Monday, April 20, 2009
Alternative and complementary therapies for cancer treatment.
Many alternatives to traditional cancer therapy exist, but there is little evidence to support their efficacy or assess their potential toxicity, and at present there is no federal regulation of these products. Agents that are commonly used include green tea, echinacea, essiac tea, flaxseed, mistletoe, and coenzyme Q as well as others.
Friday, April 3, 2009
Tuesday, March 31, 2009
Hormonal therapy
hormones are normally involved in the differentiation , stimulation , and control of certain tissues, including but not limited to lymphoid tissue, the uterus, the prostate, and the mammary glands.
The administration of estrogen to a man ultimately suppresses the production of testosterone which is useful in the treatment of prostate cancer. Corticosteroids have a powerful suppressive effect on lymphoid cells, making them useful in the treatment of acute leukemias, lymphomas, myeloma, and other myeloproliferative disorders.
Estrogen and androgen inhibitors
SERMs can have different tissues, sometimes inhibiting the action of estrogen while sometimes behaving like estrogen . Tamoxifen, which is used not only to treat estrogen-sensitive breast cancer but also to prevent breast cancer in high-risk individuals. Raloxifen is a newer SERM that has been approved for prevention and treatment of postmenopausal osteoporosis and is presently being studied in the chemoprevention of breast cancer. Flutamide is a testosterone antagonist used in the treatment of prostate cancer. It works by blocking translation of the androgen receptor to the nucleus. Flutamide is most effective when used in combination with surgical or pharmacologic castration.
Gonadotropin-releasing hormone analogue
The pharmacologic equivalent of castration can be accomplished with leuprolide, an analogue of GnRH. Leuprolide is commonly used to decrease testosterone levels in the treatment of unresectable prostate cancer.
Aromatase inhibitors
Aromatase inhibitors can eliminate functional estrogen in this population of women and may be an effective hormonal treatment of breast cancer. Anastrozole is approved for the treatment of metastatic breast cancer and appears promissing as adjuvant therapy for postmenopausal women whose tumors posses estrogen or Progesterone receptors.
The administration of estrogen to a man ultimately suppresses the production of testosterone which is useful in the treatment of prostate cancer. Corticosteroids have a powerful suppressive effect on lymphoid cells, making them useful in the treatment of acute leukemias, lymphomas, myeloma, and other myeloproliferative disorders.
Estrogen and androgen inhibitors
SERMs can have different tissues, sometimes inhibiting the action of estrogen while sometimes behaving like estrogen . Tamoxifen, which is used not only to treat estrogen-sensitive breast cancer but also to prevent breast cancer in high-risk individuals. Raloxifen is a newer SERM that has been approved for prevention and treatment of postmenopausal osteoporosis and is presently being studied in the chemoprevention of breast cancer. Flutamide is a testosterone antagonist used in the treatment of prostate cancer. It works by blocking translation of the androgen receptor to the nucleus. Flutamide is most effective when used in combination with surgical or pharmacologic castration.
Gonadotropin-releasing hormone analogue
The pharmacologic equivalent of castration can be accomplished with leuprolide, an analogue of GnRH. Leuprolide is commonly used to decrease testosterone levels in the treatment of unresectable prostate cancer.
Aromatase inhibitors
Aromatase inhibitors can eliminate functional estrogen in this population of women and may be an effective hormonal treatment of breast cancer. Anastrozole is approved for the treatment of metastatic breast cancer and appears promissing as adjuvant therapy for postmenopausal women whose tumors posses estrogen or Progesterone receptors.
Sunday, March 29, 2009
Gynecologic cancer
Types of radiation
* radiation oncology-be defined as therapeutic manipulation of radiation delivered to a target for cure or for palliation.
*electromagnetic radiation is energy that is transmitted at the speed of light through oscillating electric and magnetic fields.
*particulate radiation uses subatomic particles, instead of photons, to deliver the dose of radiation.
Dosage theory
Normal tissue as well as malignant cells are susceptible to toxicity induced by radiation therapy, the extent of which depends on total dose, fractionization, and tumor volume.
A. Repair of sublethal injury
When a specified radiation dose is divided into two doses given at separate times, the number of cells surviving is higher than that seen when the same total dose is given at one time.
B. Repopulation
The reactivation of stem cells that occurs when radiation is stopped is necessary for further tissue growth
C. Reoxygenation: hypoxic cells are known to be relatively resistant to radiation. Cells located farther than 100mm from capillary flow are at risk for hypoxia and may not be killed by radiation therapy.
D. Radiation-induced synchrony
Malignant cells are most sensitive to radiation while in the mitotic phase of the cell cycle.
* radiation oncology-be defined as therapeutic manipulation of radiation delivered to a target for cure or for palliation.
*electromagnetic radiation is energy that is transmitted at the speed of light through oscillating electric and magnetic fields.
*particulate radiation uses subatomic particles, instead of photons, to deliver the dose of radiation.
Dosage theory
Normal tissue as well as malignant cells are susceptible to toxicity induced by radiation therapy, the extent of which depends on total dose, fractionization, and tumor volume.
A. Repair of sublethal injury
When a specified radiation dose is divided into two doses given at separate times, the number of cells surviving is higher than that seen when the same total dose is given at one time.
B. Repopulation
The reactivation of stem cells that occurs when radiation is stopped is necessary for further tissue growth
C. Reoxygenation: hypoxic cells are known to be relatively resistant to radiation. Cells located farther than 100mm from capillary flow are at risk for hypoxia and may not be killed by radiation therapy.
D. Radiation-induced synchrony
Malignant cells are most sensitive to radiation while in the mitotic phase of the cell cycle.
Friday, March 27, 2009
Classes of chemotherapeutic agents
All forms of curative chemotherapy, the goal is elimination of all tumor stem cells. The method of combining agents help to combat tumor cell resistance and increase the tumor cell killing while avoiding the compounding of toxic effects.
A. Alkylating agents
B. Platinum analogues
C. Antimetabolites
D. Antimicrotubule agents
E. Topoisomerase inhibitors
F. Antibiotics
A. Alkylating agents
B. Platinum analogues
C. Antimetabolites
D. Antimicrotubule agents
E. Topoisomerase inhibitors
F. Antibiotics
Monday, March 23, 2009
Chemotherapy-induced nausea and vomitting
Doxorubicin, etoposide, or cyclophosphamide are usually associated with mild to moderate nausea and vomiting, whereas nitrosoureas, dacarbazine, and particularly cisplatin cause more severe symptoms. Antiemetic clearly reduce and often eliminate nausea and vomiting.
Ondansentron, granisetron,dolasetron have now replaced other drugs as the primary agents for the prevention and treatment of emesis from chemotherapy. These drugs are serotonin receptor-blocking agents with few side effects. Ondansentron, a single dose of 32mg prior to chemotherapy and may be repeated every 24hours, or 8 mg every 8 hours.
Dexamethasone has an antiemetic effects at a dossage 6-10 mg as a single dose prior to or both prior to and every 6 hours following-the administration of chemotherapy for two to four total doses.
Aprepitant is selective high-affinity neurokinin-1 receptor antagonist. It is approved for the treatment of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy. It is given for 3 days beginning on the day chemotherapy starts.
Prochlorperazine is given 10mg orally or iv, every 6-8 hours not exceed 40mg. Side effect is extrapyramidal.
Metoclopramide is given 10-20mg orally or iv, every 6 hours, usually in combination with dexamethasone. Side effects is extrapyramidal.
Lorazepam has both antiemetic and sedative effects. A Dose of 0,5-1mg every 4-6hours by the sublingual.
Combination: ondansentron and lorazepam, prochlorperazine and dexamethasone with aprepitant.
omeprazole, ranitidine can be useful adjunctive therapy to the antinausea regiment.
Ondansentron, granisetron,dolasetron have now replaced other drugs as the primary agents for the prevention and treatment of emesis from chemotherapy. These drugs are serotonin receptor-blocking agents with few side effects. Ondansentron, a single dose of 32mg prior to chemotherapy and may be repeated every 24hours, or 8 mg every 8 hours.
Dexamethasone has an antiemetic effects at a dossage 6-10 mg as a single dose prior to or both prior to and every 6 hours following-the administration of chemotherapy for two to four total doses.
Aprepitant is selective high-affinity neurokinin-1 receptor antagonist. It is approved for the treatment of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy. It is given for 3 days beginning on the day chemotherapy starts.
Prochlorperazine is given 10mg orally or iv, every 6-8 hours not exceed 40mg. Side effect is extrapyramidal.
Metoclopramide is given 10-20mg orally or iv, every 6 hours, usually in combination with dexamethasone. Side effects is extrapyramidal.
Lorazepam has both antiemetic and sedative effects. A Dose of 0,5-1mg every 4-6hours by the sublingual.
Combination: ondansentron and lorazepam, prochlorperazine and dexamethasone with aprepitant.
omeprazole, ranitidine can be useful adjunctive therapy to the antinausea regiment.
Sunday, March 22, 2009
Prevention of cancer
Primary prevention
1. Lifestyle modifications
2. Chemoprevention
-isotretinoin and acyclic retinoids
-aspirin and other NSAIDs
-betacarotene and vitamin E
-calcium and selenium
-tamoxifen
-raloxifene
-isoflavones
-finasteride
Other current trials:
-folic acid
-fish oils
-vitamin suplementation
-polyprenols
2. Secondary prevention
-screening for breast cancer: digital mammography, MRI.
-screening for lung cancer: CT-scan, xray
-screening for cervical cancer: papanicolaou test, HPV DNA test.
-screening for colorectal cancer: colonoscopy
-the prostate,lung,colorectal, and ovarian cancer screening trial: PSA, DRE, chest xray,sigmoidoscopy, transvaginal ultrasound, CA 125.
1. Lifestyle modifications
2. Chemoprevention
-isotretinoin and acyclic retinoids
-aspirin and other NSAIDs
-betacarotene and vitamin E
-calcium and selenium
-tamoxifen
-raloxifene
-isoflavones
-finasteride
Other current trials:
-folic acid
-fish oils
-vitamin suplementation
-polyprenols
2. Secondary prevention
-screening for breast cancer: digital mammography, MRI.
-screening for lung cancer: CT-scan, xray
-screening for cervical cancer: papanicolaou test, HPV DNA test.
-screening for colorectal cancer: colonoscopy
-the prostate,lung,colorectal, and ovarian cancer screening trial: PSA, DRE, chest xray,sigmoidoscopy, transvaginal ultrasound, CA 125.
The Ten most common cancers in the U.S. 1998-2002
Men: women
1. Prostate 1. Breast
2. Lung 2. Lung
3. Colorectal 3. Colorectal
4. Bladder 4. Uterus
5. NHL 5. Ovary
6. Melanoma 6. NHL
7. Oral/pharinx 7. Melanoma
8. Kidney 8. Thyroid
9. Leukemia 9. Pancreas
10. Pancreas 10. Leukemia
1. Prostate 1. Breast
2. Lung 2. Lung
3. Colorectal 3. Colorectal
4. Bladder 4. Uterus
5. NHL 5. Ovary
6. Melanoma 6. NHL
7. Oral/pharinx 7. Melanoma
8. Kidney 8. Thyroid
9. Leukemia 9. Pancreas
10. Pancreas 10. Leukemia
Friday, March 20, 2009
Early detection of cancer
*breast =>
-Population: women, age 20+
-Test/procedure:
breast self-examination-> monthly, starting at age 20
Clinical breast examination-> every 3 years, ages 20-39
Mammography->annual, starting at age 40
*colorectal=>
-Population:Men and women, age 50+
-tes/procedure:
Fecal occult blood test/fobt: annual, starting at age 20
Flexible sigmoidoscopy: every 5 years, age 50
Double-contrast barium enema/dcbe: every 5 years, starting at age 50
Colonoscopy: every 10 years, starting at age 50
*prostate=>
Population: age 50
Test/procedure: digital rectal examination, prostate-spesific antigen test: annualy, starting at age 50
*cervic=>
-test/procedure:
pap test: beginning 3 years after first vaginal intercourse, but no later than 21 years of age. Every 2 years using liquid-based after age 30. Three or more normal pap test and no abnormal pap test in the last 10 years may choose to stop cervical cancer screening.
*cancer-related check-up
Population: men and women, age 20+
Test/procedure:
healt examination: thyroid, testicles, ovaries, lymph node, oral cavity, and skin.
-Population: women, age 20+
-Test/procedure:
breast self-examination-> monthly, starting at age 20
Clinical breast examination-> every 3 years, ages 20-39
Mammography->annual, starting at age 40
*colorectal=>
-Population:Men and women, age 50+
-tes/procedure:
Fecal occult blood test/fobt: annual, starting at age 20
Flexible sigmoidoscopy: every 5 years, age 50
Double-contrast barium enema/dcbe: every 5 years, starting at age 50
Colonoscopy: every 10 years, starting at age 50
*prostate=>
Population: age 50
Test/procedure: digital rectal examination, prostate-spesific antigen test: annualy, starting at age 50
*cervic=>
-test/procedure:
pap test: beginning 3 years after first vaginal intercourse, but no later than 21 years of age. Every 2 years using liquid-based after age 30. Three or more normal pap test and no abnormal pap test in the last 10 years may choose to stop cervical cancer screening.
*cancer-related check-up
Population: men and women, age 20+
Test/procedure:
healt examination: thyroid, testicles, ovaries, lymph node, oral cavity, and skin.
Viral carcinogens
* epstein-barr virus = burkitt's lymphoma, hodgkins disease, immunosuppression-related lymphoma, sinonasal angiocentric T-cell lymphoma, nasopharyngeal carcinoma.
* hepatitis B = hepatocellular carcinoma
* hepatitis C = hepatocellular carcinoma
* human immunodeficiency virus-1 = kaposis sarcoma, non-hodgkins lymphoma
* human papillomavirus types 16 and 18 = cervical cancer, anal cancer.
* human T-cell lymphotropic viruses = adult T-cell leukemia/lymphoma
* hepatitis B = hepatocellular carcinoma
* hepatitis C = hepatocellular carcinoma
* human immunodeficiency virus-1 = kaposis sarcoma, non-hodgkins lymphoma
* human papillomavirus types 16 and 18 = cervical cancer, anal cancer.
* human T-cell lymphotropic viruses = adult T-cell leukemia/lymphoma
Saturday, March 14, 2009
Epirubicin
Epirubicin is used in the treatment of a variety of cancers including breast, ovarian, stomach and bowel. One way in which epirubicin works is by binding to the cancer cells’ DNA (the genetic code). This makes the DNA get tangled up and the cancer cell cannot divide or grow.
Epirubicin is a red liquid that you have as an injection or drip (infusion) into a vein ((intravenously) through a fine tube (cannula) put into the vein. To find out more about the ways of giving chemotherapy look at the section on how chemotherapy is given.
You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for epirubicin depends on which cancer you are being treated for. To find out more about the way chemotherapy treatment is planned, look at the section on planning chemotherapy .
The side effects associated with epirubicin are listed below. You can use the links (underlined) to find out more about each side effect. Where there is no link, please see our chemotherapy side effects section or click on search at the top of the page.
Common side effects of Epirubicin
Many people have one or more of the following side effects with epirubicin
Fatigue - for many people this is the most troublesome 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.
Temporary effect on the bone marrow. The bone marrow makes blood cells and a drop in its function can cause
- An increased risk of getting infections. This is due to a temporary drop in the number of white blood cells produced by the bone marrow. Having a low white blood count means that you are less able to fight infections and can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should contact your hospital urgently if you think you have an infection.
- Tiredness and breathlessness. This is due to a drop in the number of red blood cells made by your bone marrow which is called anaemia. You may need a blood transfusion to treat anaemia.
- Getting bruises more easily. This is due to a drop in the number of platelets produced by your bone marrow. You may have nosebleeds or notice your gums bleed when you brush your teeth. You may have lots of tiny red spots or bruises on your arms or legs. Contact your hospital urgently if you have this effect.
Feeling or being sick. This can be severe with epirubicin. It is usually well controlled with anti-sickness injections or tablets. If sickness happens, it usually starts a few hours after each treatment and lasts for about a day. If your sickness is not controlled, tell your doctor. You may be able to have other anti-sickness drugs that work better for you.
Hair loss. Everyone treated with epirubicin has complete head and body hair loss. Remember - this is only temporary. A cold cap may help to stop you losing your hair, but you need to talk to your doctor about how advisable this is with your type of cancer.
Inflammation in the mouth and throat. This can happen about 2-3 days after each treatment. You may have reddening of the skin in your mouth, mouth ulcers, a burning feeling and bleeding. This is usually gone within 3 weeks of treatment.
Effects on the heart. Epirubicin can cause temporary damage to the muscles of the heart, which may change the rhythm of the heart beat. In most cases this will go back to normal after the treatment is completed. Your heart will be checked before you start treatment.
Your urine may become a pink/red colour for about one day after treatment
Changes to your skin. You may have skin rashes (which may be itchy), darkening of your skin, sensitivity to light, and redness or soreness in areas of skin previously treated with radiotherapy
Epirubicin may have a harmful effect on a developing baby. It is not advisable to become pregnant or father a child whilst taking this drug. You should discuss contraception with your doctor before treatment starts.
Occasional side effects of Epirubicin
Loss of fertility - it's not known exactly what effect this drug could have on your fertility. It is important to talk to your doctor before starting treatment. Women may stop having periods (amenorrhoea). This may only be temporary.
While you are actually having the chemotherapy treatment, epirubicin can leak into the tissues around the cannula site and cause damage in that area. It is important to tell your nurse or doctor if you have any
- Stinging or burning around the cannula site
- Leakage of fluid
- Redness or swelling around the cannula site after treatment has finished
Allergic reactions can happen while the drug is going into your bloodstream. While you are having the epirubicin treatment you will be monitored for signs of allergic reaction. Tell your nurse if you have skin rashes and itching, a temperature, shivering, redness of the face, a feeling of dizziness, headaches, breathlessness, anxiety or a need to pass urine.
Diarrhoea. Drink plenty of fluids, and if your diarrhoea is severe or persistent tell your doctor or nurse.
Loss of appetite
Nails may become darker and may have white lines on them
Sore eyes (Conjunctivitis)
Side effects with high doses of Epirubicin
With high doses of epirubicin or many treatments with epirubicin there is a small chance of
Permanent damage to the heart
Developing another cancer at some time in the future
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.
Immunisations
You should not have immunisations with live vaccines while you are having chemotherapy or for 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.
It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
Epirubicin is a red liquid that you have as an injection or drip (infusion) into a vein ((intravenously) through a fine tube (cannula) put into the vein. To find out more about the ways of giving chemotherapy look at the section on how chemotherapy is given.
You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for epirubicin depends on which cancer you are being treated for. To find out more about the way chemotherapy treatment is planned, look at the section on planning chemotherapy .
The side effects associated with epirubicin are listed below. You can use the links (underlined) to find out more about each side effect. Where there is no link, please see our chemotherapy side effects section or click on search at the top of the page.
Common side effects of Epirubicin
Many people have one or more of the following side effects with epirubicin
Fatigue - for many people this is the most troublesome 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.
Temporary effect on the bone marrow. The bone marrow makes blood cells and a drop in its function can cause
- An increased risk of getting infections. This is due to a temporary drop in the number of white blood cells produced by the bone marrow. Having a low white blood count means that you are less able to fight infections and can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should contact your hospital urgently if you think you have an infection.
- Tiredness and breathlessness. This is due to a drop in the number of red blood cells made by your bone marrow which is called anaemia. You may need a blood transfusion to treat anaemia.
- Getting bruises more easily. This is due to a drop in the number of platelets produced by your bone marrow. You may have nosebleeds or notice your gums bleed when you brush your teeth. You may have lots of tiny red spots or bruises on your arms or legs. Contact your hospital urgently if you have this effect.
Feeling or being sick. This can be severe with epirubicin. It is usually well controlled with anti-sickness injections or tablets. If sickness happens, it usually starts a few hours after each treatment and lasts for about a day. If your sickness is not controlled, tell your doctor. You may be able to have other anti-sickness drugs that work better for you.
Hair loss. Everyone treated with epirubicin has complete head and body hair loss. Remember - this is only temporary. A cold cap may help to stop you losing your hair, but you need to talk to your doctor about how advisable this is with your type of cancer.
Inflammation in the mouth and throat. This can happen about 2-3 days after each treatment. You may have reddening of the skin in your mouth, mouth ulcers, a burning feeling and bleeding. This is usually gone within 3 weeks of treatment.
Effects on the heart. Epirubicin can cause temporary damage to the muscles of the heart, which may change the rhythm of the heart beat. In most cases this will go back to normal after the treatment is completed. Your heart will be checked before you start treatment.
Your urine may become a pink/red colour for about one day after treatment
Changes to your skin. You may have skin rashes (which may be itchy), darkening of your skin, sensitivity to light, and redness or soreness in areas of skin previously treated with radiotherapy
Epirubicin may have a harmful effect on a developing baby. It is not advisable to become pregnant or father a child whilst taking this drug. You should discuss contraception with your doctor before treatment starts.
Occasional side effects of Epirubicin
Loss of fertility - it's not known exactly what effect this drug could have on your fertility. It is important to talk to your doctor before starting treatment. Women may stop having periods (amenorrhoea). This may only be temporary.
While you are actually having the chemotherapy treatment, epirubicin can leak into the tissues around the cannula site and cause damage in that area. It is important to tell your nurse or doctor if you have any
- Stinging or burning around the cannula site
- Leakage of fluid
- Redness or swelling around the cannula site after treatment has finished
Allergic reactions can happen while the drug is going into your bloodstream. While you are having the epirubicin treatment you will be monitored for signs of allergic reaction. Tell your nurse if you have skin rashes and itching, a temperature, shivering, redness of the face, a feeling of dizziness, headaches, breathlessness, anxiety or a need to pass urine.
Diarrhoea. Drink plenty of fluids, and if your diarrhoea is severe or persistent tell your doctor or nurse.
Loss of appetite
Nails may become darker and may have white lines on them
Sore eyes (Conjunctivitis)
Side effects with high doses of Epirubicin
With high doses of epirubicin or many treatments with epirubicin there is a small chance of
Permanent damage to the heart
Developing another cancer at some time in the future
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.
Immunisations
You should not have immunisations with live vaccines while you are having chemotherapy or for 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.
It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
Fluorouracil
Fluorouracil is also known as FU or 5FU and is one of the most commonly used drugs to treat cancer. It is used to treat many types of cancer including, breast, head and neck, anal, stomach, colon and some skin cancers.
Fluorouracil is part of a group of chemotherapy drugs known as the anti-metabolites. Anti-metabolites are similar to normal body molecules but they are slightly different in structure. These differences mean that anti-metabolites stop cells working properly. Anti-metabolites often stop cells making and repairing DNA. Cancer cells need to make and repair DNA in order to grow and multiply. Anti-metabolites also stop normal cells working properly. This is why you get side effects.
You can have fluorouracil as an injection or infusion into a vein (intravenously). It can also be used as an ointment for skin cancer.
You usually have intravenous fluorouracil as a course of several cycles of treatment. The exact treatment plan depends on which cancer you are being treated for. To find out more about the way chemotherapy treatment is planned click on planning chemotherapy.
The side effects associated with intravenous fluorouracil are listed below. You can use the links (underlined) to find out more about each side effect. Where there is no link, please see our chemotherapy side effects section or click on 'search' at the top of the page.
Common side effects
Many people have one or more of the following side effects
Fatigue - for many people this is the most troublesome 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.
Feeling or being sick (this is usually mild)
Mouth sores and ulcers
Diarrhoea - you should drink plenty of fluids. If it becomes severe or persistent you could get dehydrated so tell your doctor or nurse.
Temporary effect on the bone marrow. The bone marrow makes blood cells and a drop in its function can cause
- An increased risk of getting infections. This is due to a temporary drop in the number of white blood cells produced by the bone marrow. Having a low white blood count means that you are less able to fight infections and can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should contact your hospital urgently if you think you have an infection.
- Tiredness and breathlessness. This is due to a drop in the number of red blood cells made by your bone marrow which is called anaemia. You may need a blood transfusion to treat anaemia.
- Getting bruises more easily. This is due to a drop in the number of platelets produced by your bone marrow. You may have nosebleeds or notice your gums bleed when you brush your teeth. You may have lots of tiny red spots or bruises on your arms or legs. Contact your hospital if you have any of these effects.
This drug may have a harmful effect on a baby developing in the womb. It is not advisable to become pregnant or father a child while on chemotherapy. You should talk to your doctor about contraception before having the treatment.
Occasional side effects
Some people have the following side effects
Hair thinning
Brittle, chipped and ridged nails
Sensitivity of the skin to sunlight - you should not use sunbeds or sit in the sun if having fluorouracil. Cover up or use a sun block.
Rashes which may be itchy
Watery eyes from increased production of tears
Gritty eyes and blurred vision
Loss of appetite
Brown marking on the skin following the line of the vein where fluorouracil has been injected
With continous infusion of fluorouracil an occasional side effect is soreness and redness of the palms of the hands and soles of the (sometimes called hand and foot syndrome or palmar-plantar syndrome). This causes tingling, numbness, pain, dryness, and a rash. Tell your doctor if this happens - you can be given vitamin B6 (pyridoxine) to help control this effect. It can help to keep your hands and feet cool, avoid very hot water, avoid tight fitting gloves or socks and keep your skin well moisturised.
Rare side effects
A very small number of people have these side effects
Total hair loss
Darkened skin
Angina or heart attack
Confusion or unsteadiness
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.
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.
Immunisations
You should not have immunisations with live vaccines while you are having chemotherapy or for 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.
It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
Fluorouracil is part of a group of chemotherapy drugs known as the anti-metabolites. Anti-metabolites are similar to normal body molecules but they are slightly different in structure. These differences mean that anti-metabolites stop cells working properly. Anti-metabolites often stop cells making and repairing DNA. Cancer cells need to make and repair DNA in order to grow and multiply. Anti-metabolites also stop normal cells working properly. This is why you get side effects.
You can have fluorouracil as an injection or infusion into a vein (intravenously). It can also be used as an ointment for skin cancer.
You usually have intravenous fluorouracil as a course of several cycles of treatment. The exact treatment plan depends on which cancer you are being treated for. To find out more about the way chemotherapy treatment is planned click on planning chemotherapy.
The side effects associated with intravenous fluorouracil are listed below. You can use the links (underlined) to find out more about each side effect. Where there is no link, please see our chemotherapy side effects section or click on 'search' at the top of the page.
Common side effects
Many people have one or more of the following side effects
Fatigue - for many people this is the most troublesome 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.
Feeling or being sick (this is usually mild)
Mouth sores and ulcers
Diarrhoea - you should drink plenty of fluids. If it becomes severe or persistent you could get dehydrated so tell your doctor or nurse.
Temporary effect on the bone marrow. The bone marrow makes blood cells and a drop in its function can cause
- An increased risk of getting infections. This is due to a temporary drop in the number of white blood cells produced by the bone marrow. Having a low white blood count means that you are less able to fight infections and can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should contact your hospital urgently if you think you have an infection.
- Tiredness and breathlessness. This is due to a drop in the number of red blood cells made by your bone marrow which is called anaemia. You may need a blood transfusion to treat anaemia.
- Getting bruises more easily. This is due to a drop in the number of platelets produced by your bone marrow. You may have nosebleeds or notice your gums bleed when you brush your teeth. You may have lots of tiny red spots or bruises on your arms or legs. Contact your hospital if you have any of these effects.
This drug may have a harmful effect on a baby developing in the womb. It is not advisable to become pregnant or father a child while on chemotherapy. You should talk to your doctor about contraception before having the treatment.
Occasional side effects
Some people have the following side effects
Hair thinning
Brittle, chipped and ridged nails
Sensitivity of the skin to sunlight - you should not use sunbeds or sit in the sun if having fluorouracil. Cover up or use a sun block.
Rashes which may be itchy
Watery eyes from increased production of tears
Gritty eyes and blurred vision
Loss of appetite
Brown marking on the skin following the line of the vein where fluorouracil has been injected
With continous infusion of fluorouracil an occasional side effect is soreness and redness of the palms of the hands and soles of the (sometimes called hand and foot syndrome or palmar-plantar syndrome). This causes tingling, numbness, pain, dryness, and a rash. Tell your doctor if this happens - you can be given vitamin B6 (pyridoxine) to help control this effect. It can help to keep your hands and feet cool, avoid very hot water, avoid tight fitting gloves or socks and keep your skin well moisturised.
Rare side effects
A very small number of people have these side effects
Total hair loss
Darkened skin
Angina or heart attack
Confusion or unsteadiness
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.
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.
Immunisations
You should not have immunisations with live vaccines while you are having chemotherapy or for 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.
It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
Docetaxel (Taxotere)
Docetaxel is one of the taxane drugs that were originally developed from the yew tree. It is also called Taxotere. Docetaxel is a man-made drug that was first made from the needles of the yew tree. It works by stopping the cancer cells from separating into 2 new cells, so it blocks the growth of the cancer. Docetaxel is used to treat cancers of the breast, lung, head and neck and prostate. In clinical trials, it may be used to treat , stomach, ovary and bladder cancers.
Docetaxel is a liquid that you have through a drip (infusion) into a vein (intravenously). Each infusion takes about an hour and you have one every 1 to 3 weeks, depending on the type of cancer you are being treated for. Docetaxel can cause an allergic reaction. To try to prevent this, your doctor will give you steroid tablets to take for 3 days, starting the day before each treatment.
You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for docetaxel depends on which cancer you are being treated for. There is more about planning chemotherapy in the main chemotherapy section of CancerHelp UK.
The side effects associated with docetaxel are listed below. You can use the links (underlined) to find out more about each side effect. Where there is no link, see the chemotherapy side effects section or click on 'search' at the top of the page.
Common side effects
Many people have one or more of the following side effects
Fatigue - patients say this is the most disruptive side effect of all. It affects up to 8 out of 10 (80%) people treated. 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.
Temporary effect on the bone marrow. The bone marrow makes blood cells and a drop in its function can cause
- An increased risk of getting infections. This is due to a temporary drop in the number of white blood cells produced by the bone marrow. Having a low white blood count means that you are less able to fight infections and can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should contact your doctor urgently if you think you have an infection.
- Tiredness and breathlessness. This is due to a drop in the number of red blood cells made by your bone marrow which is called anaemia. You may need a blood transfusion to treat anaemia.
- Bruising or bleeding more easily. This is due to a drop in the number of platelets produced by your bone marrow. You may have lots of tiny red spots or bruises on your arms or legs. You may have nosebleeds or notice that your gums bleed when you brush your teeth.
Contact your hospital if you have any of these bone marrow side effects.
Fluid retention. This occurs in about half the patients treated with docetaxel. You may have swelling of the hands and feet, breathlessness and weight gain. The steroids you will be given with the drug can help to prevent this side effect.
Rash which may be itchy. This happens in half the patients treated. You may also notice that your fingernails become discoloured. Some people also develop soreness, redness and peeling on the palms of the hands and soles of the feet (palmar – plantar syndrome). This may cause tingling, numbness, pain and dryness. Tell your doctor if this happens - you can be given vitamin B6 (pyridoxine) to help control this side effect. It can help to keep your hands and feet cool, avoid very hot water, avoid tight fitting gloves or socks and keep your skin well moisturised.
Hair loss - your hair normally falls out completely and this affects 8 out of 10 people (80%) treated. A cold cap may help to stop your hair falling out, but you need to talk to your doctor about whether this is advisable with your type of cancer.
Sore mouth affects about 4 out of every 10 (40%) patients treated
Diarrhoea affects about 4 out of every 10 (40%) patients treated
Allergic reaction during the infusion. About 1 in 4 people (25%) have an allergic reaction to docetaxel. This nearly always happens in the first 10 minutes. If you are going to have a reaction, it is most likely the first or second time you have the drug. Your chemotherapy nurse will monitor you closely for this.
Docetaxel may have a harmful effect on a baby developing in the womb. You should not become pregnant or father a child whilst taking this drug. Discuss contraception with your doctor before you start your treatment if there is any possibility that you or your partner could become pregnant.
Occasional side effects
Some people have the following side effects
Feeling or being sick this is usually mild and lasts for only a short time after having each treatment
Numbness and tingling in hands and feet
Loss of fertility - it is not known exactly what effect this drug may have on your fertility. It is important to talk to your doctor before starting treatment. Women may stop having periods (amenorrhoea). This may only be temporary.
Aching muscles and joints
High temperature (fever)
While you are having your treatment, docetaxel can leak into the tissues around the needle (cannula) and cause damage. It is important to tell your doctor or nurse straight away if you have any
- Stinging or burning around the needle
- Leakage of fluid
- Redness or swelling around the cannula site after the infusion has finished
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.
Immunisations
You should not have immunisations with live vaccines while you are having chemotherapy or for 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.
It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
Docetaxel is a liquid that you have through a drip (infusion) into a vein (intravenously). Each infusion takes about an hour and you have one every 1 to 3 weeks, depending on the type of cancer you are being treated for. Docetaxel can cause an allergic reaction. To try to prevent this, your doctor will give you steroid tablets to take for 3 days, starting the day before each treatment.
You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for docetaxel depends on which cancer you are being treated for. There is more about planning chemotherapy in the main chemotherapy section of CancerHelp UK.
The side effects associated with docetaxel are listed below. You can use the links (underlined) to find out more about each side effect. Where there is no link, see the chemotherapy side effects section or click on 'search' at the top of the page.
Common side effects
Many people have one or more of the following side effects
Fatigue - patients say this is the most disruptive side effect of all. It affects up to 8 out of 10 (80%) people treated. 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.
Temporary effect on the bone marrow. The bone marrow makes blood cells and a drop in its function can cause
- An increased risk of getting infections. This is due to a temporary drop in the number of white blood cells produced by the bone marrow. Having a low white blood count means that you are less able to fight infections and can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should contact your doctor urgently if you think you have an infection.
- Tiredness and breathlessness. This is due to a drop in the number of red blood cells made by your bone marrow which is called anaemia. You may need a blood transfusion to treat anaemia.
- Bruising or bleeding more easily. This is due to a drop in the number of platelets produced by your bone marrow. You may have lots of tiny red spots or bruises on your arms or legs. You may have nosebleeds or notice that your gums bleed when you brush your teeth.
Contact your hospital if you have any of these bone marrow side effects.
Fluid retention. This occurs in about half the patients treated with docetaxel. You may have swelling of the hands and feet, breathlessness and weight gain. The steroids you will be given with the drug can help to prevent this side effect.
Rash which may be itchy. This happens in half the patients treated. You may also notice that your fingernails become discoloured. Some people also develop soreness, redness and peeling on the palms of the hands and soles of the feet (palmar – plantar syndrome). This may cause tingling, numbness, pain and dryness. Tell your doctor if this happens - you can be given vitamin B6 (pyridoxine) to help control this side effect. It can help to keep your hands and feet cool, avoid very hot water, avoid tight fitting gloves or socks and keep your skin well moisturised.
Hair loss - your hair normally falls out completely and this affects 8 out of 10 people (80%) treated. A cold cap may help to stop your hair falling out, but you need to talk to your doctor about whether this is advisable with your type of cancer.
Sore mouth affects about 4 out of every 10 (40%) patients treated
Diarrhoea affects about 4 out of every 10 (40%) patients treated
Allergic reaction during the infusion. About 1 in 4 people (25%) have an allergic reaction to docetaxel. This nearly always happens in the first 10 minutes. If you are going to have a reaction, it is most likely the first or second time you have the drug. Your chemotherapy nurse will monitor you closely for this.
Docetaxel may have a harmful effect on a baby developing in the womb. You should not become pregnant or father a child whilst taking this drug. Discuss contraception with your doctor before you start your treatment if there is any possibility that you or your partner could become pregnant.
Occasional side effects
Some people have the following side effects
Feeling or being sick this is usually mild and lasts for only a short time after having each treatment
Numbness and tingling in hands and feet
Loss of fertility - it is not known exactly what effect this drug may have on your fertility. It is important to talk to your doctor before starting treatment. Women may stop having periods (amenorrhoea). This may only be temporary.
Aching muscles and joints
High temperature (fever)
While you are having your treatment, docetaxel can leak into the tissues around the needle (cannula) and cause damage. It is important to tell your doctor or nurse straight away if you have any
- Stinging or burning around the needle
- Leakage of fluid
- Redness or swelling around the cannula site after the infusion has finished
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.
Immunisations
You should not have immunisations with live vaccines while you are having chemotherapy or for 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.
It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
Cisplatin
Cisplatin is a chemotherapy drug that is widely used to treat different cancers including testicular, germ cell, head and neck, bladder and lung cancer. At the centre of this drug is an atom of the metal platinum. This damages the DNA of the cancer cells and stops them dividing.
Cisplatin is a clear liquid that you have through a drip (infusion) into a vein through a fine tube (a cannula) put into one of your veins. Or you may have your infusion through a central line or a PICC line.
You usually have chemotherapy as a course of several cycles of treatment. To find out more about the way chemotherapy treatment is planned click on planning chemotherapy. You usually have cisplatin every 3 or 4 weeks. You can also have cisplatin weekly for cervical cancer.
We've listed the side effects that cisplatin can cause below. You can use the links (underlined) to find out more about each side effect. Where is no link please use the search box at the top of the screen. You can also look in general side effects of chemotherapy drugs.
Common side effects of cisplatin
Many people have one or more of the following side effects with cisplatin
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.
Feeling or being sick. Sickness with cisplatin can be severe. If you do get it, it may begin a few hours after treatment and last for a few days. But it is usually possible to control this side effect with anti-sickness injections and tablets. If you are still being sick after taking anti-sickness medicine, tell your doctor.
Cisplatin can cause kidney damage. You will be given blood tests before your treatment, to make sure your kidneys are able to cope with the drug. To help prevent damage it is important to drink plenty of water and you will be given fluids into your vein before and after your treatment.
You may not be able to hear some high-pitched sounds (this usually gets better on its own)
This drug may have a harmful effect on a developing baby. You should not become pregnant or father a child while taking this drug. Discuss contraception with your doctor before having the treatment, if there is any possibility that you or your partner could become pregnant.
Temporary effect on the bone marrow. The bone marrow makes blood cells and a drop in its function can cause
- An increased risk of getting infections. This is due to a temporary drop in the number of white blood cells produced by the bone marrow. Having a low white blood count means that you are less able to fight infections and can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should contact your doctor urgently if you think you have an infection.
- Tiredness and breathlessness. This is due to a drop in the number of red blood cells made by your bone marrow which is called anaemia. You may need a blood transfusion to treat anaemia.
- Bruising or bleeding more easily. This is due to a drop in the number of platelets produced by your bone marrow. You may have lots of tiny red spots or bruises on your arms or legs. You may have nosebleeds or notice your gums bleed when you brush your teeth.
Contact your hospital if you have any of these bone marrow side effects. These effects on the bone marrow can begin about 7 days after the treatment and usually return to normal at about 21-28 days. Your blood will be checked regularly to see how well your bone marrow is working.
Occasional side effects of cisplatin
Some people have the following side effects
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.
Loss of appetite may occur a few days after your treatment
Numbness or tingling in hands or feet. For example you may find you have difficulty in doing up buttons. This can occur a few days after the treatment or some weeks after. It usually improves a few months after the treatment is finished. Occasionally, there may be some permanent numbness.
You may have ringing in the ears (tinnitus). This happens to about 3 in 10 people treated (30%), but nearly always gets better on its own.
You may have a metallic taste and a loss of taste may also occur.
Allergic reactions can happen while the drug is going into your bloodstream. While you are having the cisplatin treatment you will be monitored for signs of an allergic reaction. Tell your nurse if you have skin rashes and itching, feel hot, shivery, go red in the face, feel dizzy, have a headache, feel breathless, anxious or need to pass urine.
Side effects with high doses of cisplatin
Blurred vision can be a side effect of high doses of cisplatin. This will go back to normal once the treatment has finished. Or you may notice that you find it difficult to tell the difference between certain colours. This may carry on for a while after treatment has finished, but will usually get better on its own eventually.
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.
People you can talk to about your side effects
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.
Immunisations
You should not have immunisations with live vaccines while you are having chemotherapy or for 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.
It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
Cisplatin is a clear liquid that you have through a drip (infusion) into a vein through a fine tube (a cannula) put into one of your veins. Or you may have your infusion through a central line or a PICC line.
You usually have chemotherapy as a course of several cycles of treatment. To find out more about the way chemotherapy treatment is planned click on planning chemotherapy. You usually have cisplatin every 3 or 4 weeks. You can also have cisplatin weekly for cervical cancer.
We've listed the side effects that cisplatin can cause below. You can use the links (underlined) to find out more about each side effect. Where is no link please use the search box at the top of the screen. You can also look in general side effects of chemotherapy drugs.
Common side effects of cisplatin
Many people have one or more of the following side effects with cisplatin
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.
Feeling or being sick. Sickness with cisplatin can be severe. If you do get it, it may begin a few hours after treatment and last for a few days. But it is usually possible to control this side effect with anti-sickness injections and tablets. If you are still being sick after taking anti-sickness medicine, tell your doctor.
Cisplatin can cause kidney damage. You will be given blood tests before your treatment, to make sure your kidneys are able to cope with the drug. To help prevent damage it is important to drink plenty of water and you will be given fluids into your vein before and after your treatment.
You may not be able to hear some high-pitched sounds (this usually gets better on its own)
This drug may have a harmful effect on a developing baby. You should not become pregnant or father a child while taking this drug. Discuss contraception with your doctor before having the treatment, if there is any possibility that you or your partner could become pregnant.
Temporary effect on the bone marrow. The bone marrow makes blood cells and a drop in its function can cause
- An increased risk of getting infections. This is due to a temporary drop in the number of white blood cells produced by the bone marrow. Having a low white blood count means that you are less able to fight infections and can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should contact your doctor urgently if you think you have an infection.
- Tiredness and breathlessness. This is due to a drop in the number of red blood cells made by your bone marrow which is called anaemia. You may need a blood transfusion to treat anaemia.
- Bruising or bleeding more easily. This is due to a drop in the number of platelets produced by your bone marrow. You may have lots of tiny red spots or bruises on your arms or legs. You may have nosebleeds or notice your gums bleed when you brush your teeth.
Contact your hospital if you have any of these bone marrow side effects. These effects on the bone marrow can begin about 7 days after the treatment and usually return to normal at about 21-28 days. Your blood will be checked regularly to see how well your bone marrow is working.
Occasional side effects of cisplatin
Some people have the following side effects
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.
Loss of appetite may occur a few days after your treatment
Numbness or tingling in hands or feet. For example you may find you have difficulty in doing up buttons. This can occur a few days after the treatment or some weeks after. It usually improves a few months after the treatment is finished. Occasionally, there may be some permanent numbness.
You may have ringing in the ears (tinnitus). This happens to about 3 in 10 people treated (30%), but nearly always gets better on its own.
You may have a metallic taste and a loss of taste may also occur.
Allergic reactions can happen while the drug is going into your bloodstream. While you are having the cisplatin treatment you will be monitored for signs of an allergic reaction. Tell your nurse if you have skin rashes and itching, feel hot, shivery, go red in the face, feel dizzy, have a headache, feel breathless, anxious or need to pass urine.
Side effects with high doses of cisplatin
Blurred vision can be a side effect of high doses of cisplatin. This will go back to normal once the treatment has finished. Or you may notice that you find it difficult to tell the difference between certain colours. This may carry on for a while after treatment has finished, but will usually get better on its own eventually.
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.
People you can talk to about your side effects
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.
Immunisations
You should not have immunisations with live vaccines while you are having chemotherapy or for 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.
It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
(Taxol) Paclitaxel
This chemotherapy drug is mostly used in the treatment of ovarian, breast and non-small cell lung cancer, often in combination with other anti-cancer drugs. The drug is extracted from the bark of one particular type of Yew tree. It works by stopping the cancers cells separating into two new cells, so it blocks the growth of the cancer.
You usually have Taxol (Paclitaxel) as an injection into a vein. This drug can cause an allergic reaction. To try to prevent this, you take steroid tablets for 3 days, starting the day before your treatment.
Chemotherapy is usually given as a course of several cycles of treatment. The treatment plan for paclitaxel depends on which cancer you are being treated for. To find out more about the way chemotherapy treatment is planned, look at Planning Chemotherapy.
The side effects associated with Taxol (paclitaxel) are below. Use the links (underlined) to find out more about each side effect. For more information on side effects where there is no link see the chemotherapy side effects section or click on 'search' at the top of the page.
Common side effects
Many people have one or more of the following side effects
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.
Feeling or being sick - this is generally very well controlled with anti-sickness injections and tablets.
Temporary effect on the bone marrow. The bone marrow makes blood cells and a drop in its function can cause
- An increased risk of getting infections. This is due to a temporary drop in the number of white blood cells produced by the bone marrow. Having a low white blood count means that you are less able to fight infections and can become very unwell. You may have headaches, aching muscles, cough, sore throat, pain passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should contact your doctor urgently if you think you have an infection.
- Tiredness and shortness of breath. This is due to a drop in the number of red blood cells made by your bone marrow which is called anaemia. You may need a blood transfusion to treat anaemia.
- Getting bruises more easily. This is due to a drop in the number of platelets produced by your bone marrow. You may have lots of tiny red spots or bruises on your arms or legs. You may have nosebleeds or notice your gums bleed when you brush your teeth.
Contact your hospital if you have any of these bone marrow side effects.
Hair loss (alopecia) - this drug often causes complete hair loss. This is only temporary and your hair will grow back after your treatment is over. A cold cap may help to stop you losing your hair, but you need to talk to your doctor about how advisable this is with your type of cancer.
Numbness and tingling in the hands and feet (peripheral neuropathy).
Aching or pain in joints (arthralgia) and muscles (myalgia), a couple of days after treatment, lasting for about five days. This affects about 6 out of 10 people treated.
Mouth sores and ulcers
Diarrhoea - you should drink plenty of fluids. If it becomes severe or persistent you could become dehydrated so you should tell your doctor or nurse.
This drug may have a harmful effect on a baby developing in the womb. It is not advisable to become pregnant or father a child whilst having chemotherapy. You should talk to your doctor about contraception before you start treatment.
Mild allergic reactions - usually a rash or redness of the face. About 1 in 5 people treated have this type of reaction.
Occasional side effects
Some people have the following side effects
Immediate severe allergic reaction (doctors usually give steroids and other medicines routinely given to stop this happening more often)
Low blood pressure
Slowing down of the heart rate (bradycardia)
Abdominal pain
Temporary taste alterations
Headaches
Mild effect on the liver. You are unlikely to notice any symptoms from this. The liver function will almost certainly go back to normal when treatment is finished. To be on the safe side, your doctor will keep and eye on how your liver is working with blood tests called liver function tests.
While you are having the chemotherapy, paclitaxel may leak from the drip or injection site and damage the body tissues in that area. It is important to tell the nurse or doctor if you have any
- Stinging or burning around the site
- Leaking fluid
- Redness or swelling around the site after treatment is finished
Loss of fertility - it is not known exactly what effect this drug may have on your fertility. It is important to talk with your doctor before starting treatment. Women may stop having periods (amenorrhoea). This may only be temporary.
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.
People you can talk to about your side effects
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.
Immunisations
You should not have immunisations with live vaccines while you are having chemotherapy or for 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.
It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
You usually have Taxol (Paclitaxel) as an injection into a vein. This drug can cause an allergic reaction. To try to prevent this, you take steroid tablets for 3 days, starting the day before your treatment.
Chemotherapy is usually given as a course of several cycles of treatment. The treatment plan for paclitaxel depends on which cancer you are being treated for. To find out more about the way chemotherapy treatment is planned, look at Planning Chemotherapy.
The side effects associated with Taxol (paclitaxel) are below. Use the links (underlined) to find out more about each side effect. For more information on side effects where there is no link see the chemotherapy side effects section or click on 'search' at the top of the page.
Common side effects
Many people have one or more of the following side effects
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.
Feeling or being sick - this is generally very well controlled with anti-sickness injections and tablets.
Temporary effect on the bone marrow. The bone marrow makes blood cells and a drop in its function can cause
- An increased risk of getting infections. This is due to a temporary drop in the number of white blood cells produced by the bone marrow. Having a low white blood count means that you are less able to fight infections and can become very unwell. You may have headaches, aching muscles, cough, sore throat, pain passing urine or feel cold and shivery. Infections can sometimes be life threatening. You should contact your doctor urgently if you think you have an infection.
- Tiredness and shortness of breath. This is due to a drop in the number of red blood cells made by your bone marrow which is called anaemia. You may need a blood transfusion to treat anaemia.
- Getting bruises more easily. This is due to a drop in the number of platelets produced by your bone marrow. You may have lots of tiny red spots or bruises on your arms or legs. You may have nosebleeds or notice your gums bleed when you brush your teeth.
Contact your hospital if you have any of these bone marrow side effects.
Hair loss (alopecia) - this drug often causes complete hair loss. This is only temporary and your hair will grow back after your treatment is over. A cold cap may help to stop you losing your hair, but you need to talk to your doctor about how advisable this is with your type of cancer.
Numbness and tingling in the hands and feet (peripheral neuropathy).
Aching or pain in joints (arthralgia) and muscles (myalgia), a couple of days after treatment, lasting for about five days. This affects about 6 out of 10 people treated.
Mouth sores and ulcers
Diarrhoea - you should drink plenty of fluids. If it becomes severe or persistent you could become dehydrated so you should tell your doctor or nurse.
This drug may have a harmful effect on a baby developing in the womb. It is not advisable to become pregnant or father a child whilst having chemotherapy. You should talk to your doctor about contraception before you start treatment.
Mild allergic reactions - usually a rash or redness of the face. About 1 in 5 people treated have this type of reaction.
Occasional side effects
Some people have the following side effects
Immediate severe allergic reaction (doctors usually give steroids and other medicines routinely given to stop this happening more often)
Low blood pressure
Slowing down of the heart rate (bradycardia)
Abdominal pain
Temporary taste alterations
Headaches
Mild effect on the liver. You are unlikely to notice any symptoms from this. The liver function will almost certainly go back to normal when treatment is finished. To be on the safe side, your doctor will keep and eye on how your liver is working with blood tests called liver function tests.
While you are having the chemotherapy, paclitaxel may leak from the drip or injection site and damage the body tissues in that area. It is important to tell the nurse or doctor if you have any
- Stinging or burning around the site
- Leaking fluid
- Redness or swelling around the site after treatment is finished
Loss of fertility - it is not known exactly what effect this drug may have on your fertility. It is important to talk with your doctor before starting treatment. Women may stop having periods (amenorrhoea). This may only be temporary.
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.
People you can talk to about your side effects
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.
Immunisations
You should not have immunisations with live vaccines while you are having chemotherapy or for 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.
It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
How chemotherapy works
This page explains how chemotherapy works.
How chemotherapy kills cancer cells ?
How chemotherapy kills dividing cells ?
Will chemotherapy cure me?
What does remission mean?
How chemo kills cancer cells ?
Chemotherapy drugs damage cells that are dividing. Body tissues are made of billions of individual cells. Once we are fully grown, most of the body's cells are not dividing. They spend most of their time in a resting state and only divide if they need to repair damage. When cells divide they split into two, identical new cells. Cells in the process of dividing are more at risk of being damaged by chemotherapy. And cancer cells divide much, much more often than most normal cells. There is more detailed information about how normal cells grow and about how cancer cells differ from normal cells in the About Cancer section of CancerHelp UK. So when an individual cell divides, there are 2 and these divide to make 4 and then 8 and so on. This is how tumours grow and form lumps. Chemotherapy damages part of the control centre inside each cell that makes cells divide. Or it interrupts the chemical processes involved in cell division. The damaged cells then die.
How chemotherapy kills dividing cells
Chemotherapy damages cells as they divide. In the centre of each living cell is a dark blob, called the nucleus. The nucleus is the control centre of the cell. It contains chromosomes, which are made up of genes. These genes have to be copied exactly each time a cell divides into 2 to make new cells.
Chemotherapy damages the genes inside the nucleus of cells. Some drugs damage cells at the point of splitting. Some damage them while they are busy making copies of all their genes before they split. Cells that are at rest (most normal cells, for instance) are much less likely to be damaged by chemo. You may have a combination of different chemotherapy drugs. The combination will include chemo drugs that damage cells at different stages in the process of cell division. With more than one type of drug, there is more chance of killing more cells.
The fact that chemo drugs kill dividing cells helps to explain why chemotherapy causes side effects. It affects healthy body tissues where the cells are constantly growing and dividing. The skin, bone marrow, hair follicles and lining of the digestive system are examples of these. Your hair is always growing. Your bone marrow is constantly producing blood cells. The cells of your skin and the lining of your digestive system are constantly renewing themselves. These tissues have dividing cells and they can be damaged by chemotherapy.
But, normal cells can replace the healthy cells that are damaged by chemotherapy. So the damage to healthy cells doesn't usually last. Most side effects disappear once your treatment is over, and many only occur for the days while you are actually having the drugs (for example, sickness or diarrhoea). The section on chemotherapy side effects goes into this in more detail.
Will chemotherapy cure me?
The chance of the chemotherapy curing your cancer depends on the type of cancer you have
With some types of cancer, most people are cured by chemotherapy
With other types of cancer, fewer people are completely cured
Examples of cancers that respond particularly well to chemotherapy are testicular cancer and Hodgkin's lymphoma.
With some cancers, chemotherapy can't cure the cancer on its own. But it can help in combination with other types of treatment. Many people with breast or bowel cancer, for example, have chemotherapy after surgery to help lower the risk of the cancer coming back.
With some cancers, if a cure is unlikely, your doctor may still suggest chemotherapy to
Shrink the cancer
Relieve your symptoms
Give you a longer life by controlling the cancer or putting it into remission
What does 'remission' mean?
Remission is a word doctors often use when talking about cancer. It means there is no sign of the cancer. Doctors can be reluctant to say that a cancer is 'cured' because some cancers can come back years later. The more time that goes by, the less likely it is that a cancer will come back. But there is still that small chance. So doctors use the word 'remission'. You may hear your doctor talk about complete remission and partial remission. Complete remission means that the cancer can't be detected on scans, X-rays, or blood tests etc.
Partial remission means the treatment has killed some of the cells, but not all. The cancer has shrunk, but can still be seen on scans and doesn't appear to be growing.. The treatment may have stopped the cancer from growing. Or made it smaller so that other treatments are more likely to help, such as surgery or radiotherapy.
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
How chemotherapy kills cancer cells ?
How chemotherapy kills dividing cells ?
Will chemotherapy cure me?
What does remission mean?
How chemo kills cancer cells ?
Chemotherapy drugs damage cells that are dividing. Body tissues are made of billions of individual cells. Once we are fully grown, most of the body's cells are not dividing. They spend most of their time in a resting state and only divide if they need to repair damage. When cells divide they split into two, identical new cells. Cells in the process of dividing are more at risk of being damaged by chemotherapy. And cancer cells divide much, much more often than most normal cells. There is more detailed information about how normal cells grow and about how cancer cells differ from normal cells in the About Cancer section of CancerHelp UK. So when an individual cell divides, there are 2 and these divide to make 4 and then 8 and so on. This is how tumours grow and form lumps. Chemotherapy damages part of the control centre inside each cell that makes cells divide. Or it interrupts the chemical processes involved in cell division. The damaged cells then die.
How chemotherapy kills dividing cells
Chemotherapy damages cells as they divide. In the centre of each living cell is a dark blob, called the nucleus. The nucleus is the control centre of the cell. It contains chromosomes, which are made up of genes. These genes have to be copied exactly each time a cell divides into 2 to make new cells.
Chemotherapy damages the genes inside the nucleus of cells. Some drugs damage cells at the point of splitting. Some damage them while they are busy making copies of all their genes before they split. Cells that are at rest (most normal cells, for instance) are much less likely to be damaged by chemo. You may have a combination of different chemotherapy drugs. The combination will include chemo drugs that damage cells at different stages in the process of cell division. With more than one type of drug, there is more chance of killing more cells.
The fact that chemo drugs kill dividing cells helps to explain why chemotherapy causes side effects. It affects healthy body tissues where the cells are constantly growing and dividing. The skin, bone marrow, hair follicles and lining of the digestive system are examples of these. Your hair is always growing. Your bone marrow is constantly producing blood cells. The cells of your skin and the lining of your digestive system are constantly renewing themselves. These tissues have dividing cells and they can be damaged by chemotherapy.
But, normal cells can replace the healthy cells that are damaged by chemotherapy. So the damage to healthy cells doesn't usually last. Most side effects disappear once your treatment is over, and many only occur for the days while you are actually having the drugs (for example, sickness or diarrhoea). The section on chemotherapy side effects goes into this in more detail.
Will chemotherapy cure me?
The chance of the chemotherapy curing your cancer depends on the type of cancer you have
With some types of cancer, most people are cured by chemotherapy
With other types of cancer, fewer people are completely cured
Examples of cancers that respond particularly well to chemotherapy are testicular cancer and Hodgkin's lymphoma.
With some cancers, chemotherapy can't cure the cancer on its own. But it can help in combination with other types of treatment. Many people with breast or bowel cancer, for example, have chemotherapy after surgery to help lower the risk of the cancer coming back.
With some cancers, if a cure is unlikely, your doctor may still suggest chemotherapy to
Shrink the cancer
Relieve your symptoms
Give you a longer life by controlling the cancer or putting it into remission
What does 'remission' mean?
Remission is a word doctors often use when talking about cancer. It means there is no sign of the cancer. Doctors can be reluctant to say that a cancer is 'cured' because some cancers can come back years later. The more time that goes by, the less likely it is that a cancer will come back. But there is still that small chance. So doctors use the word 'remission'. You may hear your doctor talk about complete remission and partial remission. Complete remission means that the cancer can't be detected on scans, X-rays, or blood tests etc.
Partial remission means the treatment has killed some of the cells, but not all. The cancer has shrunk, but can still be seen on scans and doesn't appear to be growing.. The treatment may have stopped the cancer from growing. Or made it smaller so that other treatments are more likely to help, such as surgery or radiotherapy.
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
The need for a plan for chemotherapy
Chemotherapy is not usually a single treatment, but a course of treatments. A course usually takes between 3 to 6 months, but can be more or less than that. During that time, you would probably have between 4 to 8 cycles of treatment.
A cycle includes the time when you have your chemotherapy treatment and then a break before the next treatment, to allow your body to recover. So if your cycle lasts 4 weeks, you may have treatment on the 1st, 2nd and 3rd days and then nothing on the 4th to the 28th day. Then the cycle starts again. Or, as another example, you may have a 3 week cycle, where you have treatment on the 1st and 8th days, but nothing on days 2 - 7 and days 9 - 21. The treatment may include one or more intravenous chemotherapy drugs and may include chemotherapy tablets or capsules.
Depending on the drug or combination of drugs, each treatment lasts from a few hours to a few days. You may have treatments every week or every 2, 3 or 4 weeks, depending on the drugs and your treatment plan. Your doctor may refer to this as your chemotherapy regime (or chemotherapy regimen). If you're having chemotherapy as tablets you may take smaller doses daily for a few days or for many weeks or months. Then you'll have a rest period.
Why cycles of treatment?
There are a couple of good reasons why you have chemotherapy as a course of treatments over a few months. Firstly, it allows the chemotherapy to kill more cancer cells. At any one time, some of the cancer cells will be resting. Chemotherapy only attacks cells that are in the process of dividing (splitting into two). So resting cells will not be killed. Some of the cancer cells that were resting during your 1st treatment will be dividing by the time your 2nd comes around and so will be killed off. There is more about this in this section about how chemotherapy works.
The second good reason for giving treatment in cycles is that the rest between treatments allows your body to recover from any side effects. Normal cells usually repair the damage from chemotherapy more effectively than cancer cells, so damage to cancer cells should progressively build up without causing permanent damage to normal cells.
How your doctor chooses your treatment
The exact regime that your doctor chooses depends on a number of factors
The type of cancer you have
Where it is in your body
Whether it has spread
Where it has spread to (if it has)
Your doctor will also take your general health and fitness and your age into account. Some drugs have more of an effect on your body than others. Your doctor has to judge that you are well enough to be able to cope with any side effects of the treatment before you start. How often you have each cycle, and how long your treatment course lasts, also depends on many factors including
The type of cancer
The drugs used
How the cancer cells respond to the drugs
Any side effects from the drugs
Number of treatment cycles
All the treatment you are offered is based on years of research. The research will have compared different ways of giving the chemotherapy and different numbers of treatments. The people given chemotherapy in those clinical trials will have been followed up to see how they did. The combination of drugs your doctor suggests will be the best of all those tested. Usually, it takes several months to complete your course of chemotherapy treatments. You need to have enough courses to kill the cancer. But not so many that you develop severe or permanent side effects.
When you have chemotherapy through an infusion pump you can have the drugs
All the time for a few months (continuous administration)
For a few days each month
For a few weeks
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
A cycle includes the time when you have your chemotherapy treatment and then a break before the next treatment, to allow your body to recover. So if your cycle lasts 4 weeks, you may have treatment on the 1st, 2nd and 3rd days and then nothing on the 4th to the 28th day. Then the cycle starts again. Or, as another example, you may have a 3 week cycle, where you have treatment on the 1st and 8th days, but nothing on days 2 - 7 and days 9 - 21. The treatment may include one or more intravenous chemotherapy drugs and may include chemotherapy tablets or capsules.
Depending on the drug or combination of drugs, each treatment lasts from a few hours to a few days. You may have treatments every week or every 2, 3 or 4 weeks, depending on the drugs and your treatment plan. Your doctor may refer to this as your chemotherapy regime (or chemotherapy regimen). If you're having chemotherapy as tablets you may take smaller doses daily for a few days or for many weeks or months. Then you'll have a rest period.
Why cycles of treatment?
There are a couple of good reasons why you have chemotherapy as a course of treatments over a few months. Firstly, it allows the chemotherapy to kill more cancer cells. At any one time, some of the cancer cells will be resting. Chemotherapy only attacks cells that are in the process of dividing (splitting into two). So resting cells will not be killed. Some of the cancer cells that were resting during your 1st treatment will be dividing by the time your 2nd comes around and so will be killed off. There is more about this in this section about how chemotherapy works.
The second good reason for giving treatment in cycles is that the rest between treatments allows your body to recover from any side effects. Normal cells usually repair the damage from chemotherapy more effectively than cancer cells, so damage to cancer cells should progressively build up without causing permanent damage to normal cells.
How your doctor chooses your treatment
The exact regime that your doctor chooses depends on a number of factors
The type of cancer you have
Where it is in your body
Whether it has spread
Where it has spread to (if it has)
Your doctor will also take your general health and fitness and your age into account. Some drugs have more of an effect on your body than others. Your doctor has to judge that you are well enough to be able to cope with any side effects of the treatment before you start. How often you have each cycle, and how long your treatment course lasts, also depends on many factors including
The type of cancer
The drugs used
How the cancer cells respond to the drugs
Any side effects from the drugs
Number of treatment cycles
All the treatment you are offered is based on years of research. The research will have compared different ways of giving the chemotherapy and different numbers of treatments. The people given chemotherapy in those clinical trials will have been followed up to see how they did. The combination of drugs your doctor suggests will be the best of all those tested. Usually, it takes several months to complete your course of chemotherapy treatments. You need to have enough courses to kill the cancer. But not so many that you develop severe or permanent side effects.
When you have chemotherapy through an infusion pump you can have the drugs
All the time for a few months (continuous administration)
For a few days each month
For a few weeks
Cancer Research UK
NHS Information Partners
Copyright Cancer Research UK 2002
Cancer Research UK Charity Number 1089464
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