Many children receive chemotherapy in an outpatient clinic. Some are admitted to hospital for a few days.
Additional drugs may be prescribed to ease anticipated side effects. These may be given in hospital or at home.
During each chemotherapy session, your child’s urine output will be monitored closely to avoid fluid retention. The nurse will ask you to keep your child’s nappies so they can be weighed. Older children will need to use a bottle or bedpan.
Reactions to chemotherapy are uncommon. However, tell the nurse immediately if your child experiences any of the following:
- headache
- skin rash.
- sweating
- fever or chills
- difficulty breathing
- swollen, red, sore, burning or blistered skin around an IV
You may find your child’s appetite decreases for a few days after treatment. When it returns to normal you can usually serve your usual foods. You will be told if there are specific foods your child should avoid. Encourage your child to drink about twice as much as normal during chemotherapy as this helps cleanse the body.
Monitoring
Regular blood tests will be done to check how well your child’s liver, kidneys and bone marrow are working. If the doctors are concerned by the results, the next treatment may be delayed to let the body recover.
During eye salvage treatment, an EUA will be done after every 1-2 sessions of chemotherapy. Focal therapy may be used, depending on what the ophthalmologist finds. If tumours are not responding, the doctors may discuss alternative treatments.
If required, tests will be done during and after chemotherapy to look for signs of recurrence outside the eye. Tests will also assess tumour response if cancer has already spread, or if your child has trilateral retinoblastoma.
Consultations
You will usually see your child’s doctor during each chemotherapy session. Use this time to ask questions, discuss any worries, and mention anything unusual you have noticed during treatment, even if it was expected or seems trivial.
If you plan to try a complementary therapy or use an over-the-counter medicine, discuss this with the doctor. Some therapies can dangerously interact with other drugs, so be safe and ask first.
Doctors are often willing to change treatment dates by a few days to accommodate special occasions such as your child’s birthday or a family funeral. Ask your doctor if this is possible, but do so as far in advance as possible.
Chemotherapy is a very daunting treatment for most families. The first treatment is usually the hardest emotionally because you don’t know what to expect. After this, you will have a better idea of the process and how your child copes with chemotherapy. You will feel more prepared and confident during the next session.
Don’t hesitate to ask questions about any aspect of your child’s care if you are confused or concerned. Keeping good records will help you identify any concerns early.