Living With Advanced Nonsquamous Non-small Cell Lung Cancer (NSCLC) – Diet and Exercise

As you begin or continue treatment, you will face new challenges. There are measures you can take that may help. Healthy eating and exercise are important considerations. It’s also important to closely monitor your side effects and take steps to help manage them. Talk with your doctor about any questions or concerns you may have during treatment. This section offers nutrition information, guidelines for what healthy eating and exercise look like, and how they may affect how you feel while you are undergoing treatment.

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Nutrition

You probably know that following a balanced diet is an important part of a healthy life. Healthy eating is even more important as you go through treatment. Your body needs food to rebuild tissues and help you stay strong.

What does healthier eating mean?

Healthy eating means selecting a variety of foods to give your body the nutrients it needs. Your body needs many nutrients, including protein, fat, carbohydrates, water, vitamins, and minerals. Talk with your care team about how you can improve your diet.

Protein
Protein is needed for growth, to heal tissue, and to keep your immune system healthy. Good sources include fish, chicken, eggs, lean red meat, nuts, low-fat dairy products, dried beans, and soy foods.

Fat
Fat provides a rich source of energy and helps carry certain vitamins through the blood. Monounsaturated and polyunsaturated fats are better choices.

Carbohydrates
Carbohydrates give the body the fuel it needs. Good sources include fruits, vegetables, and whole grains. Other sources include bread, potatoes, rice, pasta, corn, peas, and beans.

Water
Water is the main substance in our bodies. Cells need plenty of water to stay healthy. You should drink about eight 8-oz glasses of liquid each day, which can include foods like soup and milk. If you are experiencing side effects such as diarrhea or vomiting, you may require more liquids to prevent dehydration.

Vitamins and minerals
Vitamins and minerals help the body work properly. Most are found naturally in food. Your doctor will give you vitamin B12 shots during treatment. Talk with your doctor before taking any supplements.

Exercise

Exercise during cancer treatment can help maintain your strength and well-being. Too much rest can lead to muscle weakness and reduced range of motion. Regular exercise may help you:

  • Maintain your physical ability
  • Improve balance and lower the risk of falls
  • Lessen your dependence on others for help with daily living
  • Improve your self-esteem
  • Lower the risk of being anxious and depressed
  • Reduce nausea
  • Decrease symptoms of tiredness (fatigue)
  • Control your weight

Your healthcare provider can help you put together an exercise program that’s right for you.

Download information on exercise

Your journey

Life with lung cancer

Lung cancer is the most common cancer in the world. While each person is unique, there are common steps on every journey:

  • Diagnosis
  • Planning
  • Treatment
  • A new normal

Lilly Oncology has resources to help you learn more about life with lung cancer.

Learn more at LillyOncology.com
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Indications and Important Safety Information

What Is ALIMTA® (pemetrexed for injection) Approved For?

ALIMTA® (pemetrexed for injection) is approved by the FDA in combination with cisplatin (another chemotherapy drug) for the first (initial) treatment of advanced nonsquamous non-small cell lung cancer (NSCLC), a specific type of NSCLC that has spread.

ALIMTA is approved by the FDA as a single agent (used alone) for maintenance treatment of patients with advanced nonsquamous non-small cell lung cancer (NSCLC) after you have received 4 cycles of chemotherapy that contains platinum for first treatment and your cancer has not progressed.

ALIMTA is approved by the FDA as a single agent (used alone) for the treatment of patients with recurrent, metastatic nonsquamous non-small cell lung cancer (NSCLC), a specific type of NSCLC, which has returned or spread after prior chemotherapy.

ALIMTA is not appropriate for people who have a different type of NSCLC called squamous cell.

Important Safety Information for ALIMTA

What is the most important information that I should know about ALIMTA?

ALIMTA can cause serious side effects including:

  • Low blood cell counts. Low blood cell counts can be severe, including low white blood cell counts (neutropenia), low platelet counts (thrombocytopenia), and low red blood cell counts (anemia). Your healthcare provider will do blood test to check your blood cell counts regularly during your treatment with ALIMTA. Tell your healthcare provider right away if you have any signs of infection, fever, bleeding, or severe tiredness during your treatment with ALIMTA.
  • Kidney problems, including kidney failure. ALIMTA can cause severe kidney problems that can lead to death. Severe vomiting or diarrhea can lead to loss of fluids (dehydration) which may cause kidney problems to become worse. Tell your healthcare provider right away if you have a decrease in amount of urine.
  • Severe skin reactions. Severe skin reactions that may lead to death can happen with ALIMTA. Tell your healthcare provider right away if you develop blisters, skin sores, skin peeling, or painful sores, or ulcers in your mouth, nose, throat or genital area.
  • Lung problems (pneumonitis). ALIMTA can cause serious lung problems that can lead to death. Tell your healthcare provider right away if you get any new or worsening symptoms of shortness of breath, cough, or fever.
  • Radiation recall. Radiation recall is a skin reaction that can happen in people who have received radiation treatment in the past and are treated with ALIMTA. Tell your healthcare provider if you get swelling, blistering, or a rash that looks like a sunburn in an area that was previously treated with radiation.

Who should not take ALIMTA?

ALIMTA may not be appropriate for some patients. If you are allergic to pemetrexed, tell your doctor because you should not receive it. It is not known if ALIMTA is safe and effective in children.

What should I tell my healthcare provider before receiving ALIMTA?

  • Before receiving ALIMTA, tell your healthcare provider about all of your medical conditions including:
    • if you have kidney problems.
    • if you have had radiation therapy.
    • if you think you are pregnant, or are planning to become pregnant as ALIMTA can harm your unborn baby.
      • Females who are able to become pregnant should use effective birth control (contraception) during treatment with ALIMTA and for 6 months after the final dose. Tell your healthcare provider right away if you become pregnant or think you are pregnant during treatment with ALIMTA.
      • Males with female partners who are able to become pregnant should use effective birth control (contraception) during treatment with ALIMTA and for 3 months after the final dose.
    • if you are breastfeeding or plan to breastfeed, as it is not known if ALIMTA passes into breast milk. Do not breastfeed during treatment with ALIMTA and for 1 week after the final dose.
  • Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
  • Tell your healthcare provider if you have kidney problems and take a medicine that contains ibuprofen. You should avoid taking ibuprofen for 2 days before, the day of, and 2 days after receiving treatment with ALIMTA.

How is ALIMTA given?

  • It is very important to take folic acid by mouth and receive vitamin B12 injections from your healthcare provider during your treatment with ALIMTA to lower your risk of harmful side effects.
  • Your healthcare provider will prescribe a medicine called a corticosteroid for you to take 2 times a day for 3 days, beginning the day before each treatment with ALIMTA.
  • ALIMTA is given to you by intravenous (IV) infusion (injection) into your vein. The infusion is given over 10 minutes. You will usually receive ALIMTA once every 21 days (3 weeks).

What are the possible side effects of ALIMTA?

The most common side effects of ALIMTA when given alone are:

  • Tiredness
  • Nausea
  • Loss of appetite

The most common side effects of ALIMTA when given with cisplatin are:

  • Vomiting
  • Swelling or sores in your mouth or sore throat
  • Constipation
  • Low white blood cell counts (neutropenia)
  • Low platelet counts (thrombocytopenia)
  • Low red blood cell counts (anemia)

ALIMTA may cause fertility problems in males. This may affect your ability to father a child. It is not known if these effects are reversible. Talk to your healthcare provider if this is a concern for you.

Your healthcare provider will do blood tests to check for side effects during treatment with ALIMTA. Your healthcare provider may change your dose of ALIMTA, delay treatment, or stop treatment if you have certain side effects. Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the side effects of ALIMTA. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

ALIMTA is available by prescription only.

For more information about all of the side effects of ALIMTA, please talk with your healthcare team, see the Patient Prescribing Information and full Prescribing Information, or call 1-800-545-5979.

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