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Patient Instructions

You had chemotherapy treatment for your cancer. Your risk for infections, bleeding, and skin problems may be high. You may still have mouth sores, upset stomach, and diarrhea.

You will probably get tired easily, and your appetite will be poor. You should be able to drink and eat food.

Brush your teeth and gums 2 to 3 times a day for 2 to 3 minutes each time. Use a toothbrush with soft bristles.

• Let your toothbrush air dry between brushings.
• Use a toothpaste with fluoride.

Floss gently one time a day.

Rinse your mouth 6 times a day with salt and baking soda solution (mix one half teaspoon of salt and one half teaspoon of baking soda in 8 ounces or 1 cup of water).

Do not use mouth rinses with alcohol in them. Use your regular lip care products to keep your lips from drying and cracking. Tell your doctor if you develop new mouth sores or mouth pain.

You need to be careful not to get infections.

Practice safe eating and drinking. Be careful what you eat. Do not eat or drink anything that may be undercooked or spoiled.

• Make sure your water is safe.
• Know how to cook and store foods safely.
• Be careful when you eat out. Do not eat raw meat or fish, or anything else you are not sure is safe.

See also:

• Safe eating during cancer treatment
• Safe drinking during cancer treatment

Wash your hands with soap and water often:

• After being outdoors
• After touching body fluids, such as mucus or blood
• After changing a diaper
• Before handling food
• After using the telephone
• After doing housework
• After going to the bathroom

Keep your house clean. Stay away from crowds. Ask visitors who have a cold to wear a mask or not to visit. Do not do yard work or handle flowers and plants.

Be careful with pets and animals:

• If you have a cat, keep it inside.
• Have someone else change the litter box every day.
• Do not play rough with cats. Scratches and bites can get infected.
• Stay away from puppies, kittens and other very young animals.

Ask your doctor what vaccines you may need and when to get them.

Know how to care for your central venous line or PICC line. If your doctor or nurse tells you your platelets are still low, learn how to prevent bleeding. See also: Bleeding during cancer treatment

Start to walk. Slowly increase how far you go based on how much energy you have.

You need to eat enough protein and calories to keep your weight up. See also: Eating extra calories when you are sick - adults

Ask your doctor about liquid food supplements. These can help you get enough calories and nutrition.

Be careful about being in the sun. Wear a hat with a wide brim. Use sunscreen with SPF 30 or higher on any areas of exposed skin. Do not smoke.

You will need close follow-up care with your cancer doctor and nurse.

If you have any of these symptoms, call your doctor:

• Fevers, chills, or sweats. These may be signs of infection.
• Diarrhea that does not go away or is bloody
• Severe nausea and vomiting
• Being unable to eat or drink
• Extreme weakness
• Redness, swelling, or drainage from any place where you have an IV line inserted into your body
• A new skin rash or blisters
• Jaundice (the white part of your eyes or skin looks yellow)
• Pain in your stomach area
• A very bad headache or one that does not go away
• A cough that is getting worse
• Trouble breathing when you are at rest or when you are doing simple tasks
• Burning when you urinate

Vose JM, Pavletic SZ. Hematopoietic stem cell transplantation. In: Goldman L, Ausiello D. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 184.

Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.