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.

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