Who do I contact after hours?

Between the hours of 5PM and 8AM a phone call will be transferred to the answering service who will then call the oncologist on-call. The oncologist will call you back but may not be familiar with your situation if they have not had time to pull up your record from the electronic health record.

Please have any medications, allergies, and your pharmacy telephone number and any other pertinent information ready when you call. If your phone blocks unknown calls, please “Unblock” your phone while waiting for the doctor to call you.

When calling, press 2 in phone options.

If you are calling for test results, remember that most physicians schedule a follow-up visit to discuss test results with you. If your doctor has told you he or she will call you with test results, please remember that may take several days for test results to become available. The doctor must personally review the test before you can receive a call about the results. If you are waiting for your doctor to call with results and you have not heard back within a week please call the office. We will make sure those results are seen by your doctor as soon as possible.

Refill requests – if you receive a voice message leave your name, Date of birth, phone number and the medication that needs to be refilled. You will be called back by the end of the day.

Before you call the office, make a list of problems, concerns, and questions. Keep a current medication list available.

We will determine if your problem/question can be answered or if you need to be seen in our office that day. If it is beyond our ability to provide care at any of our clinics we will have you go to the Emergency Room or call 911.

Hair loss occurs with some, but not all, chemotherapy drugs. The amount of hair loss varies from a slight thinning to complete baldness and affects the scalp, eyelashes and eyebrows, legs, armpits, and pubic area. Hair loss will typically begin two or three weeks after your first treatment. The amount of hair that you lose will depend on the type of chemotherapy drug you are taking. Hair typically begins to grow back approximately 2-3 weeks after treatment is finished. The hair may grow back differently than it was before treatment. For example color or texture (curly or straight) may be different. Remember that hair loss associated with chemotherapy is temporary and the hair WILL grow back.

In the meantime, here are a few tips to help you cope with the loss:

  • You may wish to cut your hair before it starts falling out. The experience of losing the hair is sometimes worse than dealing with it once it’s gone. If you expect to lose all or a lot of your hair, cutting it first may be easier to cope with.
  • Plan ahead; shop for a wig before your hair is gone, especially if you wish to match your natural color. Or, take this opportunity to try something different.
  • Try hats or head scarves; these are good alternatives or a compliment to a wig.
  • Remember to cover your head or use sunscreen on your scalp. Skin that has been covered with hair may be particularly sensitive to UV rays of the sun.
  • Ask your insurance company if they cover the cost of the wig.
  • Treat your new hair gently once it grows back. Avoid chemicals, bleach, peroxide, or colors.

Chemotherapy kills rapidly-dividing cells in a variety of ways, depending on the drug. Since there are many different types of cancers that all grow differently, many chemotherapy drugs have been developed to target these various growth patterns. Each drug has a different way of working and is effective at a specific time in the life cycle of the cell it targets.

For example, some chemotherapy drugs work by:

  • Damaging DNA
  • Preventing cells from dividing
  • Disrupting cellular metabolism or other critical functions

Your doctor determines what kinds of tests are needed. If you are receiving chemotherapy, you may have blood work done anywhere from the day of or up to 7 days before your scheduled treatment. This blood work will include a complete blood count (CBC), chemistry profile, and any necessary cancer markers. A blood sample for a complete blood count (CBC) will also be collected seven to fourteen days following your chemotherapy. It is important to be aware of possible symptoms of reduced red blood cell (RBC), white blood cell (WBC), or platelet (PLT) production.

Be sure to report any of the following:

  • Fever (over 101º F), congestion, or a cold.
  • A rash, blister, easily bruised skin, signs of bleeding, an infected cut, itching or burning in the genital area.
  • Weakness, fatigue, or shortness of breath.

Without receiving special anti-nausea medications, most patients will experience some nausea after treatment with chemotherapy. Nausea and vomiting may last 24-48 hours. The severity of nausea and vomiting mainly depends on which chemotherapy drugs were used. A number of very effective medications called anti-emetics or anti-nausea drugs are now available to help lessen or prevent nausea and vomiting. These medications may be given to you intravenously during your chemotherapy, or you may be given a prescription medication to take at home.

Chemotherapy works by destroying cancer cells; unfortunately, it cannot tell the difference between a cancer cell and a healthy cell. The delivery of cancer therapy often affects the body’s normal tissues or organs that are not affected by cancer. Side effects, or complications of treatment are the undesired consequence of affecting normal cells. Side effects of treatment may cause inconvenience, discomfort, and occasionally even fatality to patients. Additionally and perhaps more importantly, side effects may prevent delivery of the full dose of chemotherapy on schedule. This is extremely important to understand since your expected outcome from chemotherapy is based on delivering treatment at the full dose and schedule prescribed in the treatment plan Because the expected outcome from therapy is based on delivering treatment at the prescribed dose and schedule, a change from the treatment plan may reduce your chance of achieving an optimal outcome. This is extremely important to understand. In other words, side effects not only cause discomfort and unpleasantness, but may also compromise your chance of cure by preventing the delivery of therapy at its optimal dose and time. The most common side effects of chemotherapy are low blood counts, nausea, vomiting, hair loss, and fatigue. Some side effects may be temporary and merely annoying. Others, such as infection or a low white blood count, can be life-threatening. For example, one of the most serious potential side effects of chemotherapy is a low white blood cell count – a condition called neutropenia (new-truh-pee-nee-ah) – which can put you at risk for severe infections or treatment interruptions. Fortunately, last 20 years has brought a great deal of progress in the development of treatments to help prevent and control the side effects of cancer therapy.

These developments have:

  • Led to vast improvements in the management of symptoms associated with cancer treatment
  • Allowed for greater accuracy and consistency concerning the administration of cancer treatment
  • Made many cancer treatments more widely available to patients throughout the world.

Chemotherapy is typically given in cycles, which is a treatment followed by a period of rest. A cycle can last one or more days, but is usually one, two, three or four weeks long. A course of chemotherapy is comprised of multiple cycles. Each course is different, but generally consists of four to six cycles. The actual administration of the chemotherapy drugs may take minutes to several hours, depending on the drug or drugs given. If your chemotherapy is given through an IV, your doctor may suggest an implanted venous access device (VAD) or Port-a-Cath. VADs are surgically placed in a large vein near the heart and can stay in place for long periods of time. By using a VAD you will not have to have smaller catheters repeatedly placed in arm veins.

You will receive chemotherapy that is best suited to achieve your goals of therapy. When selecting a treatment or treatments, your doctor will consider:

  • Your diagnosis
  • How far along your cancer is in its development
  • The expected behavior of the cancer
  • Where the cancer originated
  • Your age
  • Other medical problems you may have
  • Any potential side effects from the treatment.