A chemotherapy regimen consisting of carboplatin and paclitaxel (Taxol) is used for the treatment of endometrial, epithelial ovarian, head and neck, and advanced-stage non-small cell lung cancers. It may sometimes be used to treat other cancers.
HOW CARBOPLATIN-TAXOL IS GIVEN
You will be given paclitaxel and carboplatin in the chemotherapy day unit. A chemotherapy nurse will give it to you.
During treatment, you usually see a cancer doctor, a chemotherapy nurse, or a specialist nurse. This is who we mean when we mention doctor or nurse in this information.
Before or on the day of treatment, a nurse or person trained to take blood (phlebotomist) will take a blood sample from you. This is to check that your blood cells are at a safe level to have chemotherapy.
You will see a doctor or nurse before you have chemotherapy. They will ask you how you have been feeling. If your blood results are okay, the pharmacist will prepare your chemotherapy. Your nurse will tell you when your treatment is likely to be ready.
Your nurse usually gives you anti-sickness (antiemetic) drugs before the chemotherapy. The chemotherapy drugs can be given through:
- a short thin tube the nurse puts into a vein in your arm or hand (cannula)
- a fine tube that goes under the skin of your chest and into a vein close by (central line)
- a fine tube that is put into a vein in your arm and goes up into a vein in your chest (PICC line).
You may have steroids as an injection before your treatment. Or you may be given steroid tablets to take the day before your treatment. It is important to take these exactly as the doctor or nurse has explained to you. You must tell your doctor or nurse if for any reason you have not taken them.
Your nurse gives you paclitaxel as a drip (infusion) into your cannula or line over three hours. After this, you have carboplatin as a drip for about an hour.
COURSE OF THERAPY
You usually have a course of several cycles of treatment over a few months. Your nurse or doctor will discuss your treatment plan with you.
Each cycle of paclitaxel and carboplatin usually takes 21 days (3 weeks), but this depends on the type of cancer you have.
On the first day, you will have paclitaxel and carboplatin. You then have no treatment for the next 20 days. At the end of the 21 days, you start your second cycle of paclitaxel and carboplatin. This is exactly the same as the first cycle.
This is not a complete list of all the side effects. It’s very unlikely that you will have all of these side effects, but you might have some of them at the same time.
How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you’re having. For example, your side effects could be worse if you’re also having other drugs or radiotherapy.
Common side effects:-
Each of these effects happens in more than 1 in 10 people (more than 10%). You might have one or more of them. They include:-
(a) Increased risk of infection:-
An increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery, and generally unwell. You might have other symptoms depending on where the infection is.
Infections can sometimes be life-threatening. You should contact your advice line urgently if you think you have an infection.
(b) Breathless and looking pale:-
You might be breathless and looking pale due to a drop in red blood cells. This is called anemia.
(c) Bruising, bleeding gums, and nosebleeds:-
This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).
(d) Tiredness and fatigue after treatment:-
This can happen during and after treatment – doing gentle exercises each day can keep your energy up. Don’t push yourself, rest when you start to feel tired, and ask others for help.
(e) Feeling sick:-
It is usually well controlled with anti-sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.
It is important to take anti-sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.
(f) Aching muscles and joints:-
You might feel some pain in your muscles and joints. Speak to your doctor or nurse about what painkillers you can take to help with this.
(g) Mild allergic reaction:-
You might have a mild allergic reaction during or shortly after treatment. You might have itching, rash, or a red face.
You will usually be given medication just before treatment to prevent or reduce the risk of an allergic reaction.
(h) Hair loss:-
You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg, and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different color or be curlier than before.
You might be offered scalp cooling to help reduce hair loss.
(i) Kidney damage:-
To help prevent kidney damage, it is important to drink plenty of water. You might also have fluids in your vein before, during, and after treatment. You have blood tests before your treatments to check how well your kidneys are working.
(j) Sore mouth and ulcers:-
Mouth sores and ulcers can be painful. Keep your mouth and teeth clean; drink plenty of fluids; avoid acidic foods such as oranges, lemons, and grapefruits; chew gum to keep the mouth moist and tell your doctor or nurse if you have ulcers.
Contact your advice line if you have diarrhea, such as if you’ve had 4 or more loose watery poos (stools) in 24 hours. Or if you can’t drink to replace the lost fluid. Or if it carries on for more than 3 days.
Your doctor may give you anti-diarrhea medicine to take home with you after treatment. Eat less fiber, avoid raw fruits, fruit juice, cereals, and vegetables, and drink plenty to replace the fluid lost.
(l) Numbness and tingling in fingers or toes:-
This is often temporary and can improve after you finish treatment. Tell your doctor if you’re finding it difficult to walk or complete fiddly tasks such as doing up buttons.
If you are unable to walk or do fiddly tasks such as doing up buttons, it is important to let your doctor or nurse know.
(m) Low blood pressure:-
Tell your doctor or nurse if you feel lightheaded or dizzy. You have your blood pressure checked regularly.
(n) Liver changes:-
You might have life changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the way your liver is working.
(o) Tummy( abdominal) pain:-
Tell your treatment team if you have this. They can check the cause and give you medicine to help.
Occasional side effects:-
Each of these effects happens in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
- loss of appetite
- loss of taste or a metallic taste in your mouth – your taste gradually returns to normal after treatment is finished
- loss of hearing – especially high-pitched sounds. Tell your doctor if you have hearing loss
- ringing in the ears – this is tinnitus and it often gets better after treatment has finished
- slow heart rate – your heart rate (pulse) will be checked regularly
- headaches – tell your doctor if you have headaches. Mild painkillers such as paracetamol can help
- inflammation around the drip site – tell your nurse straight away if you notice any redness, swelling, or leaking at your drip site
- nail and skin changes – these are usually mild and temporary
Rare side effects:-
These side effects happen in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:
- an allergic reaction
- changes to the lung tissue that can cause cough and breathlessness. Rarely this can be life-threatening. Contact your advice line or doctor straight away if you have any of these symptoms.
OTHER THINGS TO KNOW ABOUT
(a) Other medicines, food, and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements, and over-the-counter remedies.
(b) Pregnancy and contraception
This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you’re having treatment and for a few months afterward. Talk to your doctor or nurse about effective contraception before starting treatment.
(c) Loss of fertility
You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.
Don’t breastfeed during this treatment because the drugs may come through in your breast milk.
(e) Treatment and other conditions
Always tell other doctors, nurses, pharmacists, or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t have immunizations with live vaccines while you’re having treatment and for up to 12 months afterward. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever, and the shingles vaccine (Zostavax).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine (as an injection)