Preparing For Chemo
This invaluable pre-chemotherapy shopping list was originally created by the men and women of BreastCancer.org and modified through personal experience recommendations from other cancer patients. As Otter (a brilliant, long time member of BreastCancer.Org) points out… “Before you rent a U-Haul and head to Wal-Mart to buy everything on the list, bear in mind that you are NOT going to need most of it.” It is here as a resource when issues do arise, not as a list of must-haves. Not everything works for everybody! We all find our own path, admittedly, with the help of others on the path, and who have walked it before us.
Thank you Rock, Melissaga, Miki, Otter, Mary C, Deirdre P and all the members that have shared their experience and recommendations. Thank you for letting us share this with those battling other forms of cancer that may not have access to other professional forms of support.
It goes without saying that you should check with your oncologist regarding their recommendations and remedies for the specific chemotherapy you will be treated with. The following are recommendations for common treatments for breast cancer patients.
As you’re making your chemo preparation shopping list you may wish to check out the possible side effects of the drugs you’ll be given at ChemoCare.com .
A Pre-Chemo Shopping List
Most of the following products are available at your local drug store. We have provided the links to each of the products if you wish to order them online through DrugStore.com. These are the best prices we could find online for the appropriate products in a variety of sizes. We welcome your feedback and/or recommendations.
Hand-Sanitizer
Chemotherapy can lower your white blood cell count and increase your risk for infection. To be effective, alcohol-based hand sanitizers must contain at least 60 percent alcohol. Some cheaper brands contain less and are no better than water. Worse, they offer false protection. Fast evaporation of the alcohol means your skin won’t dry out if the product contains a moisturizer. We recommend getting a couple travel sized bottles as well to throw in your backpack, glove compartment, etc. (Beware, the scented ones; they can smell like cheap Tequila!)
Avant 16.9 oz Instant Hand Sanitizer Mild fragrance
Purell 8 oz Instant Hand Sanitizer with Aloe & Vitamin E Mild fragrance
Avant Pocket size Instant Hand Sanitizer Mild fragrance
Sani Hands 24 Instant Hand Sanitizing Wipes These are great for travel
Homemade antibacterial hand wipes (I spotted this on The Doctors)
Take equal parts of rubbing alcohol and mild or fragrance free baby lotion. You’ll need a bit more alcohol to reach 60% alcohol to 40% moisturizer. Pour into a sealable container. Add dry wipes or paper towels. This is an inexpensive alternative to costly baby wipes. This can also be poured into a dispenser and used as a hand sanitizer.
And for those well meaning supporters around you that just don’t understand the enormity of the situation, we’ve created several fun but informative 8 1/2 X 11 posters that can be used for the home or office as well as links to national public health and safety agency posters. (They are all free, PDF files.) Chemo Posters
Antibacterial Hand Soap
Keep one in each bathroom.
Dial 7.5 oz Antibacterial Hand Soap with Aloe, Moisturizing Aloe, Pump Less expensive than the Pear fragrance.
Dial 7.5 oz Antibacterial Foaming Hand Wash with Lotion, Fresh Pear Mild fragrance
Painkiller
Tylenol or Ibuprofen. Ask your oncologist which is preferred; some chemo drugs work the kidneys, others the liver so your doc may prefer one drug over another.
Ibuprofen
Rite Aid Ibuprofen, 200 mg Coated Tablets 500 tablets (best price per dose)
Advil Advanced Medicine for Pain, 200mg 200 caplets
Advil Advanced Medicine for Pain, 200mg 100 tables
Nausea and Vomiting (More to come on this subject. Please check back often)
In this day and age there is no reason for a patient to suffer from nausea and vomiting. Anti-nausea drugs have all but eliminated the constant vomiting that once accompanied chemotherapy. Be proactive and take your medicine as prescribed. Your Oncologist has an arsenal of drugs to choose from so if the first one doesn’t work request another.
- Don’t wait until it’s too late to take your meds.
- Eat several small mealsDehydration can contribute to nausea. Drink plenty of fluids.Avoid fatty, greasy, fried foods.Constipation worsens nausea.
Avoid your favorite foods while you’re nauseous. You may begin to associate them with nausea and vomiting and they will no longer be your favorite foods. I’m sure you’ve heard stories of a particular alcohol a person can no longer drink after having one too many.
N and V Diary If you are unable to control your symptoms; you may find this diary useful.
ThreeLollies.com I found this product while researching products used in other countries. This is widely popular in the UK and mentioned in several different cancer forums there. It’s marketed as a morning sickness remedy and an aid to provide relieve from a queasy stomach associated with chemo treatment. It comes in drops as well as sucker form. This company has generously offered a 10% discount with the coupon code ChemoSolutions.
Psi Bands Drug-Free Wrist Bands for the Relief of Nausea These come in several colors.
Mouth Sores – Treatment and Prevention
Dry mouth is inevitable during chemotherapy, as well as throat radiation, to some degree. Dry mouth can lead quickly to all sorts of dental issues and painful sores, so it’s important to be proactive not just for comfort, but to prevent infection. Drink plenty of water (8 to 12 glasses a day) and avoid spicy and acidic foods.
You’re at greater risk of developing mouth sores if you’re a smoker or wear dentures or have a history of mouth related conditions such as canker sores and cold sores. Click here for more information regarding mouth sores
I personally used this mouth sore cocktail: Equal parts of any liquid Benadryl and liquid Maalox. Only mix up what you are going to use (about 1 teaspoon of each). Swish in mouth for a minute or two like a mouthwash. Then spit out.
I used the Equate brand but www.DrugStore.com doesn’t carry it nor does it carry a liquid form of Benadryl. My Pharmacist said it was okay to use the children’s rather than adult liquid allergy relief. Your Pharmacist can order Liquid Benadryl for you.
Many other women swear by water with baking soda or salt. Mix 8 oz of water with one teaspoon of baking soda or salt and use as a rinse every two hours.
Biotene also makes a small bottle of mouth rinse which helps prevent/treat sore mouth. Warning: Mouth rinses and washes containing chlorhexidine and cetylpyridinium chloride — like Crest pro-health — may stain your teeth. Seriously.
Biotene 16 oz Mouthwash Alcohol free
Biotene 1.5 oz Oral Balance, Dry Mouth Relief Moisturizing Gel Travel size and great for night time moisture relieve. Biotene also has a spray but the consumer rating indicates a preference for the gel.
Biotene Dry Mouth Gum, Sugar Free Mint The gum is difficult to find in stores.
You may also try sugar free chewing gum, sugar free hard candy (some people prefer lemon flavor) or breath mints.
CremeSavers Hard Candy, Sugar Free Strawberries & Creme
LifeSavers Hard Candy, Sugar Free Butter Toffee
Dry, Chapped Lips
Keep your lips moist both night and day with lots of lip balm with SPF 15+. Most lip gloss type products don’t have enough staying power and need frequent reapplication. Remember to coat the edges of your mouth to prevent splitting of the sensitive tissues and possible infection.
Carmex Mint Flavor with SPF 15 Carded Stick
Metallic Taste in Mouth
Some people find the metallic taste from chemo accentuated by normal metal silverware. Use disposable flatware, plates and cups for times when you’re tired or immune-suppressed; plastic flatware helps offset metallic taste in mouth. Biotene mouth wash and/or mouth rinse (and/or toothpaste and chewing gum, lemon/lime cordial, Breathsavers mints) Oasis products were also mentioned.
Hairy Tongue
To avoid the sensation of hairy tongue frequent cleansing with combo of water, baking soda and salt is recommended. Sucking on lemon wedges to re-encourage salivary glands. Brushing one’s tongue with a toothbrush, hydrating with water. Cytoxan seems to mess with the salivary glands.
Dental Care
Get and use lots of new toothbrushes. Consult with your Oncologist prior to having any dental work done. If you’re behind on your dental cleaning schedule, consider having it done prior to starting chemotherapy. (As if you don’t have enough to do.) There seems to be some controversy surrounding flossing. It’s generally recommended that you do not use dental floss, however, ChemoCare.com indicates as long as your platelet count is not too low you can gently floss.
The mouth is really vulnerable to sores and infections so oral hygiene is super-important. Use an extra gentle or extra soft toothbrush. A member of BreastCancer.org shares, “I tried using a regular soft toothbrush and it didn’t work for me, my gums bled and was too harsh. So I found a Sensodyne extra gentle toothbrush and I love it! It is just right for me. I bought at least 5 of them. Remember we have to replace them often.”
If you can’t find extra gentle or extra soft you can always buy a child’s toothbrush. Granted it may have Sponge Bob Square Pants on it but they are soft and gentle on your gums.
- Do not use tooth whiting products, including whitening toothpaste.
- Run your toothbrush under warm water to help soften the bristles.
Biotene 4.5 oz Antibacterial Dry Mouth Toothpaste
Reach 4 Tooth & Gum Soft Manual Toothbrush I can’t find Sensodyne on DrugStore.com
Germ Guardian Toothbrush Sanitizer Quite possibly overkill with this one.
Dry Eyes
Try artificial tears for dry eyes. Consider Renew or Similasan brands.Eyes – Inability to focus and to see clearly because of constant tearing. Dexamethasone drops, also optical ointment for skin around the eyes. The drug irritates the skin, along w/ constant wiping of the eyes.
Rite Aid 1 oz Artificial Tears, Lubricant Eye Drops
Sinus and Nose Care
When you loose your hair, you will loose it all over your body. Trust me when I say that nose hairs really slow down nasal drip. Have at least one extra box of Kleenex and several individual packets of Kleenex. I had treatments during the winter and had a painfully dry nose. The gel provided better relieve for me than the nose spray. I also borrowed a friend’s humidifier for night. Click here for more information on nosebleeds
Kleenex Lotion Facial Tissue with Aloe & Vitamin E
Kleenex White Pocket Tissue, 8 Pack
Simply Saline Nasal Moist Gel – w/Aloe Vera
4-Way Saline Moisturizing Mist
Vicks Vaporizer with Night Light, 2 gallon Model V200 I recommend using distilled water.
Acid Reflux/Indigestion
Lots of us end up with acid reflux/acid indigestion during chemo. For me, it lasted a few weeks afterwards too. It also seemed to help a bit with that taste in your mouth that lots of us get. An H2 blocker antacids such as Pepcid or Nexium.
Pepcid AC Acid Reducer, 90 Tablets
Rite Aid Acid Reducer, Ranitidine 160 Tablets Better price than the Pepcid
Tums Antacid/Calcium Supplement, 150 Assorted Fruit
Diarrhea
Not quite as common as constipation, but some get it after the constipation and some get it instead, so having some Imodium or a similar product on hand at home is a good idea.
Imodium A-D Anti-Diarrheal 24 Caplets or
Pepto-Bismol Regular Strength Liquid
• Key worry is dehydration, so keep drinking water!
• Stay away from sugary things, as refined sugar can aggravate diarrhea
• From a dietary perspective for diarrhea, you can try the BRAT diet: Banana, Rice, Applesauce, and Toast
If you wind up with diarrhea try the flushable moist wipes; they really help with general soft tissue irritation.
Pampers Sensitive Wipes, 128 Refill Yes, baby wipes. they’re gentle enough for a baby and less expensive, but typically not flushable.
Huggies Baby Wipes, Cucumber & Green Tea, 64 Tub Mild fragrance
Huggies Baby Wipes, 64 Tub, Sensitive Fragrance free
Wet Ones Fresh ‘n Flush, 24 Individually Wrapped Wipes Great for men to carry in your pocket.
If you really want to pamper yourself, there are wipe warmers available too.
Constipation
Constipation is pretty common from both chemo and the anti-nausea (emetics). It can be severe. Don’t wait too long to take these. This is one that you’ll want to be proactive.
• Eating fiber several days before chemo can help prevent/lessen constipation. Constipation and chemo can be excruciatingly painful.
Metamucil Psyllium 160 Fiber Capsules
Benefiber Fiber Supplement, Sugar free Chewable Assorted Flavors
• Prune juice (you can mix it with Milk of Magnesia for a “cocktail”)
Phillips Milk of Magnesia, Original
• Colace (docusate sodium) is an over the counter stool softener to have on hand.
Colace Stool Softener Laxative 100 mg, Capsules
• Senekot-S (not Senekot) is a gentle laxative and stool softener. Not available at DrugStore.com
• Lots of water helps here, too.
• A square of chocolate ExLax the night of chemo, and another one the following evening then gallons of water and tea.
ex-lax Chocolate Stimulant Laxative
• Eat active culture or probiotic yogurt every single day. The secret, the poster suggests, may be taking something at the same time as the chemo before things can get really bottled up, so to speak.
• Avocados (eaten straight out of the skin, w/ a little salt, pepper, & olive oil)
Urinary and Rectal Care
Try using flushable moist wipes the first few days after chemo to prevent the discomfort/burning that may accompany urination; these may help soothe irritated tissues. You may also use a squirt bottle with warm water. I recommend using Vaseline or a diaper rash ointment as a barrier for a week or two after chemo. It also helps with the dry skin in that area. Taking precautions several days in advance for constipation will help you to avoid bleeding hemorrhoids associated with straining.
Preparation H 48 Medicated Wipes Great ratings. Thick wipes. Resealable refill pack.
Desitin Multi-Purpose Ointment, Clear Used for baby diaper rash so it works great for irritated tissue. Can be used as a barrier cream as a preventative measure.
Vaseline Petroleum Jelly External use only.
It’s essential to drink a lot of water which also means you’ll be spending an insane amount of time in the bathroom. This should also help to prevent bladder infections. Click here for information regarding urinary tract infection
Vaginal Dryness and Feminine Care
Trade your stylish, binding underwear for 100% cotton during chemo and change them often. Many women suffer from chaffing and an adult form of diaper rash. I turned my underwear inside out to protect my skin from the seams. Hanes for women makes the best underwear I could find for chemo. Buy one size too big and make sure the leg ribbing is also cotton. It also helps to use diaper rash cream or Vaseline as a moisture barrier at all times. External only. You don’t want to contribute to a yeast infection.
It’s generally recommended that women don’t use tampons due to increased risk of infection during treatment.
Vaginal dryness can lead to pain and discomfort during intercourse. A water based lubricant is highly recommended. To prevent possible introduction of bacteria you should also use condoms during the days your white blood count is low. Click here for more information regarding vaginal dryness
K-Y Jelly, 4 oz Personal Lubricant
Astroglide Personal Lubricant, 4 oz Gel
K-Y Warming Jelly Personal Lubricant
Trojan Ultra Pleasure Lubricated 12 Latex Condoms
LifeStyles Skyn Polyisoprene (non latex lubricated) 12 Condoms,
Sex and Intimacy
Chemo is past on through body fluids making condoms necessary during treatment.
Cookie with Chemoflage, a non profit organization based in Atlanta Georgia, recommends using a warming lubricant to assist in encouraging production of your own natural lubricant. Begin with a small amount to determine your sensitivity to the product.
Yeast Infections
If you’re prone to yeast infections try acidophilus capsules.
Dry Skin
Unscented moisturizer most recommended by the chemo patients in my group were Aquaphor and Udderly SMOOth with urea. I couldn’t find Udderly Smooth at any of our local stores so I ordered it online. Don’t neglect your feet. I’ve never had a problem with dry feet before chemo. I had to put the Udder Cream on with socks several times a week to keep them from cracking.
Udderly Smooth Extra Care Cream, 8 oz Unscented
Aquaphor 14 oz Baby Healing Ointment This one has more of a greasy feel.
Earth Therapeutics Aloe Socks, Pink My girl friends swear by these but your own socks work fine too.
Curel Continuous Comfort Moisturizing Lotion, Fragrance-Free
Bath and Shower
Skin Sensitivity To The Sun
It’s generally recommended that you stay out of the sun during chemo or wear sunscreen with a minimum of SPF 15+. Don’t forget bug repellent.
Carmex Mint Flavor with SPF 15 Carded Stick
Huggies Little Swimmers Sunscreen, 7.5 oz Moisturizing Fragrance Free
Natrapel 3.5 oz 8-Hour Deet Free Insect Repellent
Monitoring Your Temperature
Make sure you have a reliable thermometer and be clear as to what temperature is the point when you need to call your Oncologist. I was told 100.5.
BD Digital Thermometer What ever happened to the good old fashion, reliable mercury and glass thermometers?
Sanitary Environment
Use an antibacterial wipe such as Clorox-type wipes. Wear non-latex gloves when doing dishes and other cleaning duties to reduce nicks and cuts, at least on those low blood count days toward the end of treatment.
Closing the toilet seat before flushing will dramatically reduce distribution of bacteria in the bathroom. You may be instructed to flush twice for the first 2 days after chemo with certain drugs.
Install new or washed shower curtain liner to minimize bacteria and mold.
If you must get a professional manicure or pedicure at a local shop, bring your own manicure set. Most doctors recommend that you refrain from anything that may allow bacteria to enter the blood stream until you have completed chemo and blood counts are back to normal. Of course, after a while, your nails may not grow at all on chemo and all kinds of things can happen to them.
Make laughing and relaxing as important as cleaning!
Germ Guardian UV-C Mini Sanitizer Wand, LW9 Now this is how I like to clean. I have no idea if these work; I’m just giving you some options.
Sleeplessness
From the women on BreastCancer.org….”Lots of us have trouble with sleep during chemo. I found that steroids made me very wired and it was hard to sleep more than 2-3 hours at once. Ambien CR is great because of the “CR,” controlled release. It helps you fall asleep and STAY asleep. I found chemo was easier on me overall when I was able to get some sleep. Especially in first few days post chemo. Ambien CR or Benadryl for those that prefer to avoid sleep aids.” Click here for info regarding managing sleep problems
Chemo Bag for Treatment Day and/or Travel
BreastCancer.org member “Rock” shares…… My “chemo bag”: (A great project for a friend). Assemble a small make-up type bag (say 4″x4″x6″ or smaller) that you can move from purse to backpack back to purse to car or whatever that includes some of the stuff that’s good to have on hand when you’re out and about:
Tylenol or Ibuprofen (ask your oncologist), toothbrush, toothpaste, Breathsaver-type lozenges, chapstick, unscented hand lotion, eye drops, antibiotic ointment, Purell sanitizer or hand wipes, Saltines or animal crackers, Kleenex, digital thermometer, thin cap to ward off any sudden chills, mouth rinse. And maybe a maxi-pad in case of any port or drain mishaps. It’s important to ward off mouth sores, avoid fever/monitor temp, chemo dries out eyes, mouth, skin; lack of nose hairs causes drippy nose.)”
Food
Support your immune system with iron- and protein-rich foods.
- Protein food sources. Peanut butter, meat, (avoid soy if you are breast cancer ER and PR+)- unsweetened individual packages of applesauce
- Individual containers of cottage cheese (I find smaller servings less daunting on a queasy stomach, and may be less wasteful in the long haul)
- Eggbeaters (bland, protein)- brown rice
- crackers (inc individual packets of animal crackers or Saltines to carry around or keep in desk drawer or nightstand for queasy moments. ER+ should watch out for soy — it’s in a lot of cracker sandwiches)
- lentil soup, black bean soup, chicken broth, or some mild soup, just in case you wind up with an upset stomach and need something bland to eat
- orange popsicles, orange Pedialyte
- Careful with protein bars (or any other foods) that contain soy if you are ER+ (breast cancer).
-Sugar free fat free pudding
To help prevent heart burn and acid reflux during treatment, it helps to eat several small meals and avoid spicy food.
Chemotherapy Tips and General Care
As with all things chemo, everyone is different. What works for one person (or one therapy), may not work for everyone.
Fluids – Drink, drink and drink some more. When you are finished, drink even more! Staying well hydrated greatly helps with the side effects. You’ll want to start drinking water one to two days before you go in for your first chemo treatment. It’s hard to predict what you will or will not like because of the change in taste that can happen. If you don’t like water try adding your favorite flavor of Crystal Light. Avoid sodas they can be hard on your stomach.
Walk as often as you can. I walked for two hours twice a week. The first hour about killed me but the last hour I almost felt normal again. Try to get in 10 to 20 minutes a day. Don’t be surprised if your body mistakenly feels like it weighs 300 lbs! Take your friends up on there offers to be a walking partner. It keeps the extra pounds off (that some people gain from the steroids), gives you more energy, and lifts your mood.
Port care
The nurse may clean the port by injecting Heperin into it. A horrible taste can sometimes be avoided by holding your nose while the Heperin is injected. A numbing agent may make entry in and out of the port less painful.
Locating “Good veins”
Rock from www. BreastCancer.org shares her experience and some valuable suggestions for a better IV experience.
Yesterday I learned some handy-dandy pointers for making it easier to locate a “good” vein from which to draw blood or start an IV. A/C (Adriamycin® and cyclophosphamide) can be hard on the veins. At some hospitals, women on A/C automatically have a port surgically installed. At MSKCC, however, I was given the opportunity to use my veins. The goal is to keep my veins in good enough health that I can use them for all 8 treatments. Another goal is to “start low” on the arm so that if one vein is blown, then they can work their way up. A nurse can go to a higher vein for attempt #2, but she cannot go lower.
The standard advice is “drink lots of water” because hydrated veins are easier to find and stick. I still “blew” a vein on the back of my wrist on #4. At #5, I asked the phlebotomist (not the nurse), “Any pointers? Any advice?” She said, “Well, I’ve noticed that your hands are always cold. Cold veins don’t work very well. Warm up your hands before they put in the IV, draw blood, etc. You could use a hot pack or you could just rub your hands together. Run them under warm water. ” That’s odd, my hand is cold? Why is that? And this wonderful, brilliant phlebotomist said, “You’re probably drinking a lot of water. Are you holding your water in your right hand? It’s probably cooling off your hand and your circulation in that hand. Either drink room temperature water or hold the bottle of water in your other hand.” I could have kissed her. The nurse also had a technique for finding good veins. She had me hang my arm down off a pillow and pumping my hand open and closed to make it easier to identify a vein. The result? My IV was about 2 inches above my wrist (still low, I have another six inches of forearm to use!) and it went off without a hitch.
Aches and Pains
• Tylenol is the first pain killer of choice for A/C as it has the fewest possible side-effects. I was told “No Ibuprofen or aspirin.” The poster suggested taking a painkiller 30 minutes prior to the Neulasta injection, and then regularly for 2-3 days after. A/C & Ibuprofen are processed through the liver; Taxol and Tylenol are processed through the kidneys. For this reason, I was urged to use Ibuprofen w/ Taxol and to use Tylenol w/ A/C. I found it all very confusing. Ask your doctor which pain reliever is right for you. Regular exercise (e.g., a walk) seems to help lessen or prevent Neulasta pain for many of us.
Neuropathy and Hand Foot Syndrome (associated with the Taxanes)
- Avoid going barefoot. Always wear slippers or Crocs.
- Gently massage feet and hands with lotion to keep them soft and improve circulation. (I like Udderly SMOOth with Urea. Reasonably priced; available at www.drugstore.com)
- Wash hands (and dishes) in lukewarm water, not hot.
* Ask oncologist about taking 50 mg of B6 to address neuropathy (tingling, numbness that often appears first in feet and hands)
A description of the functions and side effects of common chemotherapy drugs is located at ChemoCare.com.
