicles or sugar-free hard candies.

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

If you wear dentures, put them in only when you are eating. Do this for the first 3 to 4 weeks after your chemotherapy. Do not wear them at other times during the first 3 to 4 weeks.
Brush your dentures 2 times a day. Rinse them well.
To kill germs, soak your dentures in an antibacterial solution when you are not wearing them.

Preventing Infections

Take care not to get infections for up to one year or more after your chemotherapy.

Practice safe eating and drinking during cancer treatment.

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, fish, or anything else you are not sure is safe.

Wash your hands with soap and water often, including:

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. Don't 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 your cat's litter box every day.
Don't 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.

Other Self-care

Other things you can do to stay healthy include:

If you have a central venous line or PICC (peripherally inserted central catheter) line, know how to take care of it.
If your health care provider tells you your platelet count is still low, learn how to prevent bleeding during cancer treatment.
Stay active by walking. Slowly increase how far you go based on how much energy you have.
Eat enough protein and calories to keep your weight up.
Ask your provider about liquid food supplements that can help you get enough calories and nutrients.
Be careful when you are in the sun. Wear a hat with a wide brim. Use sunscreen with SPF 30 or higher on any exposed skin.
DO NOT smoke.

Follow-up

You will need close follow-up care with your cancer providers. Be sure to keep all your appointments.

When to Call the Doctor

Call your doctor if you have any of these symptoms:

Signs of infection, such as fever, chills, or sweats
Diarrhea that does not go away or is bloody
Severe nausea and vomiting
Inability to eat or drink
Extreme weakness
Redness, swelling, or drainage from any place where you have an IV line inserted
A new skin rash or blisters
Jaundice (your skin or the white part of your eyes looks yellow)
Pain in your abdomen
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

Alternative Names

Chemotherapy - discharge; Chemotherapy - home care discharge; Chemotherapy - discharge mouth care; Chemotherapy - preventing infections discharge

References

Doroshow JH. Approach to the patient with cancer. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 179.

Freifeld AG, Kaul DR. Infection in the patient with cancer. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 36.

National Cancer Institute website. Chemotherapy and you: support for people with cancer. www.cancer.gov/publications/patient-education/chemotherapy-and-you.pdf. Updated May 2007. Accessed February 15, 2018.

Sideras K, Hallemeier CL, Loprinzi CL. Oral complications. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 43.

Review Date 1/31/2018

Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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