Frequently Asked Questions About Oncological Treatment

We understand that starting cancer treatment can bring many questions and concerns. Below, you will find answers to some of the most commonly asked questions about the oncological treatment process.

What is Adjuvant (Preventive) Chemotherapy in Colon Cancer?

Adjuvant chemotherapy is a type of chemotherapy given to patients after the surgical removal of the tumor to eliminate microscopic remnants that are not visible to the eye.

  • In colon cancer, adjuvant chemotherapy generally does not cause significant hair loss.
  • It may be administered in the form of tablets, tablets plus intravenous infusions, or entirely through intravenous infusions.
  • The treatment duration can be either 3 or 6 months.
  • The specific treatment plan and its duration are determined based on the characteristics of the patient and the tumor.
  • Important criteria for determining chemotherapy include whether the tumor has spread to lymph nodes, the patient’s overall condition, and whether the disease has spread to other parts of the body.

Does Every Patient Need to Receive Adjuvant Chemotherapy?

Not every patient necessarily requires adjuvant chemotherapy. It is not administered in cases of very early-stage disease or if the tumor is not expected to benefit from the treatment.

Can Adjuvant Chemotherapy Be Administered at Any Time?

No. Adjuvant chemotherapy should ideally begin within 6–8 weeks after colorectal surgery. Starting it later may reduce its effectiveness. Also, the patient’s blood values and general health must be suitable before beginning chemotherapy.

What Are the Side Effects of Adjuvant Chemotherapy in Colon Cancer?

Adjuvant chemotherapy in colon cancer usually does not cause severe nausea or vomiting. However, individual reactions may vary. Anti-nausea medication is provided before and after treatment.

If nausea or vomiting occurs, receiving IV fluids at the emergency room or a nearby hospital can prevent dehydration.

Other side effects may include diarrhea, mouth sores, or fever. If bowel movements exceed three times a day, it is important to seek emergency care immediately. Diarrhea can lead to life-threatening fluid and salt loss, so if oral intake is insufficient, intravenous fluids should be given.

If chemotherapy is administered orally, it may cause dryness or cracking in the hands and feet. Applying moisturizing cream daily or every other day can help prevent this.

Fever is the most feared side effect in patients receiving chemotherapy.
Even a single fever above 38°C (100.4°F) requires an immediate visit to the emergency department, even if the fever later subsides. This is not just to reduce the fever but to allow blood tests to be done and start antibiotics if necessary.

Another important side effect, especially in patients receiving intravenous chemotherapy containing oxaliplatin, is cold sensitivity. If oxaliplatin is used, patients should avoid:

  • Drinking cold water
  • Touching cold metal or iron
  • Standing in front of a refrigerator
  • Washing hands with cold water

Exposure to cold can cause numbness, tingling, or an electric shock-like sensation. This is usually temporary and varies by exposure level.

These side effects do not occur in all patients. Many complete chemotherapy with minimal or no side effects. By following hygiene and infection prevention measures, patients can minimize side effects.

What Are Targeted (Smart) Drugs? Are They Necessary for All Colon Cancer Patients? Who Can Receive Them?

Targeted therapies (smart drugs) are medications that act by binding to the tumor. If there is no tumor (i.e., post-surgical period), they are generally not needed. Therefore, they are not routinely used after the complete surgical removal of the tumor.

Targeted therapies used in colon cancer are administered intravenously alongside chemotherapy. Some are only used if certain tests indicate suitability; others may be used without testing.

Generally, targeted therapies do not cause nausea, vomiting, or hair loss. However, side effects may occur due to the chemotherapy they’re combined with. These may include skin rashes, high blood pressure, or less commonly, clotting or bleeding issues.

Skin side effects, such as acne-like rashes, often occur on the back, chest, and face. More severe rashes are often associated with better response to the medication, although the absence of a rash does not mean the drug is ineffective. Special creams or antibiotics may be prescribed by your doctor for these rashes.

What Are CA Tests? Do They Indicate Cancer?

CA tests (CA 19.9, CA 125, CA 15.3, CA 72.4) are blood tests used in the follow-up of patients already diagnosed with cancer. They may be elevated in certain types of cancer but are not always elevated in every cancer type.

What if I Have Cancer But My CA Tests Are Normal?

It’s possible to have cancer with normal CA levels. These markers are mainly used for monitoring certain cancer types and may not be elevated in every patient.

What if My CA Tests Are High But I’m Not Diagnosed With Cancer?

CA tests are not recommended for cancer screening in healthy individuals. High levels can occur in non-cancerous conditions. However, if a healthy individual has high CA values, a general medical examination and additional tests (e.g., colonoscopy if constipation is a complaint) may be warranted. Family history of cancer should also be evaluated.

Immunotherapy in Colon Cancer

Immunotherapy works by activating the immune system against cancer cells. In colon cancer with widespread disease, immunotherapy is only effective for patients with certain results on the MSI (Microsatellite Instability) test. Therefore, not all colon cancer patients benefit from immunotherapy. If the test indicates instability, immunotherapy may be a treatment option.

Immunotherapy does not cause hair loss and nausea/vomiting is uncommon. However, it can have side effects on the lungs, brainstem, and intestines.

What Is a Port Catheter (Artificial Vein)?

A port catheter is an artificial vein implanted under the skin beneath the collarbone. It is used for long-term IV chemotherapy administration without hospitalization. It allows repeated chemotherapy without the need to find a vein each time and can remain in place for years.

Though rare, complications such as infections at the insertion site or air leakage into the chest cavity can occur. These are treatable, and in some cases, the port may need to be removed. However, its benefits far outweigh the risks.

After each use, a blood thinner should be injected into the port to prevent blockage.

Exercise and Colon Cancer

Weight gain negatively affects the progression of colon cancer. Therefore, diet and exercise are important. At least 3 days a week, 30–40 minutes of moderate walking is recommended. During cold seasons, even walking inside the house is beneficial.

Can I Keep Pets During Chemotherapy?

Pets are companions and bring emotional support. Many patients have pets. While pets can pose a risk for infections, with proper hygiene and without close physical contact (no hugging or kissing), keeping pets during chemotherapy is generally safe. Always consult your doctor about this.

Can I Drink Alcohol During Chemotherapy?

Alcohol is not recommended during chemotherapy.

Can I Get a Fever During Chemotherapy? How Can I Prevent It?

Yes, fever can occur. To prevent infection-related fever:

  • Avoid people with colds or flu
  • Do not greet with kisses or handshakes
  • Wash your hands after using the toilet and before meals
  • Wash fruits and vegetables thoroughly; soak vegetables in vinegar water
  • Do not eat unpeeled fruits like apples
  • Avoid high-risk foods like raw meat dishes; eat home-cooked hygienic meals
  • Shower every other day and maintain body hygiene
  • Brush your teeth daily with a soft toothbrush
  • Clean dentures with mouthwash or salt/baking soda solution
  • Wear a mask in crowded areas and replace it daily

Can I Continue My Regular Medications During Chemotherapy?

Yes, but only with your doctor’s guidance. Chronic medications (e.g., for blood pressure, diabetes, or heart disease) can usually be continued.

Does Chemotherapy Harm Children Around the Patient?

No, chemotherapy does not harm others, including children. However, children may carry infections from school or daycare, so the patient should avoid close contact such as hugging or kissing.

Should I Only Rest During Chemotherapy?

Absolutely not. Moderate exercise (like walking 3–4 times per week) in clean, uncrowded environments helps maintain strength.

What Precautions Should I Take During Chemotherapy?

  • Use a mask in closed public areas, especially during outbreaks
  • Avoid eating food prepared outside the home
  • Wash hands frequently
  • Avoid close physical contact (shaking hands, hugging)
  • Drink plenty of water to help eliminate drugs through the kidneys
    • If plain water is hard to drink, add lemon, cinnamon, or fruit slices for flavor
  • Avoid being sedentary; even light movement at home is beneficial
  • Fever (38°C or higher) requires immediate medical attention, even if it resolves
  • Diarrhea (more than 2–3 times/day) also requires emergency care
    • Mild cases may benefit from mashed bananas, potatoes, or grated apple
    • Always check with your doctor before dietary changes

Avoid cold exposure after receiving oxaliplatin (e.g., cold drinks, touching cold metal, opening the fridge, washing with cold water) to prevent nerve symptoms.

Avoid nettle tea, grapefruit, and pomegranate due to drug interactions.

Anti-nausea medications may cause constipation, so stay hydrated and active.