My First Experience with Chemotheraphy Dacarbazine

I arrived in the National Cancer Centre, JPMC at 8 15 am and seeing the doctor before starting my chemotheraphy. I am the fourth patient on the list . The Nurses is aware that my weight had been dropping far and asked about my appetite, I am happy because they are alert of it. Not just taking Blood pressure and weight every of my visit to the Oncology Department. Then, while waiting, I was ask to select the menu that i can eat for thebreakfast and as a Chinese patient, off vourse i choose the chicken porridge with soya sauce and slice of onion leaf.

In the Daycare oncology unit, the Nurse there is very good and friendly, i can said .. they are brilliant and very careful. I was introduced to my personal nurse and  was given a good orientation of the place. And i was being told and explained about all the medications and course of the treatment. This is the real Nursing Care to the patient. I said that because I am also a Nurse and i had encountered many 'lazy' or 'working just to take salary' Nurses every where i go. This kind of care is really skillful and care for the patient. Thump UP the Daycare Nurse.

While I was on treatment, they do Cannulation and they managed to do only 1 (one) time. Before starting the treatment, even when do the flushing, i had already vomiting (2x) small amount. Then the nurse gave me the Pre-medication and after 30 minutes, they start the Dacarbazine IV. After that, I was less Nauseated but I asked the nurse to prepare the kidney dish ready just in case i re-vomiting again. But Well-done, i feels only on and off Nauseated but NO vomiting. What i experienced with Dacarbazine, is moderate to severe pain on the IV site. It make me weak and painful is the main complaint. Very-very lucky, the nurse offered and gave me hot compression which i found it is very helpful and did reduce my pain.

After 40 mins to 1 hour interval, I feels very unwell and I sweating and my vision went blurred and i feels very dizziness. Then i closed my eyes to rest and few minutes i regained my energy again. Then 1 nurse came to me and realised that my Blood pressure (BP) was dropping to : 70/38 .. and then they check manually which was around 86/48 and they informed the doctor. After few minutes, the doctor came to review me and observed my BP for a while and stay in the unit. He also asked me many questions and he ordered to do ECG on me. I can said... both the doctors and nurse is brilliant there.

Then, after my BP drop, they stopped it  for a while and put on normal saline only in faster rate to raise teh blood pressure but it it really unstable. Until 30 minutes later, my BP better and I restart the Dacarbazine back. That time, i was active talking to my Nurse in charge and the student nurse. My BP went up to around 130/80.. and then I finished my treatment. Well done..... to me.

Post Surgery

I had done my 4th surgery (Left  axillary lymph nodes dissection). I was admitted on the surgical ward on Thursday.. and went into the operating theater in the afternoon. It was not a long surgery only 2 to 3 hour. i could remember that, i was already vomiting the anesthetic out  when i was in the recovery room in the Theatre and I heard my collegue said.."Ping is vomiting.. suction please..." and i remembered that they changed my posiition to the right to do the suctioning but i was in the total drowsy state.


I wpke up at 4 30 pm and i vomited again. I heard my sister calling nurse and they gave me injection straight away. Next things i wake up.. around 7 20 pm, i was lying on the bed with my sister beside me and also my aunty Rose who came to visit me. i feel quite alright and i started to drink small plain water.. but i was thirsty... i asked my sister to make me a warm Milo. when she is not around going down stair, i drank much and no one is around me. Once again i vomited to the floor. Other patient family members was there and they had called nurse to help me.

The next morning.. i wake up at 2 am and also 4 am.. to see my colleague working and talked to them that early morning. They are busy. I just brushed my teeth and have my breakfast.when the doctor reviewed me.. at around 9 to 10 am.. my surgeon look at me eating.. talking and I was discharged.


One things surprised me... actually there are 2 surgery should be done..1. Left axillary 2. Left Neck... but the lymph node become disappeared during the operation. The surgeon asked me.. what happened? I said: Prayer and I took the Soursop daily. The swelling nodes as big as the Ping Pong ball size shrinking and become as big as 50 cent only. Overall.. the surgery is only small surgical procedures although it left scar...

Pre Surgery and Treatment

Hhhmm.. since I know my Melanoma metastasis and recurrent, I havent drop even 1 tear.. why? Am i weird? or what? Am i denial? Am i abnormal? I guess so.. I dont know. I just dont want to think about it. I know God had given me more strength to move on this life. The main reason why I dont cry is: I had mentally prepare and if i cry.. that is useless and cant change the situation. Eventhough if i dont get through... I will still be ready and I know... God is there for me... What i need now is .. to go through each treatment and Pray.. and mentally ready for the next fight.


Thank God.. my Bf had been so supportive in term of psychological and mentally although he is far now. It doesn;t really matter coz he had showed me His real person... which is not easy. I know that he is sad and he cried for me but I wil just always smile to him and never drop my tears again in front of him. I just pray that God will open and show him the right way and path..

Thank God too I havent got married till now or having any children. But I promised if I cure.. I will married in 2014... that is my promised to myself. In order to do that.. I need to fight till the end... and live my life with joy....." sadness.. hopeless and depressed is not a solution!!!!!!" and it only worsen situation.......

My Thought & Feelings and all Flashback Experiences

It had been long I havent put up my own ideas and thoughts and especially my own genuine feelings to this blog. I had my Surgery done twice in 2009 (No: 2 and 3). And it cure very well. I had regular appointment and never missed to see my Surgeon and the Oncologist since then. I had several CT scan done for survellaince for this 5 years before I can be categories as FREE from my Malignant Melanoma. I had my routine blood check up and everything was just fine. I am happy with my life.

Things had changed a bit since last Sunday [1st April 2012]; it's APRILFOOL day... my Left Lymph Node swell up... This is the first time in my life that my lymph node swell up very big and very painful. I took the Brufen  but with no effects at all. Monday Morning I went to see my nearby doctor, she had prescribed me with antibiotic and Brufen again. I took it with NO effect at all also. No reduced of swelling size in fact the swelling become bigger and pain me more. Tuesday.. also the same. Tuesday afternoon, my mom decided to use the SOURSOP and boiled it in 3 cup of water to make it into 1 cup MIX with chinese red sugar/ glucose. After 3 hour.. i can move my shoulder a bit and less pain. That day alone, i drank for 2 glass. The next day i wake up.. the lump had really reduced to half of its size.. WOW. it's so amazing although the pain and lump still there.

Today.. I go to see the surgeon after refix my appoinment. The surgeon said.. it is big and SCARRY! i told him.. it is even bigger than this on Monday. I showed him my last CT scan result which show 1.4 to 2.4 cm lymph node swelling in the left axillary.  He called up the Lab people and ordered FNAC biopsy to take up my cell in 2 parts... Left Neck and also Left axillary. Then the Female pathologist come.. and do the procedures and it re checked my breast [although already check by the surgeon].. she said something is lumpy at the Tail of the Left breast and dont know what is is. She asked for permission to take another sample of biopsy although not ordered by the surgeon. I agreed. Today.. I have 6 intrusive procedure of needle without Local aneatshesia apply to it. It was painful.. but I need to be strong for it.

Although the result is not yet confirmed... but I had prepared my mind for the worst case scenario of my diagnosis.. prognosis. And although I had to go through all the painful procedure again... i will have to be strong because I had my own reason and mission living in this world. I have my love one who are always there to support me and I know he loves me so much.. i need to be strong for him and my family too...

Just hope that, I will be strong and will write more...

Interferon (Roferon, Intron A)

 What interferon is

Interferon alpha is a man-made copy of a substance that some types of white blood cell make naturally in the body. The blood cells make interferon as part of the immune response, when the body reacts to infection or to cancer.
Interferon works in several ways. It interferes with cancer cells and stops them growing and multiplying. And it stimulates the immune system by encouraging killer T cells and other cells to attack cancer cells. It also encourages cancer cells to send out chemicals that attract the immune system cells to them.
Interferon is used to treat several different types of cancer, particularly renal cell (kidney) cancer, malignant melanoma, multiple myeloma and some types of leukaemia. It is also used to treat diseases other than cancer.
Interferon can only be given into the bloodstream or by injection. It is most often given by injection just under the skin (subcutaneously). How often you have it depends on what you are being treated for. It can be given daily, although it is most often given 3 times a week. If you are having interferon for some weeks or months, you can be taught to give the injection yourself at home. Or a family member can learn how to do it. You should keep your interferon in the fridge.

You should tell your doctor if you have

• Shingles or exposure to someone with chickenpox (interferon treatment may make this flare up)
• Heart disease

The side effects associated with interferon alpha are listed below. You can use the links (underlined) to find out more about each side effect. Where there is no link, the information in the chemotherapy side effects chemotherapy side effetssection may be helpful. Although interferon is not chemotherapy, the way you manage side effects may be similar. Or you can click on search at the top of the page.

Common side effects

With this drug, many people have a temporary drop in the number of blood cells made by the bone marrow, leading to the following side effects

• Increased risk of getting an infection from a drop in white blood cells - it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. 
• Tiredness and breathlessness due to a drop in red blood cells (anaemia) - you may need a blood transfusion
• Bruising more easily due to a drop in platelets - you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as Petechia

Some of these side effects can be life threatening, particularly infections.  You should contact your doctor if you have any of these side effects.  Your doctor will check your blood counts regularly to see how well your bone marrow is working
Other common side effects include

• Fatigue - patients say this is the most disruptive side effect of all. Tiredness often carries on after treatment has ended. Most people find their energy levels are back to normal from 6 months to a year after their treatment finishes.
• Flu-like symptoms: fever, chill, headache, aching muscles and joints. Nearly everyone taking interferon has this side effect at first. It usually gets better as your course of treatment continues. These symptoms usually begin 2 to 4 hours after your injection and last for about 12 hours. Take paracetamol before your injection and every 4 to 6 hours afterwards for as long as you need to. But don't take more than 8 tablets in 24 hours. You can try having your injection and paracetamol before you go to bed to see if that helps.
• Feeling or being sick - this happens to about half the people treated
• Diarrhoea Diarrhoea - you should drink plenty of fluids. If diarrhoea is severe or continues you could get dehydrated, so tell your doctor or nurse.
• Loss of appetite - may increase as your course of treatment goes on. You may also have taste changes or a metallic taste in your mouth
• Interferon may have a harmful effect on a baby developing in the womb. It is not advisable to become pregnant or father a child whilst taking this drug. You should discuss contraception with your doctor before having the treatment.

Occasional side effects

Some people have the following side effects

• A skin rash or itching at the injection site
• Hair thinningthis is more likely to happen with long courses or high doses of interferon
• Depression, confusion or extreme sleepiness. This is more common in older patients or people who have had depression before. Tell your doctor if you have these symptoms.
• Change in liver enzyme blood tests. This is usually very mild but your doctor may take regular blood tests to monitor for this.
• Heart problems. These are quite uncommon and nearly always get better when treatment is stopped. You should tell your doctor if you have had heart problems before.
• Loss of appetite
• Loss of fertility- you may not be able to get pregnant or father a child after treatment with this drug. It is important to talk to your doctor about your fertility before starting treatment. Women may stop having periods (amenorrhoea). This may only be temporary.

Important points to remember

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other drugs you are having

Some side effects are inconvenient or upsetting but not damaging to your health.
Some side effects are serious medical conditions and need treating. Where we have urged you to contact your doctor, this is because

• Your side effect may need treating
• Your drug dose may need reducing to try to prevent the side effect

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies - some drugs can react together.
Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse, clinic or ward nurse will have given you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Source taken from: Cancer research UK at URL : Cancer Research UK 

 

Masih menjalani rawatan dengan Intron-A November 2010

Sudah beberapa bulan saya menjalani rawatan dan harus di suntik dengan Intron-A ataupun Interferone alpha... rasanya sakit kerana saya harus suntik sebanyak 3 kali dalam 1 minggu.. dan rawatan ini harus di teruskan selama 1 tahun. Sakit kerana tajamnya jarum dan kesan sampingan dari ubat ini.

Selama saya menjalani rawatan ini, rambut saya bnyk yg luruh tapi ga semuanya dan rambut ku juga menjadi semakin nipis. Kadang, saya mengalami sakit di seluruh badanku dari atas, belakang dan terasa tulang-tulang ngilu akibat dari kesan sampingan Intron-A ini. Saya juga sering demam dan darahku harus sentiasa di ambil untuk di periksa di makmal. Tiap bulan, aku harus rajin mengambil darah dan harus rajin berjumpa dengan doktor ku di Oncology. Kadang, aku rasakan mual ataupun 'nauseated' dan aku juga rasakan kadang apa yang saya makan berubah rasa.

Sekarang adalah waktu yang membuat saya risau kerana Suntikan ku Interferon-A ga ada stock di seluruh Brunei dan pharmacy juga sedang berusaha mencari dan membawa stock Interferone-A ke Brunei. Kadang saya rasa malas dan seperti putus asa untuk meneruskan suntikan ini tapi ini adalah satu-satunya cara rawatan yang ada.. ga ada Pil, ga ada jenis serbuk, ga ada jenis cairan (liquid)... yang ada cuma suntikan yang menyakitkan. Seperti nya saya ga punya pilihan lain melainkan meneruskan suntikan ini.

Walaupun saya harus menjalani rawatan yang menyakitkan ini, kata doktor, ga ada Jaminan 100%  jika kanker ku tidak akan kambuh.. Tapi semuanya adalah berserah pada Tuhan saja. Kita manusia cuma dapat merancang tapi semuanya di Tangan-Nya. Semuanya tergantung cara kita berfikir.... dan cara kita menanggapi setiap persoalan yang kita hadapi.

Pengalaman menjalani rawatan di Singapore March 2010

Post ini di buat dan di tulis pada 9 Mac 2010.. tapi belum sempat aku mem-publish di blog ku... waktu aku di Hospital National University Singapore.

Sekali lagi aku terbang ke Singapora buat perubatan Kanker Melanoma ku. Walaupun kata dokter sudah di angkat tetapi menurut perubatan, aku tetap harus berubat lagi selama 1 tahun memakai Ubt yang di namakan Interferon-alpha.. Ubat aku ini di order dari United States of America dan khusus buat saya.

Aku sampai di Singapura tanggal 7 mac 2010 pagi… dari jam 3 petang di sini, aku demam, perut ku kembung dan jam 8 malam, aku muntah dan aku sakit secara fizik. Tapi kemudian sembuh sendiri dari jam 9 malam. Keesokannya, tanggal 8 Mac, 2010 aku ketemu dgn dokter dan darah ku di periksa semua. Aku sihat seperti biasa. Jam 6 petang, demam ku kembali sampai aku di periksa secara berulang dan di buat Chest X’ray lagi dan darah ku di ambil buat Culture & Sensitivity tapi hasilnya semuanya normal… malamnya aku normal lagi… Hari ini, tanggal 9 Mac 2010 aku demam lagi jam 3 petang.. sampai dokter nya bingung juga.. kerana hasil periksa ku semuanya normal.

Tanggal 8hb, FBC ku di check.. dan dokter kata mungkin aku thalaseamis trait dan tanggal 9hb, Iron panel di ambil lagi buat pengesahan sama ada aku thalaseamia trait… Pemeriksaan lain Di Pesakit Luar NUH, Singapore, TFT, LFT, dan calcium di check… Hasilnya, calcium ku rendah juga.. sepertinya semua yang ada badanku semuanya rendah dan kurang… kurang darah, kurang calcium… waktu aku masuk ke Pesakit dalam di First Class wad, aku di Swab H1N1 dan hasilnya juga normal… Malamnya, darahku di ambil lagi buat check Culture & Sensitivity, semuanya juga normal… sekarang dokter juga bingung kenapa aku demam terus.. aku Cuma doa semoga Tuhan yang menyembuhkanku…

Hidup dan tinggal di First Class Wad di NUH ini sangat selesa, semuanya di sediakan.. TV, Menu makan yang berubah setiap hari, Full Room function.. bahkan lebih mewah dari hotel di mana tempat ku tinggal… Perawat nya semuanya baik2 dan sangat ramah. Team rawatan Dokter dan perawat nya sangat baik efisien dan memenuhi standard Nursing dan Medical Care… Aku suka tinggal di sini..

Satu minggu tinggal full time di Ward sangat membosankan kerana aku sendirian di negeri yang asing… Kadang, aku menangis sendiri tapi, aku Cuma berdoa kepada Tuhan berikan aku kekuatan utk hadapi semua ini dan menjalani rawatan ku sehingga habis.

Tiap kali masuk interferon ke dalam badan ku, perawat dan incharge nya masuk ke kamar dan menjaga ku sepanjang interefrone berlangsung selama 2-3 jam. Masuk ubt interferon sangat melelahkan… Kesan nya membuatku sakit… aku menjadi lemah dan mudah jatuh, badanku tidak bertenaga, dan bahkan kalau aku jalan, harus memegang dinding dan pengerakkan ku menjadi lambat. Hampir tiap hari darah ku di ambil… dan di periksa. Sejak masuk interferone ini, aku menjadi hilang selera dan rambut ku juga banyak yang jatuh. Kesan lain yang aku alami adalah seperti seluruh badan ku sakit dan mudah sekali terjangkit kuman.

Saya cuma berharap semuanya akan cepat habis kerana aku tidak mau tinggal di sini lama2… dan pgn cepat pulang ke Brunei di mana ada keluarga, teman dan saudara… pulang ke lingkungan aku sendiri…

Intron A "Interferon Alpha-2b"

After the surgery and treatment in Singapore, now, I am receiving the treatment of Intron A and self-injection for 11 month. The side-effects is making me weak and hair loss. I am exhausted (physically) and have to drink plenty of fluid.

I need to regularly seeing my Oncologist (once every two weeks and blood test done prior to appointment). I had no choice and no alternative for other medication and the only treatment for my malignant melanoma is Intron A (Immunotheraphy).

Intron A® (interferon alfa-2b)

Generic name: Interferon alfa
Other trade name: Roferon-A^® (interferon alfa-2a)
Other names: Alpha interferon, IFN-alpha

Intron A and Roferon-A are trade names for Interferon alfa. IFN-alpha and Alpha interferon are other names for Interferon alfa. In some cases, health care professionals may use the trade names Intron A and Roferon-A or other names IFN-alpha and Alpha interferon when referring to the generic drug name Interferon alfa.

Drug type: Intron A is a "biologic response modifier." Intron A is classified as a "cytokine." (For more detail, see "How this drug works" section below).

What Intron A is used for:

• Approved for use in hairy cell leukemia, malignant melanoma, AIDS-related Kaposi's sarcoma, follicular non-Hodgkin's lymphoma.
• Other uses: Chronic myelogenous leukemia (CML), renal cell cancer, cervical cancer, carcinoid syndrome, medullary thyroid cancer, multiple myeloma, basal and squamous cell skin cancers, low-grade non-Hodgkin's lymphoma, cutaneous T-cell lymphoma (mycosis fungoides).
• Blood disorders such as: polycythemia vera, essential thrombocytopenia, thrombocytopenia purpura.

Note: If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.

How Intron A is given:

• By injection under the skin (subcutaneous, SubQ)
• By injection through a vein (intravenously, by IV)
• By injection into a muscle (intramuscular, IM)
• There is no pill form of interferon alfa
• Due to differences in dosage, you should not change brands of interferons. Discuss with your doctor or health care professional if there is a problem with supply.
• The amount of interferon alfa you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer you have. Your doctor will determine your dosage and schedule.

Side effects of Intron A:
Important things to remember about the side effects of Intron A:

• Most people do not experience all of the side effects listed
• Side effects are often predictable in terms of their onset and duration
• Side effects are almost always reversible and will go away after treatment is complete
• There are many options to help minimize or prevent side effects
• There is no relationship between the presence or severity of side effects and the effectiveness of the medication.
• The side effects of interferon alpha and their severity depend on how much of the drug is given. In other words, high doses may produce more severe side effects.

The following side effects are common (occurring in more than 30%) for patients taking Intron A:

• Early: (occurring after the first few doses)
  • Flu-like syndrome: Fever, chills, generalized aches and pains, headache, poor appetite. (Over time the intensity of these symptoms decreases depending on the dose, how it is given, and the schedule of administration).
• Later: (occurring beyond one week of therapy)
  • Fatigue
  • Low blood counts. Your white and red blood cells and platelets may temporarily decrease. This can put you at increased risk for infection, anemia and/or bleeding. Decreases are dose dependent.

Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.

Onset: 7-10 days
Nadir: 14 days, may be delayed 20-40 days in hairy cell leukemia
Recovery: 21 days

• Temporary blood test abnormalities: low calcium, high glucose, or high triglyceride levels.
• Increases in blood tests measuring liver function. These return to normal once treatment is discontinued (see liver problems).
• Weight loss
• Hair loss

These are less common side effects (occurring in 10-29%) for patients receiving Intron A:

• Early: (occurring after the first few doses)
  • Nausea and vomiting (usually mild).
  • Diarrhea (can be severe depending on dosage).
  • Low blood pressure (see blood pressure changes).
• Later: (occurring beyond one week of therapy)
  • Injection site reaction (redness, pain at site of injection)
  • Cough
  • Depression
  • Dry mouth
  • Skin rash (see skin reactions)
  • Dizziness, vertigo
  • Abdominal pain
  • Irritability (see anxiety)
  • Numbness or tingling of hands or feet
  • Sweating (see skin reactions)
  • Pain
  • Malaise (see flu-like symptoms)
  • Taste changes (metallic taste)
  • Constipation
  • Sore throat (see mouth sores)
  • Insomnia (see sleep disturbances)
  • Itching
  • Confusion, excessive sleepiness, memory loss - may occur at higher doses (see central neurotoxicity).
  • High blood pressure (see blood pressure changes)
  • Swelling of feet and ankles (edema)
  • Dry skin (see skin reactions)
  • Anxiety

Not all side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms:

• Shortness of breath, chest pain, rapid heart beat
• Depressed or have any thoughts of hurting yourself or others

The following symptoms require medical attention, but are not emergency situations. Contact your health care provider within 24 hours of noticing any of the following:

• Diarrhea (more than 4 to 6 episodes in a 24-hour period)
• Nausea that interferes with eating and is not relieved by prescribed medications
• Vomiting (more than 4 to 5 episodes within a 24-hour period)
• Unusual bleeding or bruising
• Black or tarry stools, or blood in your stools or urine
• Extreme fatigue (unable to perform self-care activities)
• Persistent fever (fever lasting/occurring beyond expected timeframe for dose and schedule).
• Anxiety, changes in thinking or mood, confusion, difficulty concentrating or trouble sleeping.
• Swelling of the feet or ankles, sudden weight gain

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

• Before starting interferon alpha treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.). Do not take aspirin, products containing aspirin unless your doctor specifically permits this.
• Do not receive any kind of immunization or vaccination without your doctor's approval while taking interferon alpha.
• Due to differences in dosage, you should not change brands of interferons. Discuss with your doctor or health care professional if there is a problem with supply.
• Interferon alfa may cause patients to develop mood or behavioral problems. Make sure to tell your doctor if you are being treated for a mental illness or had treatment in the past for any mental illness, including depression and suicidal behavior. You should also tell your doctor if you have ever been addicted to drugs or alcohol.
• Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category C (use in pregnancy only when benefit to the mother outweighs risk to the fetus).
• For both men and women: Do not conceive a child (get pregnant) while taking interferon alfa. Barrier methods of contraception, such as condoms, are recommended. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
• Do not breast feed while taking this medication.

Self-care tips:

• Drink at least two to three quarts of fluid every 24 hours (unless you are instructed otherwise), to keep yourself well hydrated throughout therapy.
• Wash your hands often.
• You may be at risk of infection so try to avoid crowds or people with colds or not feeling well, and report fever or any other signs of infection immediately to your health care provider.
• For flu-like symptoms, keep warm with blankets and drink plenty of liquids. There are medications that can help reduce the discomfort caused by chills.
• Acetaminophen or ibuprophen may help relieve discomfort from fever, headache and/or generalized aches and pains. However, be sure to talk with your doctor before taking it.
• To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
• Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
• In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
• You may experience drowsiness or dizziness; avoid driving or engaging in tasks that require alertness until your response to this drug is known.
• Conserve energy, try to get plenty of rest.
• Maintain good nutrition.
• If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and testing:

• You will be checked regularly by your healthcare professional while you are taking interferon alfa, to monitor side effects and check your response to therapy. Periodic blood work to monitor your complete blood count (CBC) as well as the function of other organs (such as your kidneys and liver) will also be ordered by your doctor.
• Your thyroid gland may also be affected by this medication. Your healthcare professional may order a blood test periodically to assess your thyroid function.

How Intron A works:
Interferon alfa belongs to the category of therapies called biologic response modifiers (BRM), also called immunotherapy. This is a type of treatment that mobilizes the body's immune system to fight cancer. The therapy mainly consists of stimulating the immune system to help it do its job more effectively.

Interferon alfa is part of a family of proteins called cytokines. Cytokines act primarily by communicating between the various cells of the body's immune system.

Interferon alfa interacts with receptors on the surface of cells. There are several ways that interferon alfa fights cancer; directly by interfering with the cancer cells ability to divide, and indirectly by modifying the bodies response to the cancer cells.

http://www.chemocare.com/bio/intron_a.asp