There are many drugs and combinations of drugs used to fight cancer. The main goals of chemotherapy are to help control, ease symptoms of cancer, and help cure (if possible).
There are many things to discuss with your doctor about planning and executing a chemotherapy plan that best suits you.
Listen in as Nancy Betran, RN shares what you can expect from chemotherapy, how to prepare, tips on how to get through chemotherapy to make your chemotherapy more successful.
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Tips On Getting Through Chemotherapy
Featured Speaker:
Nancy Bertran, RN
Nancy Bertran, RN is the Nurse Manager at Roswell Park Comprehensive Cancer Center. Transcription:
Tips On Getting Through Chemotherapy
Bill Klaproth (Host): If you or a loved one has been given a cancer diagnosis and is facing chemotherapy, what should you expect and what’s the best way to manage and get through it? With us, is Nancy Bertran, a Registered Nurse at Roswell Park Comprehensive Cancer Center. Nancy, thank you for your time today. Can you first talk about the “What to Expect” Series, which addresses a full range of questions including chemotherapy issues?
Nancy Bertran (Guest): Well, I am a Registered Nurse – actually, I’m an oncology specialized certified nurse at Roswell Park. I’ve been here 23 years and in that education opportunity, we’ve learned that the most important way for a patient to be successful in chemo is for us to frame their expectations before they arrive and reduce their anxiety about it, so we welcome this opportunity to partake in the podcast so we can demystify it for people. It seems that Hollywood has a version of extreme side-effects, being uncomfortable, and there is somewhat of that as side-effects, but it is not what Hollywood presents, and we really want to make sure that our listening people have an opportunity to say, “Oh, I think I could do that. I think I could get through that,” and come in with a greater degree of confidence in their own ability.
With this, we can talk about some expectations of what happens as their doctors say, “We’re going to set you up for some chemotherapy,” and what they can expect while they’re with us. Specifically, we can look at – when they’re coming to chemo, they’ve actually had a visit with the doctor first, and in that visit, the doctor have had a conversation with the pathologist and the pharmacy team, and saying, “For this person, the best opportunity for success would be a particular chemo regimen,” and they can talk about what regimen, how many times a week or month that they’ll get that regimen, and then start to schedule appointments. The pharmacy team here at Roswell spends some time with the patient at that moment to say, “These are the drugs that you’re going to get, and they have long names, they sound complicated, but in effect, the expectation is the drug will do its work.” You’ll continue to be an outpatient, which means you’ll go home every day. You go home to your family or your job, and you get on with the business of living while you’re being treated for your cancer.
We call this layering of information, almost like a lasagna – the doctor begins a consent process, talking about a treatment regimen, the pharmacist comes in and talks about what particular drugs that regimen will involve. By the time that the patient that comes to the chemotherapy center is introduced to the extension of their family now – they have their loved ones with them, but we’ve become their medical family. Those introductions are made, those relationships are established, and it’s the nurses then that will carry them through those regimens. It’s really, really important that we layer information so that people don’t become overwhelmed. It’s very easily to become overwhelmed when you hear the word cancer, and it’s addressed to you. At this point, we would make sure that we have an opportunity to reassure our patients, welcome to our chemotherapy room, and we’re going to make sure that you’re comfortable, and we’ll give you all the information that you need to be successful.
Bill: Well, that’s good to hear because a cancer diagnosis alone will shake you to your core and then having to learn about what they’re going to be doing to you and the processes involved, that’s just another weight on somebody. When you talk about the layering of info, that makes total sense, where you just really bring the patient along so they can easily understand the process of what’s going to happen. In that preparation for chemotherapy, Nancy, let’s talk about some things that people may not think about, like what should they wear, and can they drive there?
Nancy: Well, actually this is an outpatient ambulatory setting as most chemotherapy centers are, and yes, you can drive yourself, but we highly recommend that you bring somebody with you. The reason for that is that there is an expenditure of emotional labor, not just the physical labor of getting yourself up, and dressed, and getting to an appointment on time, but your emotions take a toll as well. We really feel that it takes a village and it’s important to have somebody who loves you, with you, to make sure that you stay focused, you stay well-supported in your personal journey. As you get to our care, that person can be in the chemo infusion room with you – and it’s not necessarily a mother, brother, sister, it can be a friend, or a neighbor, or somebody -- but we highly recommend that somebody brings you to your appointment and drives you home from your appointments. One, to address the emotional labor of that, and the other is that one of the medications that we give in preparation for a patient to receive chemo is an antihistamine, and antihistamines prevent allergic reactions to the drugs, but it also makes you sleepy. We don’t want you falling asleep at the wheel in the car on the way home [LAUGHTER]. So it’s very, very important that a driver is there. Now, some people say, “No, I don’t need a driver, I’m fine. I tolerate my regimens very well,” and that may be true going forward, but on those first initial visits, it’s important that you learn how you’re going to tolerate your medications and learn how you respond and then you can make decisions on whether or not you need a driver after that.
But it’s always fun to have somebody with you because you’re going to be with us anywhere from an hour and a half to – some of the regimens are quite long – six hours. It’s nice to have somebody with you to chat with and – a lot of the patients are bringing a deck of cards, and they’re playing cards, or they’re on their laptops, we’re all Wi-Fi accessible here. They're exchanging information with their loved ones, “Hi, I’m getting my treatment now,” and back and forth with texting and all of that good stuff. It’s time well-spent. Other people are still working, and they’re bringing their laptops and continue to work from their offices from afar. You’ll see people with their headsets on and staying very focused. As they’re getting their treatment, they're getting on with their business of life as well.
Bill: Right, and that support is very important for bringing a friend along and good that they can bring laptops and books and other things to do work. You were mentioning allergic reactions, so what about eating or drinking before going in for treatment?
Nancy: We highly recommend that people maintain their nutritional status and one of the side-effects of chemo, we know, is flat taste buds. Chemo affects all of the rapidly-dividing cells in the body, so traditionally that means your hair, that’s your nailbeds, but it’s also your taste buds. Your favorite foods become not so favorite anymore and as your appetite fails you may drop a few pounds. Chemo is weight based – it’s actually based on a calculation of how much do you weight, and so we want your weight to stay steady so that the amount of drug that we offer you also remains steady and in the system.
There’s no restrictions on dietary and we highly, highly encourage food intake. The reason for that being once chemo has done its job circulating through your body and attacking any tumor cells, we want it flushed out of your body, not linger around unnecessarily, so it’s to do its job and then to be flushed out of the body. It’s important that you drink a lot of fluids to allow that flushing process to happen. It will also overall make you to feel a little better. You won’t be feeling that run-down feeling that you can get post-treatment. All of a sudden, hydration is a wonderful thing. The body actually craves fluids, and with fluids on board, you’ll actually have a higher sense of wellness, being able to perform a little better at home, especially if you’re trying to work or raise young children.
We just want you to feel the best you can feel so we highly encourage maintaining nutrition as much as you can, drink your fluids, and when the taste buds become flat, one of the tricks that the patients themselves have shared with us is if they change the temperature of their food. Rather than having a hot pasta perhaps have a cold pasta salad, or put a little zing in it, more than you normally would do. Put a little bit more spice. Ginger happens to be a wonderful, well-received taste after chemotherapy because it breaks through that flatness in the taste buds, so gingersnap cookies, anything with ginger in it, ginger lozenges, little throat lubrications, all of that help spark the appetite a little bit.
Bill: Nancy, those are terrific tips, and can you tell us a little bit about the Chemo Infusion Center when people get there?
Nancy: We’ve just been very fortunate to open up a new wing this past summer through the generosity of our donors in the Western New York Area, and we opened up a beautiful center in the Scott Bieler Tower here, an extension of the hospital. It has beautiful views of the city and the lake, looking out over you. It’s very open; there’s a lot of windows, very accommodating, very comfortable environment.
The treatment bays have a higher degree of privacy so that you’re not having people stare at you. Our old room was very open, and everybody was watching you sleep in your chair and whatnot. It wasn’t very accommodating. It was an antique compared to what we have now. It’s state-of-the-art right now. In each treatment bay area is a smart TV so those that are more techno-savvy [sic] can get even onto the internet and do things more with the TV. Those TVs were donated by a wonderful philanthropist in the Western New York area. I don’t know if I can say his name on air, but we will, Russell Salvatore. He donated the TVs for all of the hospital, not just my chemotherapy wing and they have been so well-received by the patients and their family members. They were impressed with the high quality of them. Again, something to pass the time. They can watch their sporting events. We’d just gone through a major federal election, and they were able to keep abreast of all of the changes going on in the community, and it was just a wonderful things for them to have at no charge. Those TVs are available to them and their families throughout the day, so it’s just as wonderful, wonderful thing. We get a lot of positive feedback from it.
Bill: Well, a comfortable setting does go a long way. And lastly, why should someone choose Roswell Park Cancer Institute for their care?
Nancy: This is probably one of the most important points that we want to make about coming to a facility. Roswell Park Cancer Institute was the first in the nation – comprehensive cancer center, where they recognized cancer back in the 1900s as the disease of the future and the one that would require quite a bit of research and attention in that we’ve had several national comprehensive cancer institutes pop up around the nation and they’re very well-known, but we’re fortunate to have our center right here in the Western New York area. What that means is -- a comprehensive cancer center is that it’s not just your disease that’s going to be treated, but all treatment options available to you, the opportunity to participate in research protocols in building drugs for the future. Right now, it’s not just chemotherapy that’s making people’s lives live longer – you may have seen the ads on television for the new immunotherapies, biotherapies – they’re much more well-tolerated. They’re very much in the market right now for people to be aware of. While chemotherapy can be very harsh, the immunotherapies are well-tolerated, they're targeted therapies for specific tumor types, and they’re getting really good results and offering – the most important point here, longevity, survivorship. People are living a very long time with a cancer diagnosis right now and in that research that happens at a national comprehensive cancer institute is their best opportunity for their overall survival and quality of life. That’s probably one of the reasons why they should be looking to a national comprehensive cancer institute for their care. In that is also supportive care, pain management, palliative care, psychosocial support, case management, financial assistance, all of those things that affect the family directly while they’re in this journey and that’s all offered here at Roswell Park. It’s not just about your doctor's appointment and the drugs you’re going to receive, or the surgery, or the radiation, it’s about everything that touches your life is important to us at Roswell Park. Our Pastoral Care Department is there for multifaceted support, as well, so that’s what you get when you come to a come to a national comprehensive cancer institute, and that’s what the public deserves.
Bill: Very important points, Nancy, and thank you so much for sharing all of that information with us, and thank you for your time today. For more information, visit RoswellPark.org, that’s RoswellPark.org. You’re listening to Roswell Cancer Talk with Roswell Park Comprehensive Cancer Center. I’m Bill Klaproth, thanks for listening.
Tips On Getting Through Chemotherapy
Bill Klaproth (Host): If you or a loved one has been given a cancer diagnosis and is facing chemotherapy, what should you expect and what’s the best way to manage and get through it? With us, is Nancy Bertran, a Registered Nurse at Roswell Park Comprehensive Cancer Center. Nancy, thank you for your time today. Can you first talk about the “What to Expect” Series, which addresses a full range of questions including chemotherapy issues?
Nancy Bertran (Guest): Well, I am a Registered Nurse – actually, I’m an oncology specialized certified nurse at Roswell Park. I’ve been here 23 years and in that education opportunity, we’ve learned that the most important way for a patient to be successful in chemo is for us to frame their expectations before they arrive and reduce their anxiety about it, so we welcome this opportunity to partake in the podcast so we can demystify it for people. It seems that Hollywood has a version of extreme side-effects, being uncomfortable, and there is somewhat of that as side-effects, but it is not what Hollywood presents, and we really want to make sure that our listening people have an opportunity to say, “Oh, I think I could do that. I think I could get through that,” and come in with a greater degree of confidence in their own ability.
With this, we can talk about some expectations of what happens as their doctors say, “We’re going to set you up for some chemotherapy,” and what they can expect while they’re with us. Specifically, we can look at – when they’re coming to chemo, they’ve actually had a visit with the doctor first, and in that visit, the doctor have had a conversation with the pathologist and the pharmacy team, and saying, “For this person, the best opportunity for success would be a particular chemo regimen,” and they can talk about what regimen, how many times a week or month that they’ll get that regimen, and then start to schedule appointments. The pharmacy team here at Roswell spends some time with the patient at that moment to say, “These are the drugs that you’re going to get, and they have long names, they sound complicated, but in effect, the expectation is the drug will do its work.” You’ll continue to be an outpatient, which means you’ll go home every day. You go home to your family or your job, and you get on with the business of living while you’re being treated for your cancer.
We call this layering of information, almost like a lasagna – the doctor begins a consent process, talking about a treatment regimen, the pharmacist comes in and talks about what particular drugs that regimen will involve. By the time that the patient that comes to the chemotherapy center is introduced to the extension of their family now – they have their loved ones with them, but we’ve become their medical family. Those introductions are made, those relationships are established, and it’s the nurses then that will carry them through those regimens. It’s really, really important that we layer information so that people don’t become overwhelmed. It’s very easily to become overwhelmed when you hear the word cancer, and it’s addressed to you. At this point, we would make sure that we have an opportunity to reassure our patients, welcome to our chemotherapy room, and we’re going to make sure that you’re comfortable, and we’ll give you all the information that you need to be successful.
Bill: Well, that’s good to hear because a cancer diagnosis alone will shake you to your core and then having to learn about what they’re going to be doing to you and the processes involved, that’s just another weight on somebody. When you talk about the layering of info, that makes total sense, where you just really bring the patient along so they can easily understand the process of what’s going to happen. In that preparation for chemotherapy, Nancy, let’s talk about some things that people may not think about, like what should they wear, and can they drive there?
Nancy: Well, actually this is an outpatient ambulatory setting as most chemotherapy centers are, and yes, you can drive yourself, but we highly recommend that you bring somebody with you. The reason for that is that there is an expenditure of emotional labor, not just the physical labor of getting yourself up, and dressed, and getting to an appointment on time, but your emotions take a toll as well. We really feel that it takes a village and it’s important to have somebody who loves you, with you, to make sure that you stay focused, you stay well-supported in your personal journey. As you get to our care, that person can be in the chemo infusion room with you – and it’s not necessarily a mother, brother, sister, it can be a friend, or a neighbor, or somebody -- but we highly recommend that somebody brings you to your appointment and drives you home from your appointments. One, to address the emotional labor of that, and the other is that one of the medications that we give in preparation for a patient to receive chemo is an antihistamine, and antihistamines prevent allergic reactions to the drugs, but it also makes you sleepy. We don’t want you falling asleep at the wheel in the car on the way home [LAUGHTER]. So it’s very, very important that a driver is there. Now, some people say, “No, I don’t need a driver, I’m fine. I tolerate my regimens very well,” and that may be true going forward, but on those first initial visits, it’s important that you learn how you’re going to tolerate your medications and learn how you respond and then you can make decisions on whether or not you need a driver after that.
But it’s always fun to have somebody with you because you’re going to be with us anywhere from an hour and a half to – some of the regimens are quite long – six hours. It’s nice to have somebody with you to chat with and – a lot of the patients are bringing a deck of cards, and they’re playing cards, or they’re on their laptops, we’re all Wi-Fi accessible here. They're exchanging information with their loved ones, “Hi, I’m getting my treatment now,” and back and forth with texting and all of that good stuff. It’s time well-spent. Other people are still working, and they’re bringing their laptops and continue to work from their offices from afar. You’ll see people with their headsets on and staying very focused. As they’re getting their treatment, they're getting on with their business of life as well.
Bill: Right, and that support is very important for bringing a friend along and good that they can bring laptops and books and other things to do work. You were mentioning allergic reactions, so what about eating or drinking before going in for treatment?
Nancy: We highly recommend that people maintain their nutritional status and one of the side-effects of chemo, we know, is flat taste buds. Chemo affects all of the rapidly-dividing cells in the body, so traditionally that means your hair, that’s your nailbeds, but it’s also your taste buds. Your favorite foods become not so favorite anymore and as your appetite fails you may drop a few pounds. Chemo is weight based – it’s actually based on a calculation of how much do you weight, and so we want your weight to stay steady so that the amount of drug that we offer you also remains steady and in the system.
There’s no restrictions on dietary and we highly, highly encourage food intake. The reason for that being once chemo has done its job circulating through your body and attacking any tumor cells, we want it flushed out of your body, not linger around unnecessarily, so it’s to do its job and then to be flushed out of the body. It’s important that you drink a lot of fluids to allow that flushing process to happen. It will also overall make you to feel a little better. You won’t be feeling that run-down feeling that you can get post-treatment. All of a sudden, hydration is a wonderful thing. The body actually craves fluids, and with fluids on board, you’ll actually have a higher sense of wellness, being able to perform a little better at home, especially if you’re trying to work or raise young children.
We just want you to feel the best you can feel so we highly encourage maintaining nutrition as much as you can, drink your fluids, and when the taste buds become flat, one of the tricks that the patients themselves have shared with us is if they change the temperature of their food. Rather than having a hot pasta perhaps have a cold pasta salad, or put a little zing in it, more than you normally would do. Put a little bit more spice. Ginger happens to be a wonderful, well-received taste after chemotherapy because it breaks through that flatness in the taste buds, so gingersnap cookies, anything with ginger in it, ginger lozenges, little throat lubrications, all of that help spark the appetite a little bit.
Bill: Nancy, those are terrific tips, and can you tell us a little bit about the Chemo Infusion Center when people get there?
Nancy: We’ve just been very fortunate to open up a new wing this past summer through the generosity of our donors in the Western New York Area, and we opened up a beautiful center in the Scott Bieler Tower here, an extension of the hospital. It has beautiful views of the city and the lake, looking out over you. It’s very open; there’s a lot of windows, very accommodating, very comfortable environment.
The treatment bays have a higher degree of privacy so that you’re not having people stare at you. Our old room was very open, and everybody was watching you sleep in your chair and whatnot. It wasn’t very accommodating. It was an antique compared to what we have now. It’s state-of-the-art right now. In each treatment bay area is a smart TV so those that are more techno-savvy [sic] can get even onto the internet and do things more with the TV. Those TVs were donated by a wonderful philanthropist in the Western New York area. I don’t know if I can say his name on air, but we will, Russell Salvatore. He donated the TVs for all of the hospital, not just my chemotherapy wing and they have been so well-received by the patients and their family members. They were impressed with the high quality of them. Again, something to pass the time. They can watch their sporting events. We’d just gone through a major federal election, and they were able to keep abreast of all of the changes going on in the community, and it was just a wonderful things for them to have at no charge. Those TVs are available to them and their families throughout the day, so it’s just as wonderful, wonderful thing. We get a lot of positive feedback from it.
Bill: Well, a comfortable setting does go a long way. And lastly, why should someone choose Roswell Park Cancer Institute for their care?
Nancy: This is probably one of the most important points that we want to make about coming to a facility. Roswell Park Cancer Institute was the first in the nation – comprehensive cancer center, where they recognized cancer back in the 1900s as the disease of the future and the one that would require quite a bit of research and attention in that we’ve had several national comprehensive cancer institutes pop up around the nation and they’re very well-known, but we’re fortunate to have our center right here in the Western New York area. What that means is -- a comprehensive cancer center is that it’s not just your disease that’s going to be treated, but all treatment options available to you, the opportunity to participate in research protocols in building drugs for the future. Right now, it’s not just chemotherapy that’s making people’s lives live longer – you may have seen the ads on television for the new immunotherapies, biotherapies – they’re much more well-tolerated. They’re very much in the market right now for people to be aware of. While chemotherapy can be very harsh, the immunotherapies are well-tolerated, they're targeted therapies for specific tumor types, and they’re getting really good results and offering – the most important point here, longevity, survivorship. People are living a very long time with a cancer diagnosis right now and in that research that happens at a national comprehensive cancer institute is their best opportunity for their overall survival and quality of life. That’s probably one of the reasons why they should be looking to a national comprehensive cancer institute for their care. In that is also supportive care, pain management, palliative care, psychosocial support, case management, financial assistance, all of those things that affect the family directly while they’re in this journey and that’s all offered here at Roswell Park. It’s not just about your doctor's appointment and the drugs you’re going to receive, or the surgery, or the radiation, it’s about everything that touches your life is important to us at Roswell Park. Our Pastoral Care Department is there for multifaceted support, as well, so that’s what you get when you come to a come to a national comprehensive cancer institute, and that’s what the public deserves.
Bill: Very important points, Nancy, and thank you so much for sharing all of that information with us, and thank you for your time today. For more information, visit RoswellPark.org, that’s RoswellPark.org. You’re listening to Roswell Cancer Talk with Roswell Park Comprehensive Cancer Center. I’m Bill Klaproth, thanks for listening.