Taking your anticancer

drugs at home
Information for patients and families

When you come to the JCC for your appointments, we encourage you
to discuss your concerns with your Primary Team and/or pharmacist.
Successful ways for taking your anticancer
drugs at home.

To keep on track, use helpful reminders

 Smart phone
 Diary or journal
 Calendar
 Separate dosette or container just for your anticancer pills

Plan ahead
 If you plan to travel, talk with your Primary Team
 Get your drugs refilled before you run out

Ask us
 If you are unsure about how to take your medications
 If you do not understand why you are taking this type of
medication

Let us know how you are feeling:

Symptom assessment
• Is a set of questions about how
you are feeling and your
activity level.
• Will help us understand how you
are feeling.
• Complete before each doctor’s
appointment.
 Table of Contents

Page

Introduction ............................................................ 1

Part I:
Anticancer drugs and related side effects .................... 7

Part 2:
Lifestyles and safety................................................. 31

Part 3:
Getting to know the pharmacy services
at the JCC .............................................................. 37

Evaluation:
Tell us what you think about our booklet ..................... 53
 Taking your anticancer drugs at home

We understand what a difficult time this is for you. You may have
many questions and concerns about taking your anticancer drugs
Notes
at home. We hope that by reading this book and attending the class
on anticancer drugs, your questions and concerns are addressed.

Taking your anticancer drugs as prescribed may be challenging.

Forgetting or missing your anticancer pills can lead to the disease
coming back or getting worse. Please ask us about helpful ways
to remember to take your pills.

In the book and in the class we discuss anticancer drugs,

related side effects, how to take care of yourself while on treatment
and pharmacy services.

Blood work, tests and clinic visits are all a part of your
cancer treatment. Your Primary Team will review your
overall plan with you.

Take care of yourself

During treatment is the time when you need to take care of yourself.
Listen to your body. You may need to readjust your work and
normal routine. Continue to do your regular activities, as you
feel able. Anticancer drugs may cause overall fatigue, so:

• focus on what you can do

• surround yourself with positive people
• ask for help
• keep your ability to laugh
• find out what works best for you

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 Taking your anticancer drugs at home

Nutrition
Notes

Benefits of good nutrition

• Good nutrition can help give you strength and energy before,
during and after treatment. Good nutrition can also help you:

• heal and recover more quickly

• maintain your weight
• improve how well you handle or tolerate treatment
• decrease your risk of infection

A healthy diet is:

Eating a variety of foods that provide the nutrients needed to
maintain your health. These nutrients include:

• protein
• carbohydrates and fats
• vitamins and minerals
• water

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 Taking your anticancer drugs at home

Nutritional issues during active treatment

Notes
• Energy balance is the most important goal.

• Maintaining your weight is the best thing you can do.

• Common treatment side effects may prevent you from

eating the right amounts of foods.

• Registered Dietitians at the JCC can help you get the most
nutrition out of the foods you can eat during treatment. You do
not need a referral. Contact Supportive Care, see page 34.

Exercise
Your cancer and treatment may cause you to feel fatigued or
very tired. You may notice that you just don’t have any energy.
Most people feel this way when going through anticancer treatment
and radiation. For some, this lack of energy is very severe and
limits what they can do.

We used to think that during anticancer treatment and radiation that

it was best to rest and not do much exercise or physical activity.
We now know that doing some exercise and keeping physically
active can help most patients feel better!

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 Taking your anticancer drugs at home

Notes Keeping active during cancer treatment may have

these benefits for you:
• keep or improve your physical abilities

• improve balance, which may lower your risk of falls and

broken bones

• better blood flow to legs and lower your risk of blood clots

• less nausea

• more energy, so you have less fatigue

• better weight control

• greater independence around the house

Overall, keeping active can make you feel better

and give you more energy to do the things that
you enjoy doing.

Keeping safe
The goal of your exercise program should be that it is safe,
effective and enjoyable. Your ability to be active during and after
treatment depends on:

• the type of cancer and treatment that you have

• your level of strength and energy

• your past exercise habits

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 Taking your anticancer drugs at home

• your fitness level

• other health conditions that you may have such as heart Notes

problems or arthritis

Check with your Primary Team before starting an exercise program.

Keep in mind that when you are feeling

fatigued and have no energy that even
doing 10 minutes of exercise can make
you feel better!

Moderate exercise is defined as any activity

that takes as much effort as a brisk walk.

Smoking
If I smoke, should I quit? This is a common question that many
patients ask. We recommend that you quit, but realize this is difficult.
There are health benefits to you from quitting. Quitting smoking can:

• make your cancer treatments work better

• reduce your side effects
• improve your healing and overall health

If you want to quit, there is a lot of help and support available for you.
You may want to talk with your family doctor or pharmacist about
quitting and discuss what medications may help you quit.

For support or help to stay smoke-free:

• talk with a member of your health care team
• contact Smokers’ Helpline toll free at 1-877-513-5333
or www.smokershelpline.ca

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 Taking your anticancer drugs at home

Notes

6
 Taking your anticancer drugs at home

Notes

Part 1:

Anticancer drugs and related

side effects

7
 Taking your anticancer drugs at home

What are oral anticancer drugs?

Notes
Oral anticancer treatment is using drugs to treat cancer.
These drugs attack and destroy cancer cells or prevent their growth.
Oral anticancer drugs can also damage normal cells. Oral anticancer
drugs are taken in a pill form by mouth and swallowed. The pill
moves through the digestive system into the blood stream and
travels throughout the body.

These drugs may be chemotherapy or biologic therapy.

What is chemotherapy?
Chemotherapy is often called chemo. Many different drugs are
available as chemotherapy. These drugs can be used alone or in
combination to treat a wide variety of cancers.

Chemotherapy is a treatment using anticancer (also known as

cytotoxic) drugs which aim to destroy cancer cells. They may:

• stop cancer cells from dividing and growing by interrupting

the cell cycle
• make cancer cells less able to grow and spread

What is biologic therapy?

Biologic therapies are treatments that act on processes in cells.

They may:
• stop cancer cells from dividing and growing
• seek out cancer cells and kill them
• encourage the immune system to attack cancer cells

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 Taking your anticancer drugs at home

How is anticancer treatment given?

Anticancer treatment is usually given: Notes

• In pills – either in a tablet or capsule.

• Into your vein. This is called an intravenous or through the IV.
If you need to have IV chemotherapy at home, the medication
is given through a special pump attached to the IV. The pump
looks like a baby bottle.
• Sometimes, it is given in a needle in your muscles (IM)
or under your skin (SC).

How often is treatment?

Most anticancer treatments are given over a period of time.
How often can vary; every day, once a week or once a month.
The length of treatment varies. It depends on the type of cancer
and the type of treatment.

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 Taking your anticancer drugs at home

How do I keep on track with taking my pills?

Notes
• Take your anticancer pills the right way! Patients that take their
anticancer pills do better than those who do not. Forgetting or
missing your anticancer pills can lead to the disease coming back
or getting worse.
• Use a drug dosette JUST for your anticancer pills.
• There are many ways to keep on track – a journal,
calendar or smartphone to keep on track. Use what
is right for you! Your pharmacist or Primary Team can provide
suggestions as well.

Travelling: plan ahead

• Talk with your Primary Team before travelling.
• Carry a current list of all the drugs you take.
• Talk with your doctor before you get a flu shot or other
immunization.
• Tell other doctors, dentists and health care workers you see for
treatment that you are on anticancer drugs.

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 Taking your anticancer drugs at home

How do I safely handle my anticancer pills?

• When taking your anticancer pills it is important to wash your Notes

hands before and after taking your medication.

• If your pills are supplied in a bottle, you can tap the pill into the
bottle cap and take the pill. Do this over a table, to prevent the pill
from falling on the floor.
• If you are filling a dosette ensure it is dedicated ONLY for your
anticancer pills. Wash your hands before and after filling the daily
compartments as prescribed.
• If someone else gives you your anticancer pills, they should wear
disposable gloves, then discard the gloves in a plastic trash bag
and wash their hands.

What if I can’t swallow my pill or vomit?

• Swallow your pill whole. Do not cut or crush.
• If you can’t swallow, please let your Primary Team know.
• If you vomit right after taking the anticancer pill, do not take
another pill.
• Call your Primary Team to find out what you should do.

What do I do if I miss a pill?

• If you miss taking a pill, take it as soon as possible.
• If it is almost time for your next dose, then do not take the
missed dose, just your usual dose.
• Take your normal anticancer pill dose at the normal time.
• If you miss a dose, make a note on your calendar. Let your
Primary Team know what you missed at your next visit.

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 Taking your anticancer drugs at home

Where should I keep my pills?

Notes
• Do not store your anticancer pills with your regular medications.
• Keep your anticancer pills and all medications out of the reach
of children and pets.
• Bring unused anticancer pills back to the Cancer Centre in a
double sealed bag or pill bottle. You can also check with your
local pharmacy and bring them there.

In case of accidental pill taking:

• Call POISON CONTROL CENTRE at: 1-800-268-9017
• Put the number in your cell phone contacts and
put the number on your fridge!

When is it important to go to the

Emergency Department?
• When your temperature is 38oC or greater and your Primary
Team is unavailable to speak with you when you call. This may
be on evenings, weekends and holidays.

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 Taking your anticancer drugs at home

Side effects
There are side effects with talking anticancer drugs, but not Notes

everyone gets all the side effects. You may get some, a few or
none of the side effects.

Common side effects include:

• low blood counts

1. infection – low white cell count

2. fatigue, shortness of breath – low red blood cell count
3. bruising or bleeding – low platelet count

• nausea and vomiting – sick to your stomach

• hair loss

• mouth or throat discomfort

• constipation

• diarrhea

• changes to skin and nails

• sensitivity to the sun

• runny eyes

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 Taking your anticancer drugs at home

Low blood counts

Notes

Infections
A low white blood cell count reduces your ability to fight infections.
Some patients can develop infections that can make them quite ill.
You can die from a severe infection. Infections can usually be treated
with antibiotics.

Signs of an infection include:

• chills/shaking or feeling unwell; with or without a fever

• a fever of 38oC (100oF) or greater
• unusual sweating
• area of redness, tenderness or swelling
• sore throat along with fever
• cough with yellow or green coloured phlegm/sputum
• burning feeling when urinating
• diarrhea with fever

Common areas of infection include the bladder and chest.

If you have any signs of an infection, call your

Primary Team right away.

If you go to an Emergency Department, tell the

staff that you are on anticancer drugs.

You need to have a thermometer at home.

When you are ill, you will be asked
“what is your temperature?”

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 Taking your anticancer drugs at home

To prevent infection:
Notes
• clean your hands often, especially after using the toilet
• stay away from people who have the flu, colds or
contagious diseases
• ask friends or family not to visit if they are feeling unwell
• keep your mouth clean by brushing your teeth and rinsing
after meals
• wash all fruits and vegetables before eating
• avoid raw meat and fish
• do not share drinking glasses, eating utensils and
toothbrushes
• do not use ice from commercial ice machines
(hotels, bags from stores, gas stations)
• use rubber gloves if you must clean up after a pet
• wear gloves when gardening

Fatigue
Fatigue means that you are very tired and have low energy.
The reasons for fatigue may be:

• A low red blood cell count. Your red blood cells carry iron and
oxygen which is why you feel tired when these counts are low.
• Your cancer – cancer may cause your body to become
overactive so that it needs more energy.
• Anticancer drugs, infections and surgery make the body
use more energy.

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 Taking your anticancer drugs at home

• When cancer cells are destroyed by anticancer drugs or

Notes
radiation they release toxic products that can cause fatigue.
This results in the body needing more energy to get rid of
these toxins.

With fatigue you may:

• be short of breath
• have a total lack of energy, be tired/sleepy, weak, worn out
and drained
• lack concentration – can’t think
• not feel like eating
• feel depressed, bored or discouraged
• lack motivation or interest in social activities or sex

What to do to help with fatigue:

• take short 20 to 30 minute rest periods
• ask for help with tasks around the house
• work within your own limits, rest between activities and don’t
overexert yourself
• exercise, keep active, listen to what your body tells you
• plan nutritious, easy to prepare meals
• eat food high in protein

Listen to your body – it’s a balance between

resting, keeping active, working and exercise.

Tell your Primary Team about your fatigue

– they can offer suggestions and information that
will help you manage your symptoms of fatigue.

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 Taking your anticancer drugs at home

Bruising or bleeding
Bruising or bleeding is due to a low blood platelet count. Notes

Platelets help our bodies clot blood.

You may notice:

• that you bruise or bleed easily such as bleeding from
gums when brushing your teeth
• tiny pinpoint red and purple dots on skin
• unusual or heavy nosebleeds
• red or pink coloured urine
• dizziness, constant headaches or blurred vision
• heavy vaginal bleeding
• black “tar-like” bowel movements
• red or brown coloured sputum or vomit

To prevent bruising or bleeding:

• do not take medications containing Aspirin, or ASA, unless it is
approved by your oncologist. You may need to take aspirin to
prevent heart problems or a stroke.
• be very careful with sharp objects such as razors and knives
• use a soft toothbrush to avoid bleeding gums
• use water based lubricants during sexual intercourse
• prevent constipation, try not to strain when having a
bowel movement

If you notice any bruising or bleeding call your

Primary Team.

If you go to an Emergency Department, tell the

staff that you are on anticancer drugs.

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 Taking your anticancer drugs at home

Common symptoms of a blood clot in the leg

Notes
• Pain in the calf or leg muscle, most often one leg which
worsens when you tip your toe toward the ceiling.
• Swelling.
• Tenderness.
• Changes in your skin color around the clot area, such as
turning pale, red or blue.
• Area around the clot may feel warm to touch.

All, one, or none of these symptoms may be present.

Common signs of a blood clot in the lung

• The pain is sharp and worsens when taking a deep breath.

What to do if you think you have a blood clot

• DO NOT WAIT, you should be seen right away
by your doctor or emergency room.
• If you are unsure of your symptoms, call your
Primary Team.

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 Taking your anticancer drugs at home

Some Biologics can cause high blood pressure

• Axitinib, Pazopanib, Sunitinib, Sorafenib and Regorafenib are Notes

some of the drugs that can cause high blood pressure.

• High blood pressure = 150/100 mmHg.
Check your blood pressure (BP) at your local pharmacy once
a week or at home if you have a BP cuff. Write it down!
• To make sure that your home BP cuff is accurate bring it to
a clinic appointment and ask your nurse to check it.
• If your blood pressure top number is 150 or greater or bottom
number is 100 or greater- call your Primary Team!

Nausea and vomiting

• Not everyone will have nausea and vomiting. It depends on the
anticancer drug.
• Your oncologist may have discussed the chances of having
nausea and vomiting with you.
• Nausea and vomiting can mostly be controlled with medication.

What you can do to help prevent nausea

and vomiting:
• eat a low-fat meal before treatment
• limit spicy, fried foods and foods with strong smells
• take medication(s) as discussed with your nurse,
pharmacist or doctor
- “regular” medication is taken on a regular schedule
- “as needed” medication is taken only when needed

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 Taking your anticancer drugs at home

What may help:

Notes
• relaxation and diversion techniques – things you can do
to take your mind off the nausea and vomiting such as
resting quietly, watching TV, reading, listening to music
or doing yoga
• drink clear fluids
• eat several small meals a day and eat slowly
• relax after eating – remain in a sitting position because
this may help you digest your food better
• get some fresh air

Make sure you:

• get your anti-vomiting medications prescription filled
• take the medications prescribed by your oncologist

Call your Primary Team if you continue

to have nausea and/or vomiting.

If you go to an Emergency Department, tell the

staff that you are on anticancer drugs.

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 Taking your anticancer drugs at home

Hair loss
Some anticancer drugs may cause some or complete hair loss. Notes

You may lose your hair from all parts of your body. Hair loss does
not always happen right away. It happens about 2 to 3 weeks
after treatment.

There are many things you can do when you lose your hair:
• consider head coverings such as hats, wigs, hair pieces
or scarves
• consider “Look Good, Feel Better” workshops
• some people enjoy the freedom of being bald

Be gentle with your hair and scalp:

• avoid perms/hair colouring during your course of
anticancer treatment
• use mild shampoo such as baby shampoo
• use a soft hair brush or wide tooth comb since the scalp
can become sensitive
• avoid use of curling irons, hot curlers, straighteners or
blow dryers
• use sunscreen on your scalp

Keep in mind that your hair will grow

back once the anticancer treatment has
been completed.

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 Taking your anticancer drugs at home

Mouth or throat discomfort

Notes
Mouth or throat discomfort may begin 5 to 7 days after treatment
begins and usually lasts a few days.

One mouth sore can lead to more

– call your Primary Team!
To keep your mouth clean and your smile bright:

• brush teeth after meals with a soft toothbrush

• if you have dentures, brush and rinse them after meals

and remove them at bedtime

• floss your teeth and gums gently

• rinse your mouth 4 times a day with homemade

mouthwash - 1 teaspoon of salt in 8 oz cup of water
or 1 teaspoon of baking soda in 8 oz cup of water

• do not use commercial mouthwashes that contain alcohol

• limit spicy, acidic and rough foods – if your mouth is sore

or tender, eat soft foods or drink nutritious liquids

• do not drink or eat foods that are very hot or very cold
in temperature, let them cool down or warm up

• avoid the use of alcohol or tobacco

• your Primary Team can prescribe a special preparation for

mouth sores, so if your mouth is sore and worsening let
your team know

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 Taking your anticancer drugs at home

Dental work
• Your dentist also has to know that you are on Notes
anticancer drugs.

• While on anticancer drugs, please try to postpone any

dental work that may be needed, such as cleaning.

If your counts are too low, problems may happen when you
have dental work done. If you need dental care while on
anticancer drugs, you need to talk with your oncologist.

Your dentist and oncologist need to work together to determine

the best time for dental work.

For dry mouth

• Suck on hard, sugar-free candy or chew gum. This may help
to make saliva and relieve some mouth dryness.

• Rinse your mouth often with homemade mouthwash described

on page 22.

• You can buy some products to keep your mouth moist called
artificial saliva. Check with your Primary Team first.

For dry lips

• Lip balm or some lipsticks may help to keep your lips moist.

• Avoid licking your lips.

• Sun exposure can make cold sores and dry lips worse.

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 Taking your anticancer drugs at home

For a sore throat

Notes
• Tell your Primary Team about your sore throat – you may
need medication.

• Gargle with baking soda or salt water as recommended.

• If numbing medications are ordered, follow the instructions

you are given about eating and drinking.

Call your Primary Team if you have a sore throat,

painful mouth sores, chills or a temperature of
38oC (100oF) or higher.

If you go to an Emergency Department, tell the

staff that you are on anticancer drugs.

Constipation
Constipation is when you have to strain or push hard to have a
bowel movement. What you may notice:

• changes to your regular bowel routine such as no bowel

movement for 3 or more days

• stomachache or cramps, feel bloated, feeling of fullness

• passing gas

Constipation, if not treated, may cause blockage of the bowel.

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 Taking your anticancer drugs at home

To prevent and treat constipation:

• eat foods high in fibre Notes

• do not delay the urge for a bowel movement

• drink 8 or more glasses of liquid per day

• regular exercise, remain active

• may need to use laxatives and stool softeners

Call your Primary Team if:

• you have no bowel movement in 3 days

• you observe blood in bowel movement
• you have abdominal cramps or pain
for 2 or more days

Diarrhea
Diarrhea is loose or watery stools 4 or more times a day.
You may also have:

• abdominal cramps, pain, and feel bloated

• diarrhea can cause you to lose too much water and become
dehydrated. Being dehydrated can make you very tired.

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 Taking your anticancer drugs at home

If you have diarrhea:

Notes
• take diarrhea medication as directed

• eat low fibre food such as the BRAT diet (Bananas, Rice,
Applesauce, Toast)

• drink 8 to 12 glasses of clear fluids each day, such as water,

bouillon, sport drinks or flat carbonated soda

• limit caffeine

Call your Primary Team if you:

• have 4 or more loose bowel movements daily

• observe blood in bowel movements or
bleeding from the anal area
• have severe abdominal cramps
• have diarrhea that lasts longer than 2 days

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 Taking your anticancer drugs at home

Chemo brain or chemo fog

Chemo brain or chemo fog is a term to describe changes in Notes

thinking or memory problems in some patients after they have

anticancer treatment.

Many of these changes may last from a few months to a few years.

Common complaints are:

• short-term memory lapses
• forgetting where you put something or what you were
going to buy at the store
• difficulty finding the right word in a conversation
• difficulty multi-tasking both at home and work
• taking more time to learn new things
• taking longer to do the tasks you once did

How to help yourself if you have chemo brain or

chemo fog:
• talk with your doctor if you have mental changes as there
may be other causes including stress or other medications
– there may be medications available to help
• make notes of things you need to do or activities you need
to attend
• keep to a set routine
• learn relaxation techniques – exercising your mind and body
will help you cope if you experience “chemo brain” or
“chemo fog”. Social Work in Supportive Care may be able
to help you with this.

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 Taking your anticancer drugs at home

Changes to skin and nails

Notes
Anticancer treatment may cause changes to your skin and nails.

What you may notice:

• skin may become dry, cracked and more sensitive to sunlight

• the skin on your hands and feet is thinner and red, or you may
have numbness or tingling in your fingers and toes

• your finger and toe nails may also change in texture

and colour. The nails could become infected or lift off.

• skin redness and rash

What you can do:

• regular use of moisturizing lotion or cream

• wear loose comfortable clothing (cotton fabrics rather

than synthetic material such as polyester) and footwear

• protect your skin from direct sun exposure

• maintain gentle care of your nails

• depending on your treatment, the nurses may provide you

with cold gel gloves and/or slippers to protect your fingernails
and toenails

• a prescription for a cream may be given from your Primary

Team for the rash

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 Taking your anticancer drugs at home

Hand and Foot Syndrome:

Chemo or Biologic Anticancer Drugs Notes
Some pills such as Capecitabine, Axitinib, Sunitinib, Sorafenib and
Regorafenib can cause hand and foot syndrome:

• dry skin
• redness
• numbness

What can help:

• Immerse and cover your entire hands and feet in cool water.
• Avoid extremes of temperature, pressure and friction (rubbing)
on the skin.
• Speak with your Primary Team for advice!

Rash: Biologic Anticancer Drugs

Some anticancer biologic pills can cause an acneiform rash:
• dry skin
• redness
• acne-like bumps

What can help:

• Special creams prescribed by your Oncologist
• Do not use acne products –too drying to the skin
• Speak with your Primary Team for advice!

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 Taking your anticancer drugs at home

Sun sensitivity --- cover up!

Notes
Some anticancer drugs may cause you to have increased sensitivity
to the sun. This means that the sun can damage and burn your skin
and hurt your eyes.

To prevent damage:
• use a sunscreen with a SPF 30 or higher

• cover up when outdoors

• wear a wide brimmed hat

• wear sunglasses with Ultra Violet (UV) protection

Call your Primary Team if you develop a

severe rash or burn.

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Notes

Part 2:

Lifestyles and safety

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 Taking your anticancer drugs at home

Sexuality
Notes • You may notice a change in your sexual needs or response.

• A decrease in desire is common.

– Talk about it – with your partner or with us!
– Your periods may stop – early menopause (hot flashes,
mood swings, vaginal dryness)

Talk with your oncologist about future pregnancies and family

planning.

Pregnancy must be avoided during and for several months after

completion of treatment. Use condoms while either partner is
receiving anticancer treatment.

Anticancer treatment may cause:

• decreased sperm count – consider sperm banking
• premature menopause – hot flashes, mood swings,
vaginal dryness

If you have any questions about your sexuality, please ask us or

call Supportive Care.

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Alcohol
Do not drink on the day of your treatment. Alcohol may make your Notes

side effects worse. Alcohol may also interact with the way some
medications work. Talk with your oncologist about drinking alcohol
during your treatment.

Safety at home
For 7 days after taking anticancer drugs, wear gloves and keep
soiled items from touching you when cleaning up:

• body fluids such as urine, vomit, bowel movement or diarrhea

• linens or bed sheets soiled with body fluids

Soiled linens – wash separately with hot water and detergent.

Rinsing bedpans or basins – wear gloves and rinse very carefully.

Toilet – double flush toilets while on anticancer treatment.

Visitors
• Visitors must be feeling well – no fevers, cough or flu symptoms.

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 Taking your anticancer drugs at home

Supportive Care
Notes We have many supportive care services that are here to help you.
These include:

• Social Work

• Dietitians

• Mental Health Services (referral needed)

• Chaplaincy

• Aboriginal Patient Care Navigator

• Pain and Symptom Management (referral needed)

Most services do not need a referral. Supportive Care is on the

2nd level at the JCC.

You can reach Supportive Care Services at 905-387-9495,

ext. 64315.

We also have:

• Volunteers from the Canadian Cancer Society

• A Patient and Family Resource Centre, lobby of the JCC

• A Retail Pharmacy, 2nd level JCC

• Cafeterias at the Juravinski Hospital and Cancer Centre

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 Taking your anticancer drugs at home

Emergencies
You need to call 911 if you are: Notes

• having sudden change with breathing – harder to breathe

• having chest pain that you have not had before
• feeling that your “throat is closing up”
• vomiting blood

Infections and bleeding are emergencies.

Call your Primary Team and go to the
Emergency Department.

If you have other health concerns and do not know what to do,
call your Primary Team. Call between 9:00 am and 4:00 pm,
Monday to Friday.

After hours call your family doctor or go to the Emergency

Department.

Provide the Emergency Department with this information

(complete the chart on the next page):
• you have cancer and are currently receiving anticancer drugs
• name of your oncologist, primary care nurse
• date of last treatment
• current list of all medication, including anticancer drugs
• clinical trial patients – bring a copy of your consent

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 Taking your anticancer drugs at home

My important information
Notes
My name

My oncology team

- Oncology doctor

- Oncology nurse

My type of cancer

The names of my
anticancer drugs.

Bring in your current

medication list.

When was your last

treatment?

Do you have your

consent form, if you are
on a clinical trial?

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 Taking your anticancer drugs at home

Notes

Part 3:

Getting to know the pharmacy

services at the JCC

• Located on the 2nd level of the JCC, close to the main

elevators.
• Hours:
- Monday to Friday, 8:00 am to 5:00 pm
- Closed on weekends and statutory holidays
• Phone: 905-575-6320

JCC pharmacy staff are experts in oncology treatments

and medications. Please ask us your questions.

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 Taking your anticancer drugs at home

JCC Pharmacy services

Notes Where can I get my prescriptions filled?

• At the JCC Retail Pharmacy we are experts in cancer care.

We can provide you with your anticancer drugs and any other
take home pills for cancer treatment.
• These medications may be hard to find at your home
pharmacy. Staff can transfer refills after you have made
arrangements with your home pharmacy.
• If you are participating in a research study, you get your study
prescription filled at the JCC.

• The JCC Pharmacy can also fill prescriptions for your

non-cancer related medications.

Refills of anticancer drugs

• At the JCC retail pharmacy, please call for your refills at least
a few days before running out of anticancer pills and pick them
up before running out. Take as directed.
• If using your local pharmacy call for refills at least the day
before each anticancer treatment cycle and pick them up
before your next cycle begins. Take as directed.

Anti-vomiting pills or drugs to prevent a reaction

• If you are prescribed anti-vomiting pills (nausea pills) or drugs
to prevent reactions please have the prescriptions filled at
least a day before you start taking your anticancer drugs.

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 Taking your anticancer drugs at home

Your oncologist may prescribe:

Notes
• Medications to help with side effects such as:
 Ondansetron pills to prevent nausea and vomiting
 Nystatin special prescription for mouth sores
 Loperamide pills for diarrhea
• Anticancer pills such as:
 Imatinib for blood cancer
 Erlotinib or Gefitinib for lung cancer
• Pain pills such as:
 Morphine
 Tylenol #3
 Dilaudid
• Injections: hormonal injections for prostate cancer
• Others

These medications may not be easily found at your home pharmacy.

Allergies
Tell us if you have any allergies:
• with medications such as penicillin or sulpha drugs, and
• any type of reaction such as a rash or shortness of breath that
you have had.

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 Taking your anticancer drugs at home

Medication history
Notes
Carry a current list of all the medications you take:
• regular prescriptions
• over-the-counter medications
• vitamins, herbals or alternative treatments
• cancer treatment, including anticancer pills and anti-vomiting
medications, and others that are prescribed for you
• study medications

You can get a current list from your home

pharmacy through the MedsCheck program.

Why does the pharmacist need a list of my

medications?
Pharmacist will review all your medications including vitamins and
herbals to avoid interactions with your anticancer drugs.

40
 Taking your anticancer drugs at home

Alternative medications and herbals

Notes
It is important that you discuss this issue with your oncologist
or pharmacist before you start your anticancer treatment.
These products may:
• interact with your anticancer medication(s), such as
St. John’s Wort, grapefruit and grapefruit juice
• prevent your treatment from achieving the desired effect
• increase side effects
• cause new side effects

Regular medications
• Continue to take your regular medications as prescribed
and approved by your oncologist.
• Very important to tell your oncologist if there has been a
change in the medications that you take at home.
• We want to make sure there aren’t any problems between the
medications that you take for your cancer treatment and
your regular medications.

Changes with your medications

• If you are using the Cancer Centre Pharmacy for your
prescriptions, it is very important to tell the pharmacist when
there are changes in your pills from your home pharmacy.
• We want to make sure there are no problems between the
pills that we give you and the pills that you get from your
home pharmacy.

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 Taking your anticancer drugs at home

Paying for anticancer mediations

Notes
When you come to the Retail Pharmacy:
• bring your drug insurance information
• bring your OHIP card
• bring some form of payment (cash, debit or credit card)
• if you do not have drug coverage, talk with your Oncology
Team – a referral may be made to the Drug Access
Facilitators to help you explore possible options.

Study participants
If you are participating in a research study:
• drop off your study prescription at the retail pharmacy
• designated study pharmacy staff will process the prescription
and dispense the study pills
• pick up your study pills from the retail pharmacy

This process may take about 30 minutes.

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 Taking your anticancer drugs at home

New patient questionnaire (Pharmacy)

Please complete this information and bring it to the Cancer Centre Notes
Pharmacy the first time you come with your prescription. You also need
to bring your Ontario Health Insurance Card and any drug cards that you
may have.

Name: __________________________________________

Address: ________________________________________

Telephone: ______________________________________

Birthdate: ________________________________________

Medication allergies:  Yes  No

If yes, please list the medication name(s) and the type of reaction:

________________________________________________________

________________________________________________________

________________________________________________________

Medical conditions:

 diabetes  liver disease

 hypertension  arthritis
 heart disease  other: __________________
 kidney disease

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 Taking your anticancer drugs at home

Prescription medications that you take at home or attach printout

(MedsCheck list) from pharmacy:
Notes
Name Amount (Dose) When you take it

Non-prescription medications:

 Acetminophen  Dimenhydrinate
Tylenol® Gravol®
 Ibuprofen  Loperamide
Advil® Imodium®
 Acetylsalicylic acid  Other:
____________________
Aspirin®
Vitamins, herbals and supplements:
_______________________________________________________

_______________________________________________________

Name of your home pharmacy:

_______________________________________________________

Can we phone your home pharmacy for information?

 Yes  No

Phone number: __________________________________________

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 Taking your anticancer drugs at home

Insurance information
You may need to phone your insurance providers to get the Notes

answers to the questions listed in the box below.

This will let you know whether you have enough coverage to meet
your needs during your treatment.

If your family has more than one insurance plan, please bring each
drug card to the pharmacy.

Primary insurance
The insurance company that is contacted first to obtain coverage
for you.

Secondary insurance
The insurance company that is contacted second to obtain coverage.
The secondary coverage may cover the balance of what the primary
insurance did not cover.

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 Taking your anticancer drugs at home

Primary Secondary
Notes
Insurance Insurance
Name of
insurance
company
Percent coverage ______% ______%
Deductible
 Yes  No  Yes  No
Amount of $ $
deductible
Yearly maximum
 Yes  No  Yes  No
Amount of $ $
yearly
maximum
Lifetime cap
 Yes  No  Yes  No
Amount of $ $
lifetime cap
Pre-approval
needed for some  Yes  No  Yes  No
medications

Employee benefit plan

Your employer may offer medical coverage on a benefit plan.
If so, please bring your drug card to the pharmacy on your first visit.
Some coverage may be processed on-line.

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 Taking your anticancer drugs at home

You may need to call your insurance provider and ask:

• How much coverage you have for medications, is there a Notes

yearly or lifetime maximum?

• Whether a specific medication that your oncologist wants to

prescribe for you is covered. Also, ask if you need a doctor’s
note for approval.

Ontario Drug Benefits

If you are 65 years or older, you are eligible for drug benefits under
the government plan called The Ontario Drug Benefits Program.
Some patients on home care, social assistance and disability are
also eligible for this government program. You may also be eligible
for drug coverage through the Provincial Trillium Program.

If you are eligible for Ontario Drug Benefits or the Trillium Program,
you need to present your benefit card and/or your Ontario Health
Insurance Card to a pharmacy staff member on your first visit.

You may have to pay a fee or deductible that is not covered by the
insurance provider. This can be paid for using cash, debit card,
VISA, MasterCard, American Express or a cheque.

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 Taking your anticancer drugs at home

Pharmacy resources
Notes • Cancer Care Ontario: http://www.cancercare.on.ca
• Medication Information Sheets can be found on the
Juravinski Cancer Centre website: http:/www.jcc.hhsc.ca
Then go to > Cancer Services > Pharmacy
> Medical Information Sheets

• Information about alternative and complementary

treatments can be found at the Memorial Sloan Kettering
Cancer Centre or BC Cancer agency website:
www.mskcc.org
Then go to > Cancer Information > Integrative Medicine
> About Herbs, Botanicals & Other Products

www.bccancer.bc.ca
Then go to > Patients/Public Information
> Complementary Therapies

Support services

Patient and Family Resource Centre

Staff and volunteers are here to help you search for the information
you need. We are in the lobby of the JCC.

Phone: 905-387-9495, Ext. 65109

Email: jccpfrcentre@jcc.hhsc.ca

You can also find us on Facebook!

www.facebook.com/JCCPFRC

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 Taking your anticancer drugs at home

Canadian Cancer Society

We help you make informed decisions about your health by
Notes
providing trusted, reliable information on all types of cancer.

We offer a range of support services in your area, such as

volunteer drivers. Our volunteers wear yellow jackets.

Website: www.cancer.ca

Wellwood Resource Centre of Hamilton

Wellwood is a community based, non-profit organization which
provides information, supportive care programs and peer support
to people who have received a diagnosis of cancer, their families
and health providers.

Email: wellwood@hhsc.ca
Phone: 905-389-5884

Look Good … Feel Better Workshops

A national program to help women living with cancer improve their
appearance and self esteem. This is done by teaching beauty tips
to hide appearance related changes of illness, anticancer drugs
and radiation. One afternoon or an evening. You need to call for
an appointment.

Phone: 905-575-9220, ext. 3110

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 Taking your anticancer drugs at home

Cancer Assistance Program

Notes
A community-based volunteer organization with a commitment
to helping cancer patients and their families through the crisis
of cancer and to preventative education programs.

Phone: 905-383-9797

Specialty stores
• wigs and hair pieces
• breast prosthesis and bras
• check the Internet and/ or yellow pages

Wellspring – Halton/Peel and Niagara

At Wellspring, programs provide people with many ways to help with
coping with the diagnosis, the disease and its effects on patients,
family members and professionals.

Phone: 1-888-707-1277

Canwell Program, Hamilton, Ontario

This is an exercise and education program for people who
have cancer.

Phone: 905-667-1515
www.canwellprogram.ca

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 Taking your anticancer drugs at home

Questions
_______________________________________________________
Notes

_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

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 Taking your anticancer drugs at home

Notes ______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

______________________________________________________

52
Tell us what you think about our booklet!
After reading the booklet on Anticancer drugs please respond to each
statement. Your responses will help us improve the information.

Circle the number that best describes how you agree with the statement.
On a scale from 1 to 5, with 1 = strongly disagree and 5 = strongly agree.

Strongly Strongly
disagree agree

The information was helpful. 1 2 3 4 5

I would recommend this 1 2 3 4 5
information to other patients on
oral anticancer therapy.
I learned a way to help me to 1 2 3 4 5
remember to take my drugs the
right way.
I have a better understanding of 1 2 3 4 5
the side effects related to
anticancer drugs.
I know when it is important to call 1 2 3 4 5
my Primary Team or talk with a
pharmacist.
The information answered my 1 2 3 4 5
questions.
The words and sentences were 1 2 3 4 5
clear and understandable.

What would you add to this class to improve it to better meet your needs as a new
patient starting oral anticancer treatment?

_______________________________________________________________

_______________________________________________________________

If you attended the class on anticancer drugs, please respond to the

statements on page 54.

Please return this survey in the self-addressed envelope.

Thank-you! JCC 2015

53
Statement Strongly Strongly
disagree agree

The class was helpful. 1 2 3 4 5

I would recommend the class to 1 2 3 4 5
patients and families.

What I learned in class helped me 1 2 3 4 5

take my drugs the right way.

What advice do you have that would help other patients and
families currently going through cancer treatments?

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

54
 Hamilton Health Sciences, 2015
PD 8482 – 02/2015
dt/February 17, 2015
dpc/pted/lrgbk/AntiCancerDrugsAtHomeInfoPatientsFamilies-th.doc