My Clinic Appointments

You will have appointments with your doctor while receiving chemotherapy, immunotherapy, or both. In this resource, we will use chemotherapy to refer to one or both treatments. How often you see your doctor depends on many things, including the type of chemotherapy you are getting.

During these appointments, you will be:

• checked by your doctor and nurse to make sure you are well enough to receive your chemotherapy
• given any prescriptions you may need
• given a schedule of appointments for your chemotherapy and other tests, if needed
• given information about your chemotherapy (such as treatment schedule, what to expect during treatment, and possible side effects)

We recommend you keep notes about your experience and feelings during the treatments. Before your clinic appointment, review your notes and make a list of questions or problems that you want to discuss with your doctor or clinic nurse.

Do I need a blood test before my chemotherapy?

Ask your health care team if you need a blood test before your treatment.

If you need a blood test:

• Have your blood test done 1 to 2 days before your chemotherapy appointment. This is to make sure we have enough time to review your test results and prepare your chemotherapy.
• Check your appointment schedule to know when you should have your blood test done.
• You can have your blood test done at Princess Margaret Cancer Centre’s Blood Lab on the main floor next to the Outpatient Pharmacy.
• You may be able to have your blood work done at a blood lab close to your home, such as LifeLabs. Ask your doctor or nurse for more information.

My Chemotherapy Appointment

How will my chemotherapy treatment be scheduled?

Your clinic nurse or doctor in the clinic will give you an appointment for your chemo treatment. Please do your best to get to your appointment on time. If you are running late for your appointment, please call the Systemic Therapy Reception Desk (see contact information on page 14).

You can check your appointment date and time, including any changes to your appointment, in MyUHN Patient Portal (see more information on page 11).

How long will my chemotherapy appointment be?

Chemotherapy treatments can last from 15 minutes to several hours. This depends on the type and amount of chemotherapy you are getting. Ask your doctor or nurse how long your treatment will be. In general, be prepared to spend the day at the hospital. If you expect someone to pick you up, allow some extra time for possible delays.

Arriving before your chemotherapy appointment time does not mean that you will start your treatment earlier. We do our best to stay on time, but delays can happen at the blood lab, at the pharmacy where the chemotherapy is prepared, or at the chemotherapy unit. We apologize for any delays in advance.

What should I bring to my appointment?

• Your government issued Health Card. Check that the information on your hospital card is up to date, and tell the receptionist if there are any changes to your information. Also bring private insurance information with you if you have any.
• Medications. For your first treatment, bring in all medicines that you are taking, or a list of them, including vitamins and herbal medicines. After your first treatment, you can bring only the medicines you may need to take while you are at the hospital, such as pain or anti-nausea medicines.
• Food. You may bring snacks and food to the unit. Water and ice machines and microwaves are available for you to use. Please do not bring microwave popcorn or other strong-smelling foods as this can make other patients nauseous.
• Entertainment. You can bring a book, puzzle (like Sudoko), iPad or laptop, and your own headset.

Can I bring a family member or friend into the treatment area?

For your first visit:

You may have 1 Essential Care Partner (ECP) with you into the treatment area. An ECP is a person who you consider to be an important support person while you are in the hospital. During your first visit, your nurse will go over important information about your treatment. Your ECP can help to remember some of the information later on.

For your remaining visits:

An ECP may accompany you if you have a special need (needing help with toileting or translating).

Due to space limitations in the treatment area, we ask that your ECP stays in the waiting area. A nurse will bring your ECP into the treatment area if you need their help. Your ECP can also leave a cell phone number so your nurse can contact them if needed.

For health and safety reasons, children under 12 years old are not allowed inside Princess Margaret.

You may bring a service dog if you need one.

For the latest information on hospital visiting rules, please call 416 946 2000 or read Visiting Patients on the UHN website.

What should I do before my chemotherapy begins?

Being prepared can help reduce your anxiety. Before your appointment, it is important for you to:

• rest well the night before and eat breakfast in the morning
• drink 6 to 8 glasses of fluid, and limit your caffeine (tea, coffee)
• take the pre-chemo medicine (such as anti-nausea or steroid) as instructed by your doctor or pharmacy. Some of these medicines must be taken a day or several days before your chemotherapy treatment
• prepare things that you want or need to bring (see “What should I bring with me to my appointment”)
• arrange to have someone to take you home, especially for your first visit
• check the latest information on the hospital visitation rules

What should I do when I arrive for my chemotherapy appointment?

The Systemic Therapy treatment area is located on the 4th floor of Princess Margaret Cancer Centre. When you arrive:

1. Take a ticket and wait for your number to be called.
2. When your number is called, go to the Reception desk. You will be given a hospital ID bracelet and a pager. Reception will page you once your medicine is ready and the treatment spot is available. You may also leave a cell phone number with the receptionist.
3. When your pager goes off, please return it to the Reception desk to find out which treatment pod (purple, orange, yellow and red) you need to go to.
   
4. Once you arrive in your treatment pod, a nurse will guide you to your treatment chair or bed.

When you check in, tell the receptionist if you have or have had:

• fever 38 degree Celsius (100.4 degree Fahrenheit) or higher
• chills (feeling of coldness and shivering)
• diarrhea (loose or watery poo) that doesn’t go away
• infection (such as shingles, tuberculosis, MRSA, VRE)
• new or worsening cough
• new or worsening headache
• shortness of breath, difficulty breathing or swallowing
• feeling unwell, dizzy or faint
• trouble walking, or having unexplained falls

You may need to see a nurse before starting your chemotherapy treatment.

If you were prescribed medicines to take before starting your chemotherapy, ask the receptionist what time you should take the medicines. Taking these medicines at the right time can help you tolerate the chemotherapy treatment better.

Can I leave the unit while I wait for my appointment?

Yes, you may leave the 4th floor Systemic Therapy area while waiting to be paged. Important: The pagers do not work outside of the hospital. If you leave the building, you may miss your page.

What is available to me while I wait for my appointment?

• Resource Centre – Computers with internet are available for patients and families to use on the 4th floor and in clinic waiting rooms in the hospital. You can also browse through a collection of health information pamphlets on many topics that can help you through your cancer journey.
  More materials are available in the Patient & Family Library located on the main floor in the atrium. See the end of this resource for more information about the Princess Margaret Patient & Family Library.
• Wireless Internet – Wireless internet is available to patients and visitors with their own laptop computers. To connect to the hospital internet, select “UHN Guest”. No password is required. Ask the receptionist if you need help.
• Microwaves – Microwaves are available for patients and families to use. Please do not bring microwave popcorn or other strong-smelling foods because strong smells can make other patients nauseous. Water and ice machines are available on each treatment pod.

You may use your cell phone in the waiting and treatment areas. Please be considerate of other patients and visitors. Limit the use of your cell phone to the treatment areas and turn your ringer to vibrate. Visitors are asked to leave the treatment area to use their cell phones.

What should I do after my chemotherapy treatment?

• Get some rest. It’s OK to ask for help if you need it.
• Eat when you can and stay hydrated. Talk to your health care team if you’re having difficulty eating or drinking enough fluid.
• Your doctor may order medicines for you to take at home. Ask your pharmacy about:
  • why do you need to take the medicine
  • when and how to take the medicine properly
  • what to do if you vomit or forget to take the medicine
  • if you need to handle or dispose the medicine in certain way
  • any food or medicines that you need to avoid while on chemotherapy
• Call the clinic triage line (your clinic nurse will give you the number) if you have pain that is not going away, swelling, or pus at or around your IV site.
• Keep track of any side effects or feelings that you experience in between your treatment. Review your diary before the next appointment with your oncologist (cancer doctor) and share any concerns that you may have.

Drug Coverage

It is important to know what kind of drug coverage you have as early as possible. Knowing your drug coverage options can help you plan ahead and prevent delays in your treatment.

A social worker or medication reimbursement specialist can help you understand your drug coverage options. You can call to book an appointment with a medication reimbursement specialist or a social worker if you need:

• help figuring out how coverage works
• advice on how to move forward with planning
• more information about patient assistance program

To book an appointment:

• Medication Reimbursement Specialist: Call 416 946 4501 extension 2830
• Social Worker: Ask your doctor or nurse for a referral or call the Department of Psychosocial Oncology at 416 946 4501 extension 4525 and ask to speak to a social worker

Private Insurance

Such as plan through work, your spouse or other family members.

Who to ask?

Your employer or the plan provider.

What to ask?

• If your prescription is covered?
• What percentage you will pay for each prescription, and if you have to pay upfront

What to bring to the pharmacy?

Show the pharmacist your drug card to fill your prescription.

Valid Drug Card

From Ontario Works, Home Care, or Ontario Disability Support Program

Who to ask?

A medication reimbursement specialist, social worker or pharmacist.

What to ask?

If your prescription is covered, how the plan pays the prescription cost and what you will pay for each prescription

What to bring to the pharmacy?

Show the pharmacist your valid drug card to fill your prescription.

No insurance at all

Who to ask?

A medication reimbursement specialist, social worker or pharmacist.

What to ask?

How to apply to the Trillium Drug Program, the details of coverage, and what will you pay for each prescription.

What to bring to the pharmacy?

Once you are approved, show the pharmacist your OHIP card to fill your prescription.

Coverage as a senior (65 years old or older)

Who to ask?

A pharmacist.

What to ask?

• When you qualify for coverage?
• If your prescription is covered
• What will you pay for each prescription

What to bring to the pharmacy?

Show the pharmacist your OHIP card to fill your prescription.

Resources and Services Available

This section has information about services both at and outside the Princess Margaret Cancer Centre that may be useful to you and your family while you are receiving chemotherapy.

• myUHN Patient Portal
  myUHN is a secure hospital website that allow you to see your appointments, test results and reports, and clinic notes about your treatment plan and progresses.
  To access myUHN, you will need a registration code that you can get from clinic receptionist or by calling myUHN Support line at 416 340 3777.
• Driving services
  The Driving Services to Medical Appointments pamphlet has more information about other driving services, both free and for a fee.
• Places to stay close to the Princess Margaret Cancer Centre
  For a list of rates and places to stay close to Princess Margaret, stop by the Patient and Family Library on the main floor and ask for the Accommodations List
• The Patient and Family Library
  Location: Main floor atrium, Princess Margaret Cancer Centre
  Phone: 416 946 4501 extension 5383
  The Patient and Family Library offers computer stations, books, brochures, DVDs, audio books and e-Books with reliable information about cancer, cancer treatments and care, support organizations and services, and much more. Trained staff and volunteers can help with your questions and help you to find information and resources. Enjoy the library’s comfortable seating area to read and take notes, or to sit and relax.
• Classes and events for patients and families
  Princess Margaret offers many classes for patients, friends and families. These classes offer support and guidance at diagnosis, during treatment and after treatment. They class can help prepare you for treatment, manage side effects and cope with your diagnosis.
• Wigs and accessories
  The Wig Salon and Accessories Boutique
  Location: 3rd floor, Princess Margaret Cancer Centre
  Phone: 416 946 6596
  The Wig Salon and Accessories Boutique sells hats, wigs, head scarves, turbans and caps. The boutique also sells special purses for women who have lymphedema (swelling of the arm and hand).
• Look Good Feel Good
  The Look Good Feel Good program offers workshops for women with cancer to learn how to manage the appearance-related impact of cancer and its treatment, such as:
  • skincare and cosmetics
  • breast Care, forms and garments
  • wigs and hair alternatives
  For more information or to register, call 1 800 914 5665 or visit Look Good Feel Better.
• Gilda’s Club
  Address: 24 Cecil Street, Toronto, ON M5T 1N2
  Phone: 416 214 9898
  Website: Gilda's Club Greater Toronto
• Wellspring
  Phone: 1 877 499 9904
  Website: Wellspring
  Wellspring is a network of community-based centres that offer programs providing support, coping skills and education to cancer patients and their families. Wellspring has many locations across Canada. Call or check the website for locations.
• The Wellspring Money Matters Resource Centre
  The centre provides information on government and community income programs, resources and support to help cancer patients and their families cope with the financial difficulty that can come with a cancer diagnosis. To make an appointment with the Money Matters Case manager, call 416 961 1928 or toll-free 1 800 499 9904.

Important Phone Numbers

If you are calling to ask about a patient or to let us know that you are running late for your appointment, call:

Systemic Therapy Reception Desk
Phone: 416 946 4501 extension 5118
Hours:

• Monday to Friday from 8:45 am to 5:00 pm
• Saturday from 8:45 am to 3:30 pm

If you have any questions, concerns or suggestions, please speak to any of the Systemic Therapy staff or ask to talk to the Patient Care Coordinator (PCC) or the Unit.