Patient Preparation for Cancer Therapy: A Comprehensive Guide

Multidimensional Pre-Treatment Preparation

1. Physical Preparation

• Comprehensive assessment: H&P, labs (CBC, CMP, LFTs, coagulation, tumor markers), imaging (staging), cardiac/pulmonary eval if indicated.
• Nutritional optimization: Dietitian consult; protein 1.2–1.5 g/kg; address deficiencies; feeding tube if high-risk.
• Dental clearance: Eliminate foci of infection before chemo/radiation (osteoradionecrosis risk).
• Skin care: Moisturize, sun protection, avoid irritants (radiation fields).
• Fertility preservation counseling (sperm/egg/embryo banking) for reproductive-age patients.

2. Emotional & Psychological Preparation

• Psychoeducation: Treatment timeline, side effects, goals of care.
• Distress screening (NCCN thermometer); refer to psycho-oncology.
• Support groups, peer navigation, spiritual care.

3. Symptom Management Education

• Antiemetic regimen (5-HT3, NK1, dexamethasone) before chemo.
• Bowel regimen (prophylactic laxatives for opioids/5-HT3).
• Pain ladder; neuropathic pain adjuvants.
• Fatigue management: activity pacing, exercise prescription.

4. Practical & Logistical Preparation

• Medication reconciliation; oral chemo adherence plan.
• Transportation, lodging, caregiver schedule.
• Financial navigation: insurance, copay assistance, disability, FMLA.
• Advance care planning (goals of care, code status, proxy).

5. Follow-Up & Survivorship Planning

• Surveillance schedule (imaging, labs, late effects).
• Rehabilitation referral (PT, OT, speech, lymphedema).
• Primary care coordination for comorbidity management.

Patient-centered, multidisciplinary preparation improves tolerance, adherence, and quality of life.