Preparing for chemotherapy.

Chemotherapy (chemo) is a common type of cancer treatment that uses powerful medications to stop or kill cancer cells. The goal of chemotherapy can be to cure cancer, lessen the chance it will return, or stop or slow its growth— or in some cases, all three. Killing or shrinking cancer cells can also relieve pain and other symptoms associated with cancer. Chemotherapy may be used alone, or it may be used in combination with other therapies.

The goal of chemotherapy can be to cure cancer, lessen the chance it will return, or stop or slow its growth— or in some cases, all three.

Chemotherapy isn’t a standard treatment for early myeloma, but if the condition progresses to an active state, chemotherapy is often started. It can be tried either alone or in combination with other medications, radiation therapy, and possibly even stem cell transplantation. It is sometimes introduced after stem cell transplantation as an additional cycle of treatment.

How chemotherapy may affect you.

Chemotherapy is generally effective at killing cancer cells, but one of its downsides is that it also kills or slows the growth of healthy cells—particularly ones that grow and divide quickly, like those that line your mouth and intestines, and those that enable hair to grow. Damage to healthy cells may cause side effects, such as mouth sores, nausea, and hair loss.

The most common side effect of chemotherapy is fatigue, possibly lingering into the day after treatment. For this reason, you should consider asking a friend or family member to take you to and from your treatments.

Chemotherapy affects people in different ways. The number and intensity of the side effects you experience will depend on many factors, including the specific medication used, along with the amount and frequency, and your overall health before starting treatment.

Side effects may include:

• Nausea, vomiting, and/or loss of appetite
• Diarrhea
• Hair loss
• Fever
• Mouth sores
• Pain
• Constipation
• Easy bruising
• Infertility

Many of these side effects can be managed or treated, and most subside after treatment ends.

Because side effects can be significant, many patients receive chemotherapy in cycles that allow for periods of rest. The rest periods help minimize side effects by allowing your body to create new healthy cells. But remember, the severity of side effects—or even the absence of them—has nothing to do with how well the chemotherapy is working to kill cancer cells.

Your health care team will monitor side effects carefully and consider them when setting or adjusting your treatment course. Even if your side effects are significant, your health care team may continue the approach because it is better for you than altering the treatment.

If chemotherapy isn’t effective or is causing severe side effects, your practitioners can choose from a number of other treatment approaches.

Advance preparations.

How you get ready for chemotherapy depends on which medications you will receive and how they will be administered. You may receive chemotherapy during a hospital stay, at home, or as an outpatient at a doctor’s office, clinic, or hospital. Chemotherapy is often given through a thin needle that is placed in a vein in your hand or lower arm, but there are oral (pill by mouth), topical (lotion) and other methods of delivery.

Your doctor will give you specific instructions on how to prepare for your chemotherapy treatments. Talk to your health care team about how the medications will be administered, in what quantity, and how often, and also about steps you may need to take before starting chemotherapy. For example, with some types of chemotherapy, you may need to a have a catheter, port, or pump inserted prior to starting. Other examples include:

• Having tests and procedures to make sure your body is ready to receive chemotherapy.
• Seeing your dentist or other specialists for signs of infections unrelated to the cancer; some chemotherapy may reduce your body's ability to fight infections.
• Discussing the potential for lasting side effects, such as infertility, with your doctor.

Measuring your progress.

Your health care team will want to see you frequently during and after chemotherapy to ask how you feel, measure side effects, do a physical exam, and perform common medical procedures to measure the impact on tumor size, including MRI, CT, or PET scans. This is a good time to talk to your doctor about any side effects you’re experiencing and ask about ways to minimize them, if possible. Treatment for myeloma is often highly personalized. If chemotherapy isn’t effective or is causing severe side effects, your practitioners can choose from a number of other treatment approaches.

Life considerations.

The mental and physical fatigue of undergoing chemotherapy may make it difficult for you to work or take care of household responsibilities that you typically handle. Take it easy on yourself, particularly during the first part of chemotherapy, when you’re not yet sure how the treatments will affect you. Don’t put too much pressure on yourself to handle everything as you did before. Reach out to loved ones and friends for help when you need it. You may also want to talk with your employer about ways to adjust your work schedule during chemotherapy, if necessary.

Our CareTeam can help with preparing yourself for chemotherapy and managing your symptoms once your treatment has started.