It’s not a word people want to hear and certainly not something they want to go through. But, for those individuals with cancer, they often don’t have a choice. 

What to expect on your first day of chemotherapy

The Chemotherapy room is an area where chemotherapy treatments are given to the patient. A chemotherapy regimen (a treatment plan and schedule) usually includes drugs to fight cancer plus drugs to help support completion of the cancer treatment at the full dose on schedule. These treatments are usually done on an outpatient basis.

According to Dr. G McMichael, medical oncologist at Flora Clinic in Florida, Johannesburg, patients expect a chemotherapy room to be very morbid. “They are usually terrified of getting their first chemo treatment and don’t now what to expect the first day. Many people are quite surprised at the atmosphere that exists in a chemo room. The patients happily talk with each other and swap advice, they keep themselves busy with hobbies while they are receiving treatment. There’s a kind of camaraderie and new friendships are formed.”

Preparing for chemotherapy

If your chemo is given into a vein, it is usually done in the chemo day clinic or at a day ward. At Flora Clinic friendly nursing staff welcomes you and makes you feel at ease. The white square lights in the roof and green plants that surrounds the infusion suite, create a profound ambiance. Soft black armchairs meet you and the silver square clock on the wall keeps track of the time. A little water and coffee station is also available to quench your thirst.

When you arrive at the infusion floor, an oncology sister will take your vital signs. Before you can have your treatment you have to have blood tests. The results are necessary to make sure it is safe for you to have treatment. Each doctor will send an order to the infusion suite telling the nurses what chemo and pre-medications to administer. A pharmacist makes chemo drips for each person.

Having chemo in the day clinic can take anything from a few minutes to a few hours through a drip. You may have your chemo given through a:

• Cannula – a small tube put into a vein in your hand or arm and used for chemo drugs that can be given fairly quickly

• Central line – a tube which is put into a vein in your neck (short term) or chest (long term)

• PICC line – a type of central line that is put into a vein in your arm

• Portacath or port – a small chamber that sits under your skin at the end of the central line in your chest

Getting started with chemotherapy

You usually have treatment while sitting in a chair. As you will be in the day clinic for a few hours it is a good idea to take things to do while you are there, such as newspapers or a book.

Once you’re in the infusion suite, the nurse will order your chemo cocktail and any pre-medications that are required from the pharmacy. Your nurse will begin with a saline solution through your IV. As soon as the medications are delivered, your nurse will hang the bags of medication on the IV stand and then start the different IVs. You’ll be given pre-medications first, which may include steroids like anti-nausea medications and/or anxiety medications, and then the chemo.

During chemotherapy

The steroids may give you energy, however, the allergy drugs and anti-anxiety drugs may make you drowsy.  Dr. McMichael says that it’s important that you have a caregiver with you to get you to and from chemo the first time, as you don’t know how you’ll feel after you’re done. Throughout the chemo, your nurse will come in and check your vitals to make sure your treatment is going as planned.

In the meantime, use your infusion time to relax, eat, work, whatever you want to do. The IV stand will even roll with you in case you want to take a walk or sit outside.

After the chemo is finished, the nurse will “flush” your IV line with saline and then de-access your port or take out your IV. They may have you wait a few minutes after the chemo is done to make sure you don’t have any reactions to the medications.

At that point, you can go home.

Tips for first treatment: 

• Always bring along a family member or friend. Patients are very nervous for their first treatment and usually don’t take in all the information provided on the day – an extra person can help to remember.

• Make sure you get all the contact numbers of the chemo day clinic or day ward where you get treated – including emergency numbers.

• Ask questions about your treatment. The more information you have about your treatment and possible side effects, the more relaxed you’ll be.

• Take healthy snacks along to treatments as some treatments may take long.

• Talk to fellow patients – they have many tips about side effects that can help you while at home.

• Find out if you’ll be able to drive home after treatment as some medication may cause drowsiness.

• Listen carefully to instructions on how to administer medication at home.

• Learn the names of nursing staff that treats you- it improves communication when you call the clinic.

• Immediately call nursing staff if your drip hurts, burns, turns red in colour or starts swelling up.

• Make sure you drink plenty of fluids – veins are harder to find when a patient is dehydrated.

Written by Elsje Beneke