Precautions during chemotherapy for breast cancer
I. Preparation before chemotherapy for breast cancer
Pre-operative neo-adjuvant chemotherapy patients should start chemotherapy as soon as possible after the diagnosis is confirmed by puncture biopsy; post-operative adjuvant chemotherapy should be started after the recovery from surgery (wound healing, usually within 1 month after surgery)
2. Before breast cancer chemotherapy, the patient’s height and weight must be measured to calculate the body surface area and decide the chemotherapy dose;
3.Before chemotherapy for breast cancer, it is generally recommended to perform large venous puncture to establish long-term venous access to reduce drug leakage and damage to tissues;
4.Patients with preoperative neoadjuvant chemotherapy need to have sentinel lymph node biopsy before chemotherapy to clarify axillary staging;
5.Patients with normal blood, heart, liver and kidney function tests before chemotherapy, or assessed by doctors whether chemotherapy can be administered.
II. Chemotherapy drugs for breast cancer
The commonly used chemotherapeutic drugs for breast cancer are: anthracyclines (A, such as epirubicin EPI, birubicin THP, etc.), paclitaxel (T, paclitaxel or doxorubicin), cyclophosphamide (C), fluorouracil (F), etc;
2, generally choose combination regimens such as: AT, CAF, TAC, TC, AC-T, etc., generally 3-week regimens, or two-week regimens;
3.A cycle of chemotherapy is usually infused for 3-4 days, chemotherapy drugs are usually used on the first and second day, and the rest of the daily infusion is to reduce chemotherapy reactions and enhance the efficacy of drugs, patients should know which bottle is chemotherapy drugs and pay attention to drug reactions;
Side effects of chemotherapy and treatment
Bone marrow suppression is the most common and problematic side effect of chemotherapy for breast cancer. Almost every patient will experience bone marrow suppression and decrease in white blood cells, and the general rule is that white blood cells will start to decrease on the 3rd-5th day after chemotherapy, and the extreme period will be 7-10 days, after which they will gradually rise. At this time, serious complications such as infection will occur if not handled properly. We usually check the blood routine on days 4, 7 and 10, and use leukostimulants (granulocyte colony-stimulating factor) on days 5-8. Most patients need subcutaneous leukostimulants to get through the extreme phase of chemotherapy. Each person has a different pattern and should keep in mind the changing pattern of their own bone marrow suppression. Patients with fever or special weakness after chemotherapy should immediately check the blood picture and find a doctor for prompt treatment;
2. Allergic reaction A few people may have serious allergic reactions to paclitaxel drugs, so pretreatment is necessary. That is, take dexamethasone tablets in two divided doses 12 hours before paclitaxel infusion (usually the second day of chemotherapy), and patients should remember! Only liposomal paclitaxel does not require oral dexamethasone tablets due to drug modification;
3, other side effects are common gastrointestinal reactions (nausea and vomiting), peripheral nerve damage, elevated transaminases, bone pain, etc., all temporary. Hair loss can occur in almost everyone, making patients distressed, but also temporary, after six months will grow new hair, some even better than the previous, so do not worry.
Fourth, the patient precautions
1, during chemotherapy pay attention to strengthen nutrition, to easily absorb, protein vitamin enough, and eat more blood food such as pig liver, bone soup, etc.;
2, can eat some blood health products such as gum, red dates, etc., can also take oral blood Sheng, vitamin B4, etc.;
3, chemotherapy period due to the decline in resistance to pay special attention to prevent colds, etc., to enhance warmth, in chemotherapy 2-12 days with a mask;
4, large vein care is a relatively troublesome thing, especially most patients between chemotherapy are at home. Generally weekly intravenous cannula need to flush 1-2 times with heparin dilution to prevent blockage, the wound can be changed once a week (change film), should be at the nurse to understand the care, foreign patients can be flushed in the local community hospital to change the film.