Catholic University Catholic Hematology Hospital

Hand Hygiene

This is the simplest but most important habit. Since our hands are full of germs, it's crucial to wash them after eating, coming back inside from outdoors, and after using the bathroom. When washing your hands, use liquid soap and running water, making sure to thoroughly clean between your fingers, under your nails, and your fingertips.

• 1.

  Duration of the entire procedure (20-30 seconds)

  • ①

    Apply a palmful of the product in a cupped hand, covering all surfaces.

  • ②

    Rub hands palm to palm.

  • ③

    Right palm over left dorsum with interlaced fingers and vice versa.

  • ④

    Palm to palm with fingers interlaced.

  • ⑤

    Backs of fingers to opposing palms with fingers interlocked.

  • ⑥

    Rotational rubbing of left thumb clasped in right palm and vice versa.

  • ⑦

    Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa.

  • ⑧

    Once dry, your hands are safe.

  Source of data : World Health Organization

• 2.

  Duration of the entire procedure (40-60 seconds)

  • ①

    Wet hands with water.

  • ②

    Apply enough soap to cover all hand surfaces.

  • ③

    Rub hands palm to palm.

  • ④

    Right palm over left dorsum with interlaced fingers and vice versa.

  • ⑤

    Palm to palm with fingers interlaced.

  • ⑥

    Backs of fingers to opposing palms with fingers interlocked.

  • ⑦

    Rotational rubbing of left thumb clasped in right palm and vice versa.

  • ⑧

    Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa.

  • ⑨

    Rinse hands with water.

  • ⑩

    Dry hands thoroughly with a single use towel.

  • ⑪

    Use towel to turn off faucet.

  • ⑫

    Your hands are now safe.

  Source of data : World Health Organization

• 3.

  Cough etiquette

  

  Source of data : http://www.cdc.gov/flu/protect/covercough.htm

Oral Care

To protect the delicate tissues inside your mouth, use a soft-bristled toothbrush for cleaning. Brush your teeth four times daily—after each meal and once more before you go to sleep. Rinse your toothbrush thoroughly under running water after each use and allow it to air-dry to prevent bacterial growth.

Bathing

Your skin is home to bacteria that typically don't cause any problems. However, during periods of weakened immunity, these bacteria can lead to infections. Showering every 2 to 4 days is recommended, using a gentle touch without harsh scrubbing. Clean the skin folds carefully, like underarms, groin, and behind the knees, to ensure thorough hygiene.

Anal Care

For any wounds or hemorrhoids, consider sitz baths. Sitting in warm water can alleviate discomfort, decrease swelling, and aid the healing process.

Other Precautions

These guidelines are designed to minimize your risk of infection and to support your overall health during treatment. Always consult with your physician for personalized advice and before making any changes to your health care routine.

• ①

  Nail Care : Keep your nails well-trimmed but not too short to avoid cuts and protect your skin. Always wear shoes or socks to prevent foot injuries.

• ②

  Shaving : Use an electric razor to minimize the risk of nicks or cuts.

• ③

  Skin Lesions : Avoid squeezing pimples or blisters as this can cause infection.

• ④

  Nose and Ears : Refrain from picking at your nose or ears to prevent irritation or injury.

• ⑤

  Illness Exposure : Stay away from individuals with colds or contagious illnesses to reduce your risk of infection.

• ⑥

  Medical Consultation : Speak with your doctor about any preventive vaccinations and the timing of dental procedures.

• ⑦

  Environmental Factors : Consider removing items from your home environment that could increase infection risk, like curtains, carpets, houseplants, and pets.

• 1.

  Prioritize Rest : It's important to ensure that you're getting enough rest. Adequate sleep is vital for recovery and overall well-being.

• 2.

  Balanced Diet : Aim for a nutritious and well-balanced diet. Eating a variety of healthy foods supports your body's needs and can aid in managing symptoms.

• 3.

  Safety with Dizziness : If you're experiencing dizziness, be extra cautious. This means being careful when driving, looking after children, or going out. It's important to ensure your safety and the safety of others.

• 4.

  Rise Slowly : If you're getting up from a lying or seated position, do it slowly. Standing up too quickly can cause a drop in blood pressure, which might lead to dizziness as your brain momentarily gets less oxygen. To avoid this, take your time: first sit up, pause, and then stand up gradually. This allows your body to adjust and can help prevent dizziness.

Signs of Bleeding

• You might notice signs like small, pinpoint red spots on the skin (petechiae), bruising with little to no trauma, blood in your stool or urine, a prolonged time for bleeding to stop, frequent nosebleeds, or bleeding gums. You may also experience redness in the whites of the eyes (conjunctival congestion).
• For female, an increase in menstrual flow can be a sign. It's important to take it easy and rest as much as possible during this time.

Safety Measures to Prevent Bleeding

• It's wise to avoid any high-impact activities or exercises that could lead to bleeding or bruising.
• Before engaging in physical activities, have a discussion with your physician. They can guide you on safe exercises based on your platelet count. Gentle activities like walking, stationary biking, or light stretching can be good starting points. However, contact sports or high-risk activities like skiing should be postponed until your platelet count is stable, ideally above 100,000.
• Take extra care to avoid injuries that could lead to bleeding. This means being gentle with your skin and avoiding harsh towels or vigorous rubbing.
• Keep an eye out for any new skin changes, such as petechiae. These signs of bleeding under the skin should gradually fade as your platelet levels recover, but it may take some time.
• When brushing your teeth, use a soft-bristled toothbrush and steer clear of dental floss if your platelet count is low to prevent gum bleeding.
• Opt for an electric razor over traditional blades to reduce the risk of cuts while shaving.
• Be gentle with your nose to avoid nosebleeds. This means not blowing it too hard and not picking it.
• Should you cough up or vomit blood, it's crucial to contact a healthcare professional without delay. This could be a sign of a more serious bleeding issue that needs immediate attention.

Strategies to Alleviate Nausea and Vomiting

These measures can help you cope with the side effects of chemotherapy. It's also important to communicate with your physician about your symptoms, as they can adjust your treatment plan to better suit your needs and improve your comfort.

• Ventilate Your Space : Keep the air fresh by regularly airing out rooms to eliminate any strong odors that could trigger nausea.
• Quiet and Rest : Spend time in a calm environment and ensure you get adequate sleep, which can help manage nausea.
• Post-Meal Activity : After eating, avoid lying flat for at least two hours. Gentle walking can aid digestion, or you can choose to sit and relax.
• Comfortable Clothing : Wear loose-fitting clothes to avoid pressure on your abdomen.
• Manage Nausea : If nausea arises, try to stay calm. Deep breathing exercises may provide relief.
• Cool Compress : Apply a cool cloth to your forehead or neck to ease discomfort.
• Address Constipation : Keep constipation under control as it can exacerbate nausea.
• Distractions : Engage with loved ones, enjoy music, watch your favorite shows, or play games to keep your mind off the nausea.
• Relaxation Techniques: Practices like meditation, mindfulness, or yoga can be beneficial in diverting your attention and reducing feelings of nausea.

Dietary Guidance for Treatment Days.

• First Day of Treatment : Begin with gentle, easy-to-digest foods like soups, porridge, or bread.
• Managing Nausea : If you tend to feel nauseous during chemotherapy, it's best to avoid eating 1-2 hours before your session.
• Food Temperature : Foods that are too hot can have a stronger aroma, which might cause discomfort. Instead, choose cold or room-temperature meals.
• Food Selection : Stay away from foods that are very sweet, rich in fat, overly salty, or spicy, as they're more likely to cause nausea. Foods with strong odors should also be avoided.
• Fruit Juices : Fresh, cool fruit juices without added sugar can be soothing and nourishing.
• Listen to Your Body : Don't force yourself to eat if you're feeling nauseated. Trust your body's signals.
• Meal Size and Pace : Eat smaller amounts more frequently rather than large meals, and take your time chewing to help with digestion.
• Fluid Intake : To avoid overfilling your stomach with liquids, try not to drink during meals. Instead, hydrate one hour before or after eating.
• Soft Foods : If solid foods are too challenging, switch to soft options like porridge, or consider nutritional drinks like Ensure or Boost.
• Oral Care : Rinse your mouth after eating to eliminate any residual tastes or acidity, which will also help in maintaining good oral health.

Recognizing Oral Inflammation Post-Chemotherapy

You may observe several indications of inflammation in your mouth, such as:

• Dry Mouth and Taste Changes : You might experience a sensation of dryness, notice a white coating on your tongue, or find that your sense of taste is altered.
• Throat Redness and Swelling : The mucous membranes of your throat may become red and swollen, which can make swallowing a challenge.
• Severe Cases : In more extreme situations, oral ulcers, bleeding, or infections can occur, which require immediate medical attention.
• Denture Care : If you use dentures, it's crucial to keep them clean by using a mouthwash solution to disinfect them. Dentures might cause additional irritation during this time, so consider wearing them only during meals for greater comfort.

These symptoms are common and typically begin to manifest 5-7 days after chemotherapy treatment. They usually resolve on their own within 1-3 weeks. However, if you experience any of these symptoms, it's important to discuss them with your physician to ensure proper management and to reduce the risk of secondary infections.

Preventive Measures Against Oral Inflammation During Chemotherapy

Taking these steps can significantly reduce the risk of developing oral inflammation and can help maintain the health of your mouth throughout your chemotherapy treatment. If you have any concerns about your oral health, don't hesitate to reach out to your healthcare team for personalized advice and support.

• Oral Hygiene : Keep your mouth clean by brushing with a soft toothbrush and fluoride toothpaste after each meal.
• Dietary Choices : Steer clear of spicy, hard, rough, or acidic foods, as well as certain juices, to minimize mouth irritation.
• Soft Diet : If inflammation does develop, opt for soft, bland foods that are gentle on the mouth. This includes items like canned foods, porridge, soups, cooked vegetables, and broths.
• Lip Care : Apply a lip moisturizer, such as Vaseline, to combat dry lips.
• Dental Health Pre-Chemotherapy : Discuss the condition of your gums and teeth with your primary care physician before beginning chemotherapy to address any potential issues beforehand.
• Avoid Irritants : Refrain from using alcohol and tobacco, as well as mouthwashes with alcohol content. These substances can exacerbate dryness and lead to additional irritation and discomfort.

Understanding Constipation

• Constipation occurs when bowel movements become less frequent and stools become difficult to pass. It's often characterized by stools that are hard and dry, and you may find yourself straining or spending a long time in the bathroom attempting to have a bowel movement. Afterward, you might feel like you haven't completely emptied your bowels.

Preventing Constipation

• Consistent Meal Times : Eating your meals at regular times each day can promote regular bowel movements, so stick to a routine.
• Hydration : Drinking plenty of fluids, especially water, is crucial. Aim for about 7-8 cups a day to help keep stools soft and easier to pass.
• Fiber Intake : Include foods high in fiber, such as fruits and vegetables, in your diet. Fiber isn't digested and helps increase stool bulk and softness, making bowel movements easier.
• Physical Activity : Regular exercise, like walking, is important. Try to stay active and avoid prolonged periods of lying down if possible.

During Bowel Movements

• Respond Promptly : Don't ignore the urge to have a bowel movement.
• Avoid Straining : Straining can lead to issues like hemorrhoids or an increase in intracranial pressure. This is particularly important if you have high blood pressure.
• Use Enemas Cautiously : They can introduce infections if not used properly.
• Laxatives : Consult your physician before using any laxatives, as improper use can be harmful.

When to See a Doctor

Remember, maintaining a healthy lifestyle with a balanced diet and regular exercise can help prevent constipation. However, if you experience any concerning symptoms, it's important to seek medical advice promptly.

• Prolonged Constipation: If you haven't had a bowel movement in more than three days.
• Blood in Stool: If you notice blood in your stool or around your anus.
• Ineffective Stool Softeners: If you've taken a stool softener and haven't had a bowel movement within 1-2 days.
• Abdominal Pain or Vomiting: If you experience persistent abdominal cramps, vomiting, or both.
• Abdominal Distension: If your abdomen is swollen, and you feel nauseous, have vomiting, and are unable to pass stool or gas.
• Abdominal Sounds and Pain: If you hear loud noises from your abdomen along with pain.

When dealing with diarrhea, you might notice these symptoms

• You could have frequent loose or watery bowel movements, more than three to four times a day, or lasting for over 24 hours.
• Also, because food moves quickly through the intestines during diarrhea, your body might not absorb vitamins, minerals, and fluids as well as it should. This could potentially lead to weight loss or dehydration.

Certainly, here are some strategies to manage and improve diarrhea

• Ensure you're staying hydrated. Replenish any fluids you've lost.
• During intense bouts of diarrhea, you might want to limit your intake of solid food to give your intestines a rest. Instead, try to consume clear liquids like fruit juices without pulp or barley tea.
• Since your intestines might be a bit sensitive, it's best to eat small portions of food.
• Try to avoid foods that are high in fat.
• Stick to foods that are easy to digest, such as thin rice soup or porridge.
• As diarrhea can cause you to lose sodium and potassium, consider foods or drinks that are high in these electrolytes. Sports drinks, orange juice, tomatoes, and peaches are all good choices.
• Limit your intake of dairy products, as lactose can sometimes trigger diarrhea.
• Avoid foods that are hard to digest, like vegetables high in fiber, tough foods, and whole grains.
• Try to eat foods at room temperature, and avoid foods that are very hot or very cold.

When should you talk to a doctor?

• If you have diarrhea that's more like liquid for more than three to four times, or if the diarrhea lasts longer than a day.
• If you see blood around your anus or in your stool.
• If you lose more than 5.5 pounds (2.5 kilograms) after you start having diarrhea.
• If you get new stomach cramps and pain that last more than two days along with diarrhea.
• If you have a fever.
• If you pass a small amount of stool that looks like diarrhea after not being able to go for several days. (This could be because the stool is blocking your intestines and the liquid is leaking out around it)

How should one care for the anal area after diarrhea?

• If there are wounds on the anus, there is a potential for infection, which can lead to pain and inflammation.
• Taking warm sitz baths (sitting in warm water between 86 to 104°F (30~40℃) for 10 to 15 minutes, two to three times a day) can be beneficial.
• For women, it is important to wipe from front to back after a bowel movement and keep the area clean.
• Additionally, do not use rectal suppositories and avoid using any special medications or ointments without the direction of your primary care provider.

As you navigate through hair loss, you might find these care tips helpful

• Make sure to wash your hair regularly to keep your scalp clean.
• Shampoo gently and avoid vigorous scrubbing. Instead of rubbing your hair dry, pat it gently with a towel.
• Consider using hats, scarves, or wigs to cover your head.
• When combing your hair, do so softly to avoid pulling out hair.
• Try to avoid using hair dryers, curling irons, hair dyes, and perms. These can be harsh on your hair follicles and can cause your hair to dry out. Also, try to limit your scalp's exposure to direct sunlight.
• Don't hesitate to share your concerns about hair loss with your healthcare team and your family. It can also be helpful to connect with other patients who are experiencing hair loss. Sharing your feelings and experiences can provide emotional support.

What might skin changes look like?

• You might notice a variety of symptoms. These could include erythema (redness), pruritus (itchiness), xerosis (dry skin), acne, exfoliation (peeling skin), hyperpigmentation (darkened areas of skin), photosensitivity (increased sensitivity to sunlight), erythema of the extremities (redness on your hands or feet), bands of pigment change on your nails, and onychodystrophy (nails that crack or split).

What can you do to take care of your skin?

• You might notice symptoms like rashes, redness, bruising, or swelling on your skin.
• Wear clothing that's comfortable and shoes that fit well to prevent blisters. You might also want to wear protective socks to avoid injuring your feet.
• Try using a mild soap and consider using liquid soap from a pump dispenser when you shower every 2-3 days. Bar soaps can be more likely to harbor germs.
• Avoid using rough towels and be sure to wash your groin area, perineum, and armpits thoroughly.
• Try to avoid rubbing your skin too hard, as this can cause damage. Don't scrub or wipe your skin too vigorously.
• Use your own towels rather than sharing with others.
• If your skin is dry, consider applying oil or a moisturizing lotion after you shower. Be aware that lotions containing alcohol can dry your skin out even more, so it's best to avoid these.
• It's usually a good idea to steer clear of saunas, public baths, steam rooms, and long baths.

How can you manage skin changes?

• Dermatitis, Pruritus Use a mild soap for cleansing to soothe your skin. After bathing, make sure to dry your skin thoroughly and apply a soothing skin lotion to help relieve symptoms.
• Acne Resist the urge to touch or try to handle acne lesions yourself. Instead, seek professional medical treatment.
• Cutaneous Hyperpigmentation After chemotherapy, any darker areas of skin (hyperpigmentation) should gradually fade over time.
• Photosensitivity Try to avoid direct sunlight, particularly between 10 am and 3 pm when the sun's rays are strongest. Stay away from sunlamps and sunbathing. Use wide-brimmed hats, sunglasses, masks, and long-sleeved cotton clothing to protect your skin. Apply a sunscreen with an SPF of 15 or higher 15 to 30 minutes before you go outside.
• Erythema of the Hands and Feet You might experience pain, swelling, or redness in your palms and soles, which could progress to blistering and then to peeling and skin regeneration. These symptoms usually go away within 3 to 7 days after you stop treatment. To help with recovery, try to avoid getting your hands and feet wet and consider using cold therapy. Use a mild soap and a lotion that doesn't contain alcohol. If you have severe pain, blistering, or peeling skin, contact your healthcare team right away to get the right treatment.
• Nail Changes During chemotherapy, your nails might darken or develop white lines. They could also become brittle, dry, cracked, or even start to come off. Be careful not to tear your nails or cut your skin when you're trimming your nails. Avoid cutting them too short, and cut straight across instead. Using lotion or cream on your nails can help keep them healthy. Protect your nails by wearing gloves when you're doing housework like washing dishes or cleaning. Try to avoid using nail polish and artificial nails, as these can irritate your nails and increase your risk of getting an infection.

When dealing with fatigue, these strategies might help

• Try to stick to your normal daily activities as much as you can, but rest as soon as you start to feel tired.
• Avoid standing or sitting up too quickly, as this can make you feel dizzy. Move slowly instead.
• Plan to take breaks between activities so you can rest.
• Keep a regular sleep schedule and make sure you're getting enough rest.
• Stay hydrated and eat a balanced diet that's rich in protein and vitamins.
• Try to avoid smoking, and limit your intake of caffeine and alcohol. Depending on your white blood cell count, you might be able to include fresh fruits in your diet.
• While it's important to rest, try not to stay sedentary all the time. Simple, gradual exercises can be beneficial.
• Find ways to distract yourself from your fatigue. You might find it helpful to listen to music, go for a drive, practice deep breathing, or use muscle relaxation techniques.
• Try to reduce your workload if you can, and avoid tasks that cause you stress.
• Engaging in religious or social activities, talking about your feelings, and remembering happy times can all improve your mood and help you fight fatigue.
• Don't hesitate to talk to your healthcare team about your symptoms. They can provide treatment options that are tailored to your needs.

Managing your pain effectively can involve a few different strategies

• Painkillers, or analgesics, are the simplest and most convenient way to relieve pain. It's important to follow your physician's instructions about how much to take, how often to take it, and how to administer it. If you have any questions, don't hesitate to ask your healthcare team.
• You should take your pain medication regularly, not just when you eat. To keep your pain under control, make sure to take your next dose before the effects of the last one wear off.
• The strength of your pain medication should match the severity of your pain.
• There are many different types of painkillers available. For severe pain, you might need a stronger medication like morphine. Even when using these potent drugs, following your prescription carefully can prevent problems like addiction.

Opioid painkillers can cause a number of side effects, including

Around 30% of people who take opioid medications report these side effects. They usually start to appear 2 to 5 days after you begin treatment. If you notice any of these symptoms, it's important to take action right away to ensure your safety and manage any discomfort.

• Constipation : This is a common side effect because opioids can slow down the movement of your bowels.
• Sedation/Drowsiness : Opioids can make you feel less alert and more sleepy.
• Nausea/Vomiting : These stomach and digestive symptoms are relatively common and can be caused by opioids.
• Slowed Breathing : Opioids can slow down the part of your brain that controls your breathing.
• Difficulty Urinating : Opioids can affect the muscles that control your bladder, which can make it harder for you to urinate.

In addition to pain medication, there are several other strategies that can help manage your pain

• Integrative Therapies: These therapies can be used alongside painkillers to help control your pain more effectively.
• Relaxation Techniques: Techniques like relaxation therapy, cold packs, heat packs, massage, and rest can all help relieve pain.
• Distraction: Activities like listening to music or watching TV can help take your mind off your pain. These methods can boost the effectiveness of painkillers and help manage other uncomfortable symptoms.

A pain journal

The first step in managing your pain effectively is being able to describe it accurately.

• ①

  Where exactly is your pain?

• ②

  How severe would you say your pain is? (Please mark it on the line provided)

• ③

  What does the pain feel like?

• ④

  Is it an aching, burning, tingling, or prickling sensation?

• ⑤

  When does your pain start, how long does it last, and does it fluctuate?

• ⑥

  Are there certain things that make your pain worse?

• ⑦

  What have you found that helps relieve your pain?

• ⑧

  How does your pain affect your day-to-day activities?

Relaxation Training 1. Slow Deep Breathing for Relaxation

Deep breathing exercises can help you relax, boost the effectiveness of painkillers, and relieve pain.

• ①

  Take a deep breath in, slowly.

• ②

  Exhale slowly, imagining that tension is leaving your body.

• ③

  Continue to breathe in and out slowly and rhythmically at a pace that feels comfortable for you.

• ④

  To help you focus on your breathing, silently count 'one, two, three' as you inhale and 'two, two, three' as you exhale. With each exhale, silently tell yourself 'peaceful,' 'relaxed.'

• ⑤

  Repeat steps 3 and 4 for about 20 minutes.

• ⑥

  Finish up by taking a few slow, deep breaths. As you breathe, tell yourself 'my mind is clear and at ease.'

Relaxation Training 2. Simple Touch or Massage, and Applying Heat for Relaxation

• ①

  If you're a caregiver, put on disposable gloves and then hold the person's hand, touch them briefly, or gently massage their shoulder for about 3 to 10 minutes.

• ②

  Soak the person's feet in warm water or wrap them in a warm, damp towel. Setting aside a specific time for this kind of massage can create a sense of expectation and trust for the person you're caring for.

Relaxation Training 3. Exercise of Recalling Peaceful Past Memories

Thinking back on past memories that brought you a sense of peace and deep comfort can help to ease your current state.
Consider these questions:

• ①

  Try to remember a time when you felt extremely calm, at ease, reassured, hopeful, and peaceful.

• ②

  Imagine something that evokes a strong sense of peace within you. What are you thinking about?

• ③

  Does listening to music ever give you a dream-like feeling? Do you have a favorite song?

• ④

  Is there a poem that lifts your spirits and helps you relax?

• ⑤

  Have you ever been actively involved in your religious community? Do you have a favorite book, hymn, or prayer?

Relaxation Training 4. Music Listening Exercise

Listening to music that brings you peace and deep comfort can help ease your current state.
Here are some suggestions:

• ①

  Play your favorite music at a comfortable volume. With your eyes open, focus on a single object for a while.

• ②

  If you prefer, you can close your eyes and picture the music in your mind.

• ③

  Try to connect with the rhythm of the music. You could do this by massaging your body, listening to different songs, or tapping your hands or feet to the beat.

Managing Neurological Changes

• Be careful when handling hot objects as you could burn yourself without realizing it.
• Regularly move your hands and feet, such as by rubbing your hands together or clenching and unclenching your fists.
• Always check the temperature of the water before you put your hands or feet in it to prevent thermal shock.
• Keep your hands and feet clean, and trim your nails straight across to help prevent injuries.
• Wear socks made of soft cotton to help prevent skin irritation.
• Avoid walking around barefoot. Choose shoes that have some extra room and don't have pointed toes to avoid squeezing your feet.
• Use an electric razor when you shave to reduce the risk of cuts.
• Avoid cold temperatures and make sure to keep warm when you go outside in the winter.
• Be careful about driving or operating machinery.

Resuming sexual activity is a normal and important part of the recovery process after chemotherapy.

Depending on the specific chemotherapy drugs used, there might be a temporary decrease in the production of sex hormones. The cancer itself or the side effects of treatment can also lead to a lower sex drive and reduced sexual function. However, these issues can be deeply influenced by your emotional state, and understanding and support from your partner can help manage them.

Chemotherapy drugs can potentially cause genetic abnormalities in sperm and fetuses, as well as infertility, so it's recommended to use contraception during treatment. Men who are undergoing chemotherapy should use condoms during sex to prevent their female partners from being exposed to the chemotherapy drugs.

• ①

  For males

  Chemotherapy can have an impact on sperm production, leading to a decrease in both the number and movement of sperm cells. This can result in a lower sperm count within 2-3 months of starting treatment. However, this is usually a temporary effect, and in most cases, sperm count returns to normal within about 3 months after treatment ends. If you're considering having children in the future, it's important to discuss this with your healthcare team. You might want to consider options like sperm banking or planning to try for a pregnancy at least 6 months after your chemotherapy is completed.

  • Potential Effects After Chemotherapy You might experience fatigue, depression, stress, a decreased sex drive, difficulty getting or maintaining an erection, trouble with ejaculation or orgasm, or decreased sensitivity in your erogenous zones.
• ②

  For females

  After starting treatment, you may notice that your menstrual cycle becomes irregular or even stops altogether. While this is usually temporary, in some cases, it can take months or even years for your menstrual cycle to return to normal after treatment ends. In severe cases, this could lead to early menopause. If you enter menopause, you might experience a rapid increase in bone loss due to a lack of estrogen, which could lead to osteoporosis. It's important to talk to your healthcare team about this, as you might need to consider estrogen replacement therapy.

  • Potential Effects After Chemotherapy You might experience fatigue, depression, stress, a decreased sex drive, pain or bleeding during sex, dryness and inflammation of the vaginal lining, difficulty reaching orgasm, or decreased sensitivity in your erogenous zones.

Before you start having sex again, it's important to give yourself time to readjust to life at home after a long hospital stay. After going through intense treatment, you might find that you get tired easily. As the stress and emotional strain of dealing with your illness decrease, your interest in sex is likely to return naturally.

You can safely resume sexual activity when your platelet count is at least 60,000-70,000/mm³ and there's no risk of getting an infection from your partner. That's why it's important to keep your environment clean. Using a suitable lubricant can help prevent irritation, bleeding, or infection. Women might notice changes in their natural vaginal lubrication because of the effects of chemotherapy, so using a water-based or hypoallergenic lubricant can be helpful. If you notice any unusual symptoms like genital discharge, burning sensations, odor, or itching after having sex, you should talk to your healthcare team.