What happens during your first chemotherapy treatment?

— In LISOD, chemotherapy treatment can be approved to the patient by the tumorboard that summons every day.

 Chemotherapy is administered prior to the surgery (neoadjuvant), post surgery (adjuvant), and also to improve the quality of life (palliative).

During first visit to us first thing patient gets is a general blood test. It is important to make it on the day of treatment, as guided by all protocols and standards, even if patient comes with all test results, say, a week or two-week old. The reason is that our patients are quite peculiar, their general picture can change every day.

If the test detected an inflammatory process and there are clinical manifestations of the inflammatory process, the cause of it will be found and treatment recommendations given. Treatment is available inpatient in the LISOD hospital.

In case when leukocytosis is a side effect of steady drug use patient is eligible for chemotherapy treatment.

If leukocytes do not reach the lower limit of normal, or in case of low thrombocytes (below 100) this is the absolute prohibition to the chemotherapy,  not only first treatment, but also subsequent ones. If this is the case, patient will receive physician’s advice on how to deal with it, when to make a follow up test, and when planning the first treatment can start.

After blood values (leukocytes, thrombocytes, etc.) are confirmed normal, the patient goes up to the chemotherapy department to meet the nurses; his anthropometric data (height, weight on the day of the procedure) will be taken, blood pressure, heart rate, cardiogram; blood is taken for biochemical analysis and coagulogram. After test results are available physician prepares a protocol. It is prepared based on body surface area, weight (for some drugs) and peripheral blood values (leukocytes, platelets, hemoglobin). Attention is paid to the function of kidneys and liver, since these are the main organs of detoxication during chemotherapy; we evaluate them according to creatinine, uric acid, electrolytes in case of the kidneys and bilirubin, ALT, AST in case of the liver.

The protocol and dose are individual in each clinical case, because patients differ. Different weight, age, and blood count therefore, any protocol (pre-, post-surgical, palliative) must take into account the patient's objective status. If needed, the dose is reduced.

Todate, to reduce toxic side effects from cytostatics, chemotherapy goes together with premedication. These are certain drugs that we administer to the patient to reduce toxic post treatment manifestations (nausea, allergic reactions, other).

After first chemotherapy, we recommend that all patients stay with us for a while for monitoring. This will give us understanding of the response to the treatment, also if needed help the person by infusing certain groups of drugs.

After first protocol of chemotherapy, the patient meets with the doctor to discuss further treatment plan. Thereafter, the patient is discharged and can go home. If need be, patient can contact his chemotherapy doctor at any time. This way even when out of the hospital patients are not left alone facing side effects. We stay in touch ready to offer care at any time.