What to Expect

A Guide to Outpatient
Cancer Infusion Therapy
at the University of Michigan

We will refer to this booklet often.

Please bring it to your appointments.

A Guide to Chemotherapy
This Guide Contains:

On Page:

What is Chemotherapy
About Clinical Trials

5
5

Preparing for Chemotherapy

How Should I Prepare?

Learn About Chemotherapy

Develop a Flexible Plan
Schedule a Pretreatment Dental Visit
Take Care of You

Frequently Asked Questions

Should I Eat before Treatment?
How Long Will I Be There?
What Should I Bring?
Can I Drive?
Can I Bring My Family with Me?
Is Food Available?
Where Can I Fill My Prescriptions?
Will My Insurance Cover It?

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Chemotherapy Treatment Day

Infusion Chemotherapy
Where Will I Receive My Treatment?
Where Do I Park?
Where Do I Report and Check-In?
What Happens During Infusion Treatment?

Continuous Infusion Chemotherapy (Pumps)

What Does a Continuous Infusion Involve?
Where Will I Receive My Pump Infusion?
How Long Will I Be There?

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After Chemotherapy Treatment

What Can I Expect?
When Should I Contact My Doctor?
Precautions after Chemotherapy
Facing Forward after Chemotherapy

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Resources
University of Michigan Blood Drawing Facilities
Maps
Important Phone Numbers
How to Call Your Doctor

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32-39
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8 Must Know Facts:

These are the facts that are most important for your infusion
preparation. These and other helpful information can be
found in this booklet.

1. Plan to spend most of the day in the center for your

first visit.

2. You must have a driver for your first chemotherapy

visit.

3. Only one adult visitor is allowed with you in the infusion

area.

4. No children are allowed in the area.

5. Eat lightly..Do not skip meals prior to your infusion.
6. See a dentist before you begin chemotherapy.
7. Try a stress reducing activity before chemotherapy,
plan to continue this activity throughout your
cancer treatment.

8. Be safewear sensible shoes and loose, comfortable

clothing.

Staff of the following programs provided information for this handbook:

Cancer Patient Education, Medical Oncology, Oncology Nursing, and the
Patient & Family Support Services Program
3

Welcome
This guide provides answers to many common questions about chemotherapy
treatment; offering ideas to prepare for treatment and describing what it will be
like. It also contains suggestions to help you care for yourself during treatment.
Our goal at the University of Michigan Comprehensive Cancer Center is to
provide our patients and families with the highest quality care. This includes
administering the necessary treatments as well as providing the education and
support needed throughout these treatments.
This booklet should be used in combination with the Chemotherapy and You
booklet produced by the National Cancer Institute. This booklet is your main
resource for information about chemotherapy, managing its side effects and
understanding how to prevent them. It is very important to use this book as a
resource throughout your chemotherapy treatment course. Copies of this
booklet and other educational materials can be found at the Patient Education
Resource Center (called the PERC) on level B1 of the Cancer Center.
Your health care team will
also provide you with verbal
and written instructions about
your chemotherapy
treatment. You should refer
to these materials for
information about your
specific treatment plan.

What is Chemotherapy?
Chemotherapy (chemo) is the treatment of cancer with drugs that can destroy
cancer cells. These drugs often are called "anticancer" drugs. Most people
dont know that cancer chemotherapy includes a variety of drugs that are
given in a variety of ways such as:

Drugs that are given into the bloodstream through an IV (called

intravenous chemotherapy). These drugs can be given over minutes or
hours called an infusion.

Drugs are also given slowly and continuously over several days using a
pump. This is called a continuous infusion.

Drugs that are taken by mouth as pills or liquids (called oral

chemotherapy)

Drugs that are placed directly into a body area (called intracavitary
chemotherapy)

Drugs that are placed on the skin as creams

This booklet will focus on all cancer infusion treatments (including continuous
infusion treatments) at the University of Michigan. Information regarding the
other types of chemotherapy treatment will be given to you by your health care
team.

This is a good place to stop and review the section called Questions and
Answers About Chemotherapy in Chemotherapy and You (page 1).

About Clinical Trials

Your doctor may suggest that you consider participating in a clinical trial (also
called a research study or protocol).

Clinical trials are used to test and develop new treatments. The goal of these
trials is to find ways to improve treatment. While a trial or study is active or
In progress we will not know whether any potential benefit has been found.
The trial must be closed and the data analyzed before the treatment is made
widely available to patients.
There may be some additional risks associated with research. Your doctor will
discuss in detail with you both the potential risks and benefits of joining the trial.
Your written permission will be given before you can start on a clinical trial.
Oversight committees at the University of Michigan Medical Center conduct an
extensive review of all clinical trials. These committees include an Institutional
Review Board or IRB composed of other cancer doctors, doctors in other
specialties and lay people.

The IRB reviews all clinical trials before they are

available to patients and again at different times during the research.

This

ensures that the clinical trial remains safe for patients.

All patients who are on a clinical trial receive the best supportive care possible.
Their reactions to the treatment are watched closely. A doctor can stop the
treatment if it does not seem to be working. The patient may choose to leave
the study at any time. If a patient leaves a study for any reason, standard care
will be started.
Clinical trials are voluntary. Your cancer will be treated whether you decide to
join a trial or not. Talk to your doctor about any questions you have regarding
clinical trials at the University of Michigan Comprehensive Cancer Center.

Preparing for Chemotherapy

Getting ready for chemotherapy can be scary. Patients often experience many
different feelings. We offer these 4 ways to best prepare you for chemotherapy
treatment. You will be called by a cancer nurse educator in the Cancer Skills
Lab prior to treatment. The nurse will review your chemotherapy education and
is available to answer questions you may have before treatment. An
appointment can be made at no charge Monday through Friday from 8am to
4pm by calling (734) 232-6366.

4 ways to prepare for chemotherapy:

#1

Learn about chemotherapy

To understand what chemotherapy is, how it is administered and what side

effects may occur during or after your treatment, read the booklet
Chemotherapy and You before your treatment begins. This booklet provides
information that will be used before, during and after treatment.

As you review

this material, write down your questions in the area at the end of this booklet.
Bring this booklet with your questions to your clinic appointment and discuss
them with a member of your treatment team.
It is helpful to look at the chemotherapy educational material given to you
before you receive your first treatment. This includes items for clinical trials such
as an informed consent, drug information sheets, nutrition information and more!
This can be a lot to review, so it might be helpful to choose an information
gatherer. This is someone who will read the information and let you know what
you need to know, when you need to know it.

#2

Develop a flexible plan

Chemotherapy is given in separate sessions over one or more days. These

sessions are grouped together and called a cycle. Each grouping or cycle
of chemotherapy is repeated several times with a gap of time in-between. The
time between cycles of chemotherapy is usually two to three weeks, but will
vary according to the type of chemotherapy.
Your doctor will review the usual schedule for your chemotherapy. However,
chemotherapy schedules change often during a cycle for a number of reasons.
Thus, you will need to be flexible about your schedule in advance. Make room
for treatment delays, changes in start/stop date, etc.

#3

Schedule a pretreatment dental checkup if timing allows

The mouth can be a source of infection during some types of chemotherapy

treatment. For this reason, it is helpful to have a checkup before you begin
treatment if you have not had one in the last 6 months. If a dental check-up is
not possible before your treatment begins, discuss this with your cancer doctor.
This is a good time to review the mouth care section in the Chemotherapy and
You booklet. You can find it on pages 35-37. Follow the instructions for mouth
rinses that are described in this section.

#4

Take care of YOU

Treatment can be a stressful time for you and for those around you. It is
important that you focus on your needs during this time. The following is a list of
suggestions to help you:

9 Ask for Help

Select someone close to you to help organize help for the chores and
activities you would normally do. Learning to accept help from others can
be difficult, but may be necessary. If you can learn to let others

helptheyll be happy doing it, and youll be happy to have things done!

9 Reduce Stress

Techniques for Stress Reduction

Identify one or two ways to reduce

stress and relax. Practice them
before your treatment begins. Plan
to use these techniques on the day
of treatment.

9 Be Comfortable
Plan to be comfortable during your
infusion chemotherapy
appointment. Most patients like to
wear loose, comfortable clothing.

These are a few suggested activities.

Every patient is different and will find help
in different ways.
If an activity doesnt help, try another.

Deep Breathing Exercises

Biofeedback
Guided Imagery
Distraction: Music, Art, Hobbies
Journaling

Visit the Patient Education Resource

Center on level B1 of the Cancer Center
for information on these programs at the
University of Michigan or visit our website
@ www.mcancer.org

Also, you may need to roll-up your

sleeves. Wear clothing that allows you to do this.

9 Dress for Safety

Patients receiving infusion chemotherapy may experience sedation or
other symptoms that place them at risk for falling. We are committed to
keeping you safe in the chemotherapy infusion areas. Please help us by
wearing sensible, stable shoes like athletic shoes or slip-resistant socks.

Have a thermometer
in your house.
and be able to read it
easily.

9 Gather Supplies
Stock up on items you may need
after treatment such as dressing
supplies, medications, food and
beverages. All patients should also
have a thermometer in their house
and be able to read it.

Frequently Asked Questions

Should I eat before treatment?
Many patients worry about eating before their treatment. Please eat
according to your normal schedule, dont skip any meals and take your
medications as scheduled.
Infusion Chemotherapy:
You may find it best to eat a light meal and avoid fried, spicy, or acidic
foods prior to your treatment. Do NOT skip meals prior to treatment

unless your doctor tells you to.

Oral Chemotherapy: If you are taking chemotherapy by mouth, be sure to
ask your medical team if you should take it with food or not.

How long will I be there?

It is best to plan on spending most of the day at the center for your first
chemotherapy treatment. Some patients may have their treatment finished in
several hours, but this is difficult to predict. Once you have received the first
treatment, the staff will be better able to predict how long you should allow for
all future treatments.
Infusion Chemotherapy:
The length of infusion chemotherapy treatments

Your first
treatment
visit may last
a full day.

vary. This depends on the type of treatment you

will receive and how you receive it. In addition to the treatment itself,
additional time will be spent receiving anti-nausea medications,
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medications that prevent reactions, or hydrating fluids. You will also

spend time learning about your treatment, having your questions
answered and making plans for further treatments.
Chemotherapy medications are made after you have arrived and your
doctor has approved the infusion. Many patients will experience waiting
time while chemotherapy is prepared.
Continuous Infusion Chemotherapy:
Patients who receive continuous infusion chemotherapy through a pump
device will need additional time for their appointment. This additional
appointment time is used for the following activities:

learning how to manage the infusion pump at home,

identification of and referral to the home care agency that will

provide your care in the home, and

setting up the infusion pump and verifying its calibrations and

settings.

What should I bring?

Please bring the following items with you on the day of treatment:

Your insurance card

Your hospital registration (blue) card

The names and addresses of your referring physician and primary

care physician

A list of the herbs and supplements you are currently taking

A list of all medications you are currently taking

A designated driver if this is your first treatment.

Assistive devices such as canes or walkers that you use at home.

Your education folder

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These items are OPTIONAL to bring with you on the day of treatment:

A portable cassette player, iPod or compact disc player with

relaxing music

A small cooler with snacks, beverages or lunch for yourself

(a refrigerator and microwave oven are available)

The Cancer Center offers several programs for patients and families while in
the center that include:

A free wireless guest network for internet access. You must bring
your own computer with a wireless network card to access this
service.
iPod and iTouch loan program. These devices are offered to
patients and families for loan while in the center. You may check
these out at the Patient Education Resource Center at no cost. You
will be asked to leave your drivers license at the center while your
device is in use.

Can I drive?
Arrange for a driver for your first chemotherapy treatment. You may
receive medications that make it unsafe for you to drive.

The length of

treatment varies, making it difficult to anticipate a pick-up time after

your treatment. If your driver is not staying with you, it is best that they
are accessible and flexible about the time of pick-up. We will be happy
to call your driver 30 minutes before you are done with your treatment.

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Can I bring my family to the infusion area?

Due to space constraints and safety concerns, only 1 adult visitor may
accompany you to the infusion area. For their safety, children under 16
years of age are not allowed in the infusion area.

Is food available?
A small nourishment room is located within the infusion area. The refreshments
are available free of charge for patients and include juice, coffee, tea, milk and
crackers. We recommend patients bring a sack lunch and snacks for the day.
Two microwaves are available. Other food services are available throughout
the hospital.
Vending machines: Level 2 of the Cancer Center and Level B1 at the
east entrance to University Hospital. Available 24 hours / 7 days per week.
Vending is also available at the Infusion Center at Canton.
Coffee / Snack Stand: Level 2 of the Cancer Center on the bridge
connecting the center to University Hospital. Some seating is available.
Open Monday through Friday, 7 a.m. to 5 p.m.
Cafeteria: Level 2 of University Hospital. Available 24 hours a day, seven
days a week.
Einstein Bagels: Level 2 of University Hospital. Available Monday through
Friday, from 6:00 a.m. to 8:00 p.m. and weekends 6:00 a.m. to 3:00 p.m.

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Where can I fill my prescriptions?

Cancer Center Building: An outpatient pharmacy is located on the B1
level. Both prescription and non-prescription medications are dispensed
or sold here.
Hours: Monday through Friday: 9am to 5:30 pm
University Hospital (Taubman Building): An outpatient pharmacy is
located on level 1 of the Taubman clinic building, near the main
Information Desk. Both prescription and non-prescription medications are
dispensed or sold here.
Hours: Monday through Friday:
Saturday:

9am 6pm

9am 4pm

Canton Clinic: The Canton Infusion area does not have an outpatient
pharmacy onsite.

Will my health insurance cover chemotherapy treatment costs?

It is important to talk to your health insurance plan about what costs it will
pay for, BEFORE you begin chemotherapy treatment. The
Chemotherapy and You booklet offers questions to ask your health
insurance plan on page 7. The UM Cancer Center Billing and Customer
Service Office staff is available to discuss questions about chemotherapy
costs and billing. They can be reached at (734) 647-8663.
Information about financial assistance and counseling at the UM Cancer
Center can be found in the Patient & Family Support Services Handbook,
at the Patient Education Resource Center or online at www.mcancer.org.

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Treatment Day:
Infusion Chemotherapy
Where Will I Receive My Treatment?
Infusion chemotherapy is given in 3 infusion
areas within the medical center, on the
inpatient units and at the UM Canton
satellite clinic. The 3 areas within the
medical center include:
1. The infusion areas in the Cancer Center
building, (Level B1 of the Cancer Center)
2. The infusion area in the Med INN building, (Level 4 of the Med INN)
3. The infusion room on the Adult Inpatient Unit (8A unit of University Hospital).
The Cancer Center Infusion Area at Canton located in the Canton Health
Center. This is a satellite clinic within
the University of Michigan Health
System. It is located east of 1-275
and west of 1-94. A map is located
at the back of this handbook.
Specially trained and chemotherapy
certified nurses administer treatments
and care for patients receiving
treatment in each infusion area.

Where will I receive my

treatment at the Cancer Center?
The infusion room staff will decide
which of the infusion areas is best
suited for your type of treatment.
Patients are scheduled to arrive in the
Cancer Center for most
appointments, but may be
transported to the Med INN infusion
area or the 8A infusion area for
treatment.

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Where Do I Park?
Cancer Center Infusion Area AND Med INN Infusion Area:
Park in the cancer center parking lot, which is labeled Lot B. Remember
to bring your parking ticket to the infusion area with you for validation to
receive reduced parking rates.
8A Infusion Room at University Hospital:
Park in the University Hospital Parking area which is labeled Lot A.
Remember to bring your parking ticket to the infusion area with you for
validation to receive reduced parking rates.
Infusion at Canton Center
Enter the parking lot from Saltz Road. Follow the signs to infusion, park
near the main entrance to the building. There is no charge for parking at
this center.

Where Do I Report and Check-IN?

Cancer Center Infusion Area:
Enter the building on the ground or B2 level. The infusion area is one
floor up, Level B1 at reception area A.
If you are having blood drawn before your treatment, you should
proceed to the blood drawing area on level B2. Once the blood is
drawn, go up one level to B1 and check-in at reception area A.
If you have a doctors appointment on the same day as treatment, you
should check-in at your doctors clinic first. Once your doctor
appointment is completed, proceed to infusion check-in at reception
area A. Have your blue registration card ready and sign in at the checkin desk.
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8A Infusion Room University Hospital:

Enter the University Hospital building on level 1 or level 2. Follow signs to
the University Hospital East Elevators. Take the east elevators to the 8th
level and follow the signs to 8A. Once on the unit, proceed to the
window with the information sign above it.
Med Inn Infusion Area:
Enter the Cancer Center building on level B2 or the ground level.
Check in at the reception desk in the lobby. They will direct you to the
Med INN infusion area.
Infusion at Canton Center:
Refer to the map at the back of this book. The Canton Center Clinics are
located in Canton, Michigan at the intersection of Canton Center and
Saltz Roads. Enter the complex from Saltz Road, park in the designated
area and proceed through the main entrance doors. There is an
information desk and staff directly in front of you as you enter the building.
They will check you in for your appointment.

What happens during the infusion treatment?

Arranging to have your
blood work drawn the
day PRIOR to
chemotherapy will help
reduce time waiting for
results before treatment
can begin.
Blood drawing locations
are listed at the back of
this book.

Chemotherapy treatment is a complex process.

Your treatment will begin with your doctor, who
will evaluate your medical status and determine
if treatment is possible. This often happens the
same day as your scheduled treatment and
requires blood work.

Once your doctor

approves treatment, orders for the

chemotherapy and supportive care are sent to
the pharmacy for preparation.
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The chemotherapy preparation process can take several hours. During this time
you may take a pager from the infusion check-in staff and move around the
health center. The infusion staff will page you when your chemotherapy is
prepared.

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Continuous Infusion Chemotherapy

(Chemotherapy Pumps)

Chemotherapy that is given slowly over 1 or more days is called continuous

infusion chemotherapy. It is given with a pump device that you will carry with
you while the chemotherapy is infusing. Pumps are often attached to catheters
or ports. They control how much and how fast chemotherapy goes into the
catheter or port.

What does a continuous infusion involve?

Home Care
Continuous infusion chemotherapy is a home care treatment. You will be
followed by the University of Michigans HomeMed Program while receiving
continuous infusion treatment. The HomeMed staff arranges for supplies and
equipment, checks your insurance coverage and arranges to have your infusion
disconnected once it is completed.

All of these arrangements must be

coordinated before your chemotherapy treatment can begin.

Education
Patients receiving a continuous infusion are taught to care for their pump and
will manage and troubleshoot alarms or problems that may occur at home.
This may be overwhelming as you are also learning about chemotherapy
treatment in general. Our nurse educators in the Cancer Center Skills Lab will
work with you and your family; making sure you are comfortable with the pump
before your treatment begins.
We have found that patients experience less stress and are better able to care
for their pumps and themselves at home if they receive education PRIOR to the
day of treatment.

We will work with you and your doctor to arrange a

teaching session with the cancer nurse educators before the day of treatment.
This requires an additional visit for patients who dont have tests or other
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appointments scheduled before treatment.

You will receive a continuous

infusion pump training manual at this session. The manual contains information
specific to your pump and its alarms and settings, the supplies necessary,
changing batteries and when to call for help. The nurse educators will review
all of this information with you at the teaching appointment.
Coordination
There are many steps involved in providing chemotherapy with a pump at
home. Arrangements must be made with the home care agency, supplies
must be delivered, the pump must be calibrated and the chemotherapy
prepared specifically for pump infusion. Each of these steps is complicated
and involves different agencies and staff.
We understand that this process is complicated.

A U-M Cancer Center

continuous infusion coordinator will help you through the process and ensure
that it is as efficient as possible. Our coordinator will contact you to review your
infusion appointments and will schedule the teaching session as well. You may
contact the coordinator at (734) 647-8579, Monday through Friday, 8am to 4pm.

Where will I receive my chemotherapy pump treatment?

If you receive chemotherapy before your pump connection, the HomeMed
nurse will meet you in the infusion area. You will be connected to the pump
and the continuous infusion at the end of your chemotherapy treatment.
If you are receiving only a continuous infusion with a pump, the HomeMed
staff may arrange to meet you in the Skills lab. They will connect your pump
and begin your infusion in the Skills lab rather than in the cancer infusion area.
The Skills Lab is located on level 3 of the Med INN Building. Take the Med Inn
elevators to level 3 and follow the signs to your right.

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How long will I be there?

Patients who receive continuous infusion chemotherapy will need more time for
their appointment. This additional appointment time is used for the following
activities:

learning how to manage the infusion pump at home

identification and referral to the home care agency that will

provide your care in the home

setting up the infusion pump and verifying its calibrations and

settings

It is best to plan on spending most of the day at the center for your first
chemotherapy treatment. Some patients may have their treatment finished in
several hours, but this is difficult to predict. Once you have received the first
treatment, the staff will be better able to predict how long you should allow for
all following treatments.

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After Chemotherapy Treatment

Once your infusion is completed you will be sent home.

Your doctor will review

what is normal to experience after treatment when you discuss your

chemotherapy plan.

The Chemotherapy and You book is a valuable resource

during the time after chemotherapy. Refer to it for any questions and then
contact your health care team if you dont find answers. Your doctor and
nurses are available at the numbers on the back page of this book.

What can I expect?

It is normal to be worried about the possible
side effects of chemotherapy. These feelings
can be overwhelming before chemotherapy
begins. It is important to discuss your concerns
with your doctor. Remember that not all
patients experience side effects. In fact, many
people have few or no side effects from their
treatment. The severity and type of side effects
that occur will depend on the treatment you
are receiving.
Even though some side effects might be expected, you should always notify
your doctor if any side effects occur.
Review the Side Effects and Ways to Manage Them section of Chemotherapy
and You before you begin your treatment. You will find a detailed description of
some of the common side effects of chemotherapy, how to prevent them as
well as how to manage them. Your health care team will continue to provide
information to you as you progress through your treatments. Remember that

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each chemotherapy treatment is different, and every patient will face different
obstacles.

When should I contact my doctor?

Notify your doctor for the following:

Shaking chills or fever

(a temperature of 101 F or 38.3 C)
Notify your doctor immediately if you
develop a temperature, do not delay.

Notify your doctor or nurse if

you are experiencing a side
effect, even one that might
be expected. See the phone
numbers on the last page of
this book.

Unusual cough, sore throat, lung

congestion or shortness of breath

Burning discomfort when you urinate

Redness, pain or sores in your mouth

Nausea, vomiting or inability to eat or drink for more than 24 hours.

Diarrhea (loose, watery stools) for more than 24 hours.

Constipation (no bowel movement in 2-3 days)

Bleeding or unusual bruising

Pain not controlled by your current medications

Any new or unusual symptom that concerns you

For Pump Problems:

In general, you should contact HomeMed for any problems with your
pump, the chemotherapy itself or with your supplies. The HomeMed
Number is 1-800-862-2731.

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Precautions in the Home After Chemotherapy Treatment

Precautions need to be taken to protect you and your caregivers from
contacting the chemotherapy medicine. Chemotherapy leaves the body
through urine, vomit, blood and stool. Most chemotherapy medications will be
out of your body in less than 48 hours.
We have outlined general precautions that you should follow during your
infusion and for 2 days (48 hours) after your chemotherapy is done. In general,
these precautions help you avoid all body fluids that may contain
chemotherapy. Please talk to your health care team if you have questions
about chemotherapy precautions.
Hazardous Waste Container
Place a container in your home to hold soiled gloves, dressings and items such
as diapers that contain body wastes. The size of the container will vary by the
amount of supplies you are using.
Hazardous waste containers should be made of heavy, puncture-proof plastic,
have a lid and be marked Hazardous Waste for safety. Store it out of reach of
children.
Your local health department or public safety department can describe local
codes or ordinances regarding disposing of hazardous waste containers.
Regulations prohibit the UM from accepting your containers for disposal.
Laundry
Use gloves to handle laundry soiled with chemotherapy to keep it from
contacting your skin. Wash any soiled linen or clothes right away in your washer
with your regular soap. If you do not have a washer, place the soiled items in a
plastic bag until they can be washed.
waste container.

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Discard the gloves in the hazardous

Skin Care
Skin can become irritated from the chemotherapy. If you get chemotherapy or
body wastes on your skin, wash the area with soap and water, then dry. Call
your doctor if there is redness or irritation on the skin that lasts longer than one
hour.
Body Wastes
Small amounts of chemotherapy are present in urine, stool, and vomit. If you are
exposed to any body wastes, wash the area with soap and water. Others in your
household may use the same toilet as long as all waste is flushed down the toilet.
If you use a commode, bedpan, urinal or a basin for vomiting, wear gloves
when emptying the waste, rinse the container with water and clean it at least
once a day with soap and water.
If you do not have control of your bladder or bowels, use a disposable, plasticbacked pad, diaper or sheet to absorb urine and stool. When it becomes
soiled, change immediately and wash the skin with soap and water.
If you have an ostomy, wear gloves when emptying and changing the
appliance. Diapers, pads and gloves soiled with chemotherapy wastes should
be disposed of in the hazardous waste container.
If body wastes splash into your eyes, flush them immediately with water for 10 to
15 minutes and call your doctor.
Pregnant and/or Breast Feeding Caregivers
Pregnant or breast feeding women should wear gloves and gowns when caring
for patients receiving chemotherapy. This includes changing chemotherapy
bags, discarding wastes and cleaning body substances such as diapers and
baby spit.

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Sexual Activity and Pregnancy

You should not have sexual activity for 48 hours after receiving chemotherapy
because body fluids may contain chemotherapy.
It is very important that you or your partner not get pregnant while having
chemotherapy. You should use 2 forms of birth control to avoid pregnancy
while you are using this medicine and for at least 6 months after your treatment
ends. This is very important for both men and women. Notify your physician if
pregnancy occurs while you are receiving cancer treatment.

Antiseptic hand lotions or gels

can be better at killing germs.

Hand Washing
Hand washing is one of the most important
things you can do to prevent infection.
Wash your hands before and after the
following:

Eating

Preparing food

Going to the bathroom

Touching body fluids (yours and

They should NOT be used if your

hands are visibly soiled or have
body fluids (such as blood) on
them, use liquid soap and water
instead.
Off-brand hand gels can be less
expensive.

others) such as blowing your nose

Working with plants or soil

Using gloves for a task or procedure

Always check the label for the

gel or lotion to contain either
ethyl alcohol (ethanol),
normal propyl alcohol (n-propyl)
or isopropyl alcohol in
concentrations
between 60-90%.

Supplies:
Antibacterial soap or antiseptic lotion / gel that do not require water
Paper towel
Procedure for using antibacterial soap:
1. Wet your hands and wrists under running water.

26

2. Scrub vigorously with an antibacterial soap for 10 seconds. Work lather

between fingers, under nails, over palms and on backs of hands and wrists.
3. Rinse hands and wrists and dry with a clean

Singing one chorus of

paper towel.

Happy Birthday to You

while washing your

4. Turn off faucet with a paper towel.

hands. This usually takes

Procedure for using antiseptic lotions and gels:

about 10 seconds!

1. Place lotion or gel on the palm of your hand

2. Rub vigorously for 10 seconds. Work lotion or gel between fingers, under
nails, over palms and on backs of hands and wrists.
3. Let your hands air dry.

Facing Forward After Chemotherapy Treatment

The end of cancer treatment is often a time to rejoice. You are probably
relieved to be finished with the demands of treatment and are ready to put the
experience behind you. Yet at the same time, you may feel sad and worried. It's
common to be concerned about whether the cancer will come back and what
you should do after treatment.
When treatment ends, you may expect life to return to the way it was before
you were diagnosed with cancer. But it can take time to recover. You may have
permanent scars on your body, or you may not be able to do some things you
once did easily. Or you may even have emotional scars from going through so
much. You may find that others think of you differently now - or you may view
yourself in a different way.
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One of the hardest things after treatment is not knowing what happens next.
Many cancer survivors feel that they had lots of information and support during
their illness, once treatment stopped, they enter a whole new world - one filled
with new questions.
There are a number of resources available to help you once you complete your
chemotherapy treatment including:

The Facing Forward Program

This booklet, written by the National Cancer Institute is available to all
patients at the UM Cancer Center. If you dont receive one after your
infusion concludes, contact the Patient Education Resource Center on
Level B1 of the Cancer Center at (734) 647-8626.
Facing Forward is also offered as a one day session four times a year, with
speakers on topics described in the NCI booklet. This class is available at
no cost to UM patients and offers the opportunity to meet experts on
survivorship issues (such as workers rights, legal issues, managing health
concerns etc.). Information about future dates can be found online at
www.cancer.org or by calling the CancerAnswerline at 1-800-865-1125.

Patient Education Resource Center

The Patient Education Resource Center (or PERC) offers many resources
on issue after chemotherapy. The PERC is located on level B1 of the
Cancer Center and can be reached at (734) 647-8626. Hours of
operation are Monday through Friday, 9am until 4pm.

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Resources
There are many resources available to patients and their families at the
University of Michigan Comprehensive Cancer Center that will help you
throughout your treatment. These
resources can be found in the Patient
and Family Support Services
Handbook available in each clinic, at
the Patient Education Resource

Information about patient and

family resources can be found at
the Patient Education Resource
Center on Level B1 of the Cancer
Center or online at

Center and at our website.

www.mcancer.org

These services include:

Nutrition Services and the Nutrition Counseling Clinic

Managing Emotions and the PsychOncology Clinic

Financial Assistance Programs

Hair loss resources, community organizations and websites for hair loss
products

Information about chemotherapy, side effects and resources available at

the Patient Education Resource Center (PERC)

Information about the Facing Forward Program

Fertility Program

Some men and women who receive chemotherapy become infertile, which
means they are unable to have children. If you plan to have children, talk to
your doctor before your treatment begins. The UM Cancer Center has a Fertility
Counseling Program for cancer patients. Information about this program can
be found online at www.mcancer.org or by calling (734) 647-8626.

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University of Michigan Health System Blood Drawing

Facilities
These are the UM facilities that offer blood drawing services. Lab results drawn
at these facilities will be available to your cancer center physician within 24
hours. Directions can be found online at
http://www2.med.umich.edu/healthcenters/index.cfm . You may also find this
information at the Patient Education Resource Center on Level B1 of the Cancer
Center or by calling the CancerAnswerline at 1-800-865-1125

At the University of Michigan Hospital:

UM Cancer Center
1500 E. Medical Center Dr., Level B2
Ann Arbor, MI 48109
Phone: 734-647-8913
Hours: Monday Friday 7:00 am to 6:00 pm
UM Taubman Center/Level 2
1500 E. Medical Center Dr., Level 2
Ann Arbor, MI 48109
Phone: 734-936-6781
Hours: Monday Friday 8:30 am to 3:30 pm
UM Taubman Center/Level 3
1500 E. Medical Center Dr., Level 3
Ann Arbor, MI 48109
Phone: 734-936-6760
Hours: Monday 7:00 am to 8:00 pm &
Tuesday Friday 7:00 am to 6:00 pm

Ann Arbor Area:

Ann Arbor Briarwood Medical Group
375 Briarwood Circle, Bldg 3
Ann Arbor, MI 48108-0768
Lab Draw Phone: 734-998-0284 Fax: 734-998-5708
Hours: Monday - Friday 7:00 am to 5:30 pm
East Ann Arbor Health Center
4260 Plymouth Road
Ann Arbor, MI 48109-2701
Lab Draw Phone: 734-647-5685 Fax: 734-647-6457
Hours: Monday Thursday 7:00 am to 7:30 pm &
Friday 7:00 am to 5:30 pm & Saturday 8:00 am to 12:30 pm

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West Ann Arbor

Chelsea Health Center
14700 East Old US 12
Chelsea, MI 48118
Lab Draw Phone: 734-475-4483 or 734-475-4471
Fax: 734-433-4246
Hours: Monday Friday 8:00 am to 4:45 pm
West Ann Arbor Health Center
4900-A West Jackson Road
Ann Arbor, MI 48103
Lab Draw Phone: 734-998-7036 ex 226
Fax: 734-998-7370
Hours: Monday Friday 8:00 am to 4:00 pm

North of Ann Arbor

Brighton Health Center
8001 Challis Road
Brighton, MI 48116
Lab Draw Phone: 810-494-2648 Fax: 810-494-2645
Hours: Monday Thursday 7:00 am to 7:00 pm
Friday 7:00 am to 5:00 pm & Saturday 9:00 am to 12 noon

East of Ann Arbor

Canton Health Center
1051 N. Canton Center Road
Canton, MI 48187
Lab Draw Phone: 734-844-5280 Fax: 734-844-5288
Hours: MonThurs 7:30 am-7:30 pm; Fri 7:30 am-5:00 pm & Sat 8:30 am-12pm
Livonia Health Center
20321 Farmington Road
Livonia, MI 48152
Lab Draw Phone: 248-888-0893 ex. 254 Fax: 248-888-1390
Hours: Monday Friday 8:30 am to 4:30 pm

South of Ann Arbor

Ypsilanti Health Center
200 Arnet, Suite 200
Ypsilanti, MI 48198
Lab Draw Phone: 734-482-6221
Fax: 734-544-2262
Hours: Monday Friday 8:00 am to 4:30 pm

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Important Phone Numbers:

Area Code (734)

Fertility Counseling Program

763-4323

Finance and Billing Services

(Cancer Center)

647-8663

Home Med

1-800-862-2731

Infusion Appointments

647-8908

Infusion Centers

Call Main Number (647-8908) and

ask for the specific infusion area:
Cancer Center Infusion
Med INN Infusion
Canton Center Infusion

Skills Lab Appointments

647-8579

Nutrition Clinic Appointments

647-8902

PsychOncology Clinic Appointments

232-6366

UMHS Paging Operator

963-6267

This document is not intended to take the place of the care and attention of
your personal physician or other professional medical services.
Our aim is to promote active participation in your care and treatment
by providing information and education.
Questions about individual health concerns or specific treatment options
should be discussed with your physician.
2008 The Regents of the University of Michigan
Document # 00063/ Revised 10/08

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How to Contact Your Doctor

Monday through Friday (8am to 5pm):
Call (734) _______________________
After hours, weekends and holidays:
Call the page operator at (734) 936-6267 and
ask to speak to the following physician:
U Hematology/Oncology Physician on Call
U Gynecologic /Oncology Physician on Call
U Bone Marrow Transplant Physician on Call
S Neurologist on Call
U Other:

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