Preoperative neoadjuvant chemotherapy is increasingly being used in the preoperative treatment of gastric cancer and has some positive implications for the treatment of gastric cancer. Many patients or family members exposed to neoadjuvant chemotherapy often ask what they need to pay attention to during and after treatment, which is answered below from three main aspects: body, mind, and environment.
Body: Improve lifestyle habits and adjust dietary patterns
Before neoadjuvant chemotherapy, the doctor will prescribe a number of tests, including routine blood tests, liver and kidney function tests, and an electrocardiogram. The main purpose of these tests is to assess the patient’s physical condition to determine whether he or she can tolerate chemotherapy and at what intensity. Doctors also usually test for tumor markers before neoadjuvant chemotherapy, not only to further understand the staging and other characteristics of the tumor, but also as a reference basis for assessing the effectiveness of treatment.
In terms of their own condition, patients also need to be well prepared before chemotherapy and actively cooperate during treatment. For example, it is important to maintain a good work schedule, stop smoking and drinking, and exercise in moderation to maintain good physical condition.
The diet should be especially careful to “eat small and frequent meals”. The newest and most recent addition to the list is the newest and most recent addition to the list. Therefore, it is recommended that daily food should be soft and easy to digest, and avoid eating too much. During chemotherapy, chemotherapy drugs can cause a certain degree of irritation to the gastrointestinal mucosa, which can lead to gastrointestinal reactions, such as nausea, vomiting, and diarrhea. Therefore, irritating foods, cold and spicy foods should be avoided as much as possible during chemotherapy to reduce the burden on the gastrointestinal tract.
Psychological: keep a positive mindset and stay away from bad information
During treatment, it is very important for patients to maintain a positive mindset, including being open and accepting, actively cooperating with treatment and examination, and avoiding psychological problems such as anxiety and depression. The influence of psychological factors is very obvious, and excessive anxiety can affect physical status, resistance, etc., which can affect the effectiveness of treatment and the implementation of the treatment plan. The patient also needs to fully respect and trust the treatment recommendations of the health care provider, to filter the information obtained, and to avoid believing in so-called “prescriptions” such as paraphernalia, and that evidence-based treatment options are the appropriate choice.
Environment
Environment: family support and care
Patients are often very sensitive during treatment, and their families need to first get rid of their fear of cancer and chemotherapy, help them build confidence, and provide psychological comfort and guidance. In addition, because side effects such as nausea, vomiting, hair loss, and even bone marrow suppression and liver and kidney damage may occur during chemotherapy, family members should pay particular attention to careful care and nursing of patients and follow medical advice to observe possible local symptoms, physical condition, and diet.
Chemotherapy-related side effects, especially to be on the alert
It is very important to understand that chemotherapy-related side effects are something that patients and their families need to be aware of, especially during and after neoadjuvant chemotherapy, in addition to receiving chemotherapy side effect prevention and management measures as prescribed by their doctors:
- The chemotherapy drugs that kill or inhibit tumor cells often have a greater impact on normal cells, especially proliferating cells, so it is important to be prepared for the possibility of hair loss, skin flaking, and other countermeasures, such as having a wig, ice headgear (not recommended with oxaliplatin because oxaliplatin is peripherally neurotoxic and hypothermia can exacerbate the toxicity), etc. ), etc.
- During chemotherapy, regular blood tests, liver function, kidney function, and other related tests are recommended to detect and early identify side effects of chemotherapy, usually once a week, and the doctor will treat any abnormalities to ensure that chemotherapy goes smoothly.
- Different chemotherapy regimens and different drugs are used for different patients and produce different side effects. For example, oxaliplatin can produce peripheral neurotoxicity, with pins and needles and tingling sensations on the skin surface (especially at the ends of the hands and feet) after irritation; capecitabine can cause dryness and ulceration of mucous membranes, such as mouth ulcers and broken skin surfaces. Talking to your doctor about possible side effects can also be extremely helpful in avoiding anxiety and panic.
- Any side effects, especially serious ones, that occur during chemotherapy should be promptly reported to your healthcare provider, who will treat them as appropriate and consider stopping chemotherapy.
Pre-operative neoadjuvant chemotherapy can be seen as the first battle against tumor for gastric cancer patients. By paying attention to the above issues and actively cooperating with treatment, we will be one step closer to beating gastric cancer. (Contributed by Xin Wang, Department of Gastrointestinal Oncology, The First Hospital of China Medical University)