(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.


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