What to Expect from Outpatient Cancer Infusion Therapy

A Guide to Infusion Therapy at the University of Michigan

This information is meant for the patients, friends and families of the U-M Rogel Cancer Center. It has been created to answer many of the questions you may have about your treatment, how to prepare and what it will be like. It also has suggestions about caring for yourself during treatment.

What can I expect?

It is normal to be worried about the possible side effects of chemotherapy. It is important to talk about your concerns with your doctor. Remember that not all patients have side effects. In fact, many people have few or no side effects from their treatment. The type of side effects and how bad they may be will depend on the treatment you are getting.

Even though some side effects might be expected, you should always call your doctor if any side effects happen.

Review the "Side Effects and Ways to Manage Them" section of Chemotherapy and You before you start your treatment. You will find a full description of some of the common side effects of chemotherapy, how to prevent them as well as how to manage them. Your health care team will continue to give information to you as you progress through your treatments.

When should I call my doctor?

Call your doctor for if have the following symptoms:

• Any symptom that concerns you
• A fever of 100.5 Fahrenheit or greater (38.05 C). Notify your doctor immediately if you develop a temperature, do not delay
• Bleeding or unusual bruising
• Burning pain when you urinate
• Constipation (no bowel movement in 2-3 days)
• Diarrhea (loose, watery stools) for more than 24 hours
• Nausea, vomiting or unable to eat or drink for more than 24 hours
• Pain not controlled by your medications
• Redness, pain or sores in your mouth
• Unusual cough, sore throat, lung congestion or shortness of breath

Home Infusion

If you are on continuous home infusion and have a problem with your pump, call the HomeMed® Program for any problems with your pump, the chemotherapy itself or with your supplies. The HomeMed™ Number is 800-862-2731.

Precautions in the home after chemotherapy treatment

Precautions need to be taken to protect you and your caregivers from coming into contact with chemotherapy medicine. Chemotherapy leaves the body through urine, vomit, blood, stool, sweat, mucus and sexual fluids. Most chemotherapy medications will be out of your body in less than 48 hours.

We have outlined general precautions that you should follow during your infusion and for 2 days (48 hours) after your chemotherapy is done. In general, these precautions help you avoid all body fluids that may contain chemotherapy. Please talk to your health care team if you have questions about chemotherapy precautions.

Handling Trash or Laundry

Use Nitrile® gloves to handle laundry soiled with chemotherapy to keep it from coming in contact with your skin. Wash your hands before and after removing the gloves.

If possible, wash contaminated laundry right away. If you cannot wash it right away, place it in a leak-proof double plastic bag and wash as soon as possible. Run them through the washer twice using laundry soap and color safe bleach.

Place gloves and gowns and soiled items into a leak-proof double plastic bag.

Skin Care

Skin can become irritated from chemotherapy. If you get chemotherapy or body wastes on your skin, wash the body part with soap and water, then dry. Call your doctor if there is redness or irritation on the skin that lasts longer than one hour.

Body Wastes

Small amounts of chemotherapy are present in urine, vomit, blood, stool, sweat, mucus and sexual fluids. If you are exposed to any body wastes, wash the body part with soap and water. Others in your household may use the same toilet as long as you close the lid and flush twice. If you use a commode, bedpan, urinal or a basin for vomiting, wear Nitrile® gloves when emptying the waste, rinse the container with water and clean it at least once a day with soap and water.

If you do not have control of your bladder or bowels, use a disposable, plastic-backed pad, diaper or sheet to soak up urine and stool. When it becomes soiled, change right away and wash the skin with soap and water. Diapers, pads and gloves soiled with body wastes should be placed in a securely fastened leak-proof plastic bag, then double bagged and placed in your regular trash.

If you have an ostomy, wear Nitrile® gloves when emptying and changing the appliance for 48 hours.

If body wastes splash into your eyes, flush them right away with water for 10 to 15 minutes and call your doctor.

Pregnant and/or Breast Feeding Caregivers

Pregnant or breast feeding women should wear Nitrile® gloves and gowns when caring for patients receiving chemotherapy. This includes changing chemotherapy bags, discarding wastes and cleaning body substances such as diapers and "baby spit".

Sexual Activity and Pregnancy

Do not have sexual activity for 48 hours after getting chemotherapy because body fluids may contain chemotherapy. It is very important that you or your partner not get pregnant while having chemotherapy. You should use 2 forms of birth control to avoid pregnancy while you are using this medicine and for at least 6 months after your treatment ends. This is very important for both men and women. Tell your doctor if pregnancy occurs while you are getting cancer treatment.

Handwashing

Hand washing is one of the most important things you can do to stop infection. Wash your hands before and after:

• Eating
• Making food
• Going to the bathroom
• Touching body fluids (yours and others) such as blowing your nose
• Working with plants or soil
• After touching garbage
• Using gloves for a task or procedure

Antiseptic hand lotions or gels can be better at killing germs.

They should NOT be used if your hands are visibly soiled or have body fluids (such as blood) on them, use soap and water instead.

Off-brand hand gels can be less expensive.

Always check the label for the gel or lotion to have either ethyl alcohol (ethanol), normal propyl alcohol (n-propyl) or isopropyl alcohol in concentrations between 60-90%.

Supplies:

• Antibacterial soap or antiseptic lotion / gel that do not need water
• Paper towel

Method for using antibacterial soap:

1. Wet your hands and wrists under running water.
2. Scrub vigorously with an antibacterial soap for 10 seconds. Work lather between fingers, under nails, over palms and on backs of hands and wrists.
Tip: Sing one chorus of Happy Birthday to You while washing your hand usually takes about 10 seconds!
3. Rinse hands and wrists and dry with a clean paper towel.
4. Turn off faucet with a paper towel.

Procedure for using antiseptic lotions and gels:

1. Place lotion or gel on the palm of your hand.
2. Rub vigorously for 10 seconds. Work lotion or gel between fingers, under nails, over palms and on backs of hands and wrists.
3. Let your hands air dry.

Facing Forward After Chemotherapy Treatment

The end of cancer treatment is often a time to rejoice. You are probably relieved to be finished with the demands of treatment and are ready to put the experience behind you. Yet at the same time, you may feel sad and worried. It's common to be concerned about whether the cancer will come back and what you should do after treatment.

When treatment ends, you may expect life to return to the way it was before you were diagnosed with cancer. But it can take time to recover. You may have permanent scars on your body, or you may not be able to do some things you once did easily. Or you may even have emotional scars from going through so much. You may find that others think of you differently now - or you may view yourself in a different way.

One of the hardest things after treatment is not knowing what happens next. Many cancer survivors feel that they had lots of information and support during their illness, once treatment stopped; they enter a whole new world - one filled with new questions.