1. Cancer Medications in the Home Cancer Medications in the Home 1

2. Cancer Medications & Teamwork ● Health providers play a role ● Increased use of cancer medications at home ● Patient’s role is expanding Healthcare team + Patient = Improved Patient Outcome

3. Medications to Treat Cancer ● Cytotoxic Chemotherapy ● Hormonal Agents ● Immunotherapy ● Targeted therapies

4. Supportive Care Medications ● Prevent nausea ● Prevent reactions from IV drugs ● Prevent diarrhea or constipation ● Increase white blood cells ● Treat blood clots ● Example: steroids, antibiotics

5. Cancer Treatment Goals ● Neo-adjuvant: Shrink cancer before surgery ● Adjuvant: Reduce chance of cancer coming back after surgery ● Metastatic: Shrink or control cancer growth (palliative)

6. Cancer Treatment Plans ● Treatment plans (regimens) – combination of cancer meds (oral and IV) plus supportive care meds ● Treatment Cycles o time period medications are given o counted in days – treatment occurs on day 1 o Usually dispensed one cycle at a time to increase safety 6

7. Cancer Treatment Plans May include oral cancer meds, IV cancer meds or both. May include radiation therapy Radiation may be given before, after or during medication

8. Unwanted (Adverse) Effects ● Cytotoxic drugs o Drop in white blood cells/platelets o Sick to stomach, vomit, diarrhea o Hair loss ● Targeted therapies o Skin rashes, sensitivity to sun, diarrhea, changes in blood pressure or heart function ● Hormone or Immunotherapies o Side effects are specific to process in body affected

9. How can you help? ● Know signs (symptoms) of cancer versus unwanted effects of medications ● Write down symptoms you have ● Ask how to identify which symptoms require immediate medical attention ● Tell provider about symptoms, unwanted effects ● Tell your provider about missed doses ● Talk about if your treatment needs changing

10. True or False? 1. Oral cancer medications have less side effects than injected (IV) medications. 2. Oral cancer medications are safer to take than IV medications.

11. Drug Interactions ● “Patient Story” ● Drug interactions may occur with any medication: prescription, over the counter, vitamins & minerals, herbal or natural products, specific foods and alcohol ● Can be harmful and reduce effectiveness of treatment

12. You can prevent harm from drug interactions …here’s how You can prevent harm from drug interactions …here’s how ● Use the same pharmacy ● Keep a list of all medications-work with your pharmacists ● Share your list with all healthcare providers ● Read instructions on labels on all medication bottles ● Always read auxiliary labels and other handouts given

13. How can you prevent errors in your prescriptions? ● Know names of your meds - generic & brand ● Know what your tablets or capsules look like ● Spell your drug names for healthcare providers ● Check 5 Rs-right patient, right med, right dose, right time, right route ● If a medicine does not look or sound right-ASK the provider to check

14. Safety in YOUR Home Safety in YOUR Home Do not split or crush cancer medications Tell your pharmacist if you cannot swallow the drugs whole Store drugs in a secure place away from heat & moisture Store drugs out of reach of children and pets Take medications to a pharmacy for disposal

15. Safety in YOUR Home: Hazardous Medications ● Many cancer medications are “hazardous” o Can cause harm to healthy person o Limit exposure ● Ask if your medications are hazardous o Learn safe handling of medication o Learn safe clean up of body wastes

16. Safety in YOUR Home: Hazardous Medications ● Wear gloves when handling tablets or capsules o Wash hands after removing gloves ● Body waste is contaminated for about 48 hours after the last dose of medication is taken (IV or oral) o Wear gloves when cleaning up waste o Wash hands well o Close toilet lid and flush twice

17. Safety in YOUR Home: Hazardous Medications Safety in YOUR Home: Hazardous Medications ● If a spill occurs: o Use spill kit if provided o Wear gloves when cleaning up o Wash soiled clothes separately o Wash surfaces twice

18. Cancer Medications and Safety: What did we learn? YOU are part of the team YOU can help prevent errors Learn about your cancer and your treatment plan Know which medications you take and how Ask if there are extra safety precautions for your medication Ask if anything doesn’t look right

19. Where Can You Look for More Information? CancerCare Manitoba website www.cancercare.mb.ca CCMB Patient and Family Resource Center CCMB Pharmacy Department Ph: 204-787-1902

20. The Patient Journey If you or a loved one have a cancer diagnosis, there are things you can do to help.

21. The Patient Journey: What You Need to Know & Do 1. Confirmed Diagnosis & Treatment Plan Choose patient advocate to attend meetings Share your concerns & fears with your team Ask questions about your treatment choices Ask providers’ contact names & numbers Ask for information on your type of cancer Read up on your cancer & treatment choices

22. The Patient Journey: What You Need to Know & Do 2. First Follow Up Meeting ● Ask questions about: o How to safely take your meds at home o Possible side effects and what to do o Write down key content discussed o Ask if you do not understand o Repeat back key messages you heard

23. The Patient Journey: What You Need to Know & Do 3. Ongoing during your Journey Review your cancer meds and how to take safely at home Write a list of all your cancer meds Read how to take properly Ask questions if you are not sure Review possible side effects of cancer meds

24. The Patient Journey: What You Need to Know & Do 4. Self Monitor & Agree to Follow Plan Review possible side effects of cancer meds Write in a journal your cancer symptoms and any side effects of cancer medications Write any problems you are having Share this info with your provider Ask questions Use aids such as reminder notes to help you

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