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.


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