Care of Women Undergoing Chemotherapy
Chemotherapy is a mode of treatment of breast cancer, wherein chemical which interfere with the growth of cancer cells are introduced in to the body. The agents used for chemotherapy in breast cancer are most platinum based agents and anti metabolites like bleomycin.
Since the agents used for chemotherapy have very frequent and often severe side effects, women undergoing chemotherapy for breast cancer should be educated about the various problems and side effects of chemo. Women must also be advised about the care and precautions to be taken before and after chemotherapy.
Most women with breast cancer will receive some form of chemotherapy post surgery for breast cancer. Women may get anywhere from 2-6 cycles of chemo. Some of the commonest side effects and complications associated with chemotherapy include oral ulcers, nausea, vomiting, hair loss, poor appetite, weight loss, loose motions, and fever. Chemotherapy can also suppress the bone marrow and can lead to a dangerous decline in blood components. The most dangerous of these deficiencies is the reduced count of neutophills, which leads to severe illness called neutropenic sepsis.
The following are the precautions and care to be observed by women undergoing chemotherapy for breast cancer:-
A) Care of a patient with Mucositis (inflammation and ulceration of oral mucosa) after chemotherapy for breast cancer
1. Brush teeth and tongue with soft bristled brush or sponges every 8 hours. This is because chemo leads to oral ulcers and bacteria in the mouth can gain entry in to blood via these ulcers. Frequent brushing helps remove the bacterial load inside the mouth.
2. Rinse the mouth with solution of half saline and half water every 12 hours for the same reasons as mentioned above.
3. Avoid use of alcohol or glycerine based mouthwashes.
4. Apply petroleum jelly to the lips after each episode of mouth care as needed.
5. Women post chemo should consume foods which are not spicy or hard.
6. Women should follow a routine consisting of brushing and gargling after every meal. This will help prevent further ulceration and infection.
B) Prevention of Infection
1. Avoid crowds and other large gathering of people who might be ill.
2. Do not share personal toilet articles, such as tooth brushes, paste, wash cloths or deo sticks etc, not even with your spouse.
3. Bathe daily
4. Wash armpits, groin, genitals, and anal area at least thrice a day with an antimicrobial soap like dettol or savlon.
5. Clean your tooth brush daily either by running it through a dish washer, or by immersing it is a dilute solution of liquid laundry bleach.
6. Wash hands thoroughly with antimicrobial soap before eating or drinking, after touching a pet, after shaking hands with anyone, as soon as you come home from any outing and after using the toilet.
7. Avoid eating any uncooked foods like salads, coleslaw, meat, pork, fruits, or vegetables. Ensure that the food you eat is well cooked and free from bacterial contamination.
8. Do not eat leftover food kept in the fridge or share food from the same plate.
9. Wash dishes between use with hot sudsy water or use a dish washer.
10. Do not drink water that has been standing for longer than 15 minutes.
Following these precautions will prevent much of the infection seen in the post chemo period, thus preventing one of the commonest causes of reduced quality of life post chemo for breast cancer.