Browser does not support script.
Skip to main content
Find out how we produce our information|
This information is about a chemotherapy| treatment using cisplatin| and fluorouracil (5FU)|. It's used to treat cancers affecting the gullet| (oesophagus), the head and neck| area, and anal |cancers.
Sometimes cisplatin and 5FU chemotherapy is given at the same time as radiotherapy|. This is known as chemoradiation. Sometimes this treatment may be referred to as fluorouracil and cisplatin chemotherapy.
This treatment involves two chemotherapy drugs: cisplatin and fluorouracil, which is also known as 5FU.
Cisplatin and 5FU treatment can be given to you either during a short stay in hospital, or as a day patient. You will need to have a blood test before your treatment – either on the same day, or a few days beforehand. You will also be seen by a doctor, specialist nurse or pharmacist. If the results of your blood test are normal, the pharmacy will prepare your chemotherapy drugs|. This may take a couple of hours.
The nurse will insert a thin, flexible tube (cannula) into a vein in your hand or arm. You may find this uncomfortable or a little painful but it shouldn't take long. Some people have their chemotherapy given through a thin, plastic tube inserted under the skin and into a vein near the collarbone (central line|), or passed through a vein in the crook of their arm (PICC line|). You'll almost certainly need a central or PICC line if you are treated as an outpatient. Your doctor or nurse will explain more about this.
You'll be given some anti-sickness (anti-emetic)| drugs before your chemotherapy. These are usually given by injection through the cannula, central line or PICC line, which is connected to a drip (infusion). Some anti-sickness medicines may be given as tablets.
The cisplatin (a clear fluid) will be given as an infusion into a vein through your cannula or line. You'll be given plenty of fluid through your drip before and after the cisplatin to keep your kidneys working normally. This is known as pre- and post-hydration.
After this, you'll be given a continuous infusion of 5FU (a clear fluid) through the drip. You'll need to stay in hospital for the infusion, unless you have a central or PICC line. If you do have a line, this part of the treatment can be given to you using a small, portable pump. This allows a controlled amount of the drug to be pumped into your bloodstream over a set period of time. The pump is small enough to be carried in a belt or holster. This means that once the pump is connected to your central line and the treatment is started, you can go home.
When the infusion is finished, there may be some fluid left in the pump. This may be normal, as some types of pump need to be overfilled to get the correct dose. You can check with your nurse or pharmacist whether you have this type of pump.
If you're being treated as an inpatient, you can go home when it has finished and the cannula will be removed before you go. If you have a central or PICC line it will usually stay in place, ready for your next cycle of chemotherapy. You'll be shown how to look after the line.
You'll be given a supply of anti-sickness drugs to take home with you. It's important to take these as directed even if you aren't feeling sick. This is because some anti-sickness drugs are much better at preventing sickness than stopping it once it starts.
Your doctor may use the word 'regimen|' (eg the cisplatin 5FU regimen) when talking about your chemotherapy. This means the whole plan or schedule of your particular chemotherapy treatment.
There are different ways of giving cisplatin and 5FU, depending upon your situation. Below are descriptions of three different schedules for this chemotherapy regimen. Your doctor or nurse can explain how you'll be having your chemotherapy.
On the first day of your treatment you'll be given an infusion of cisplatin with pre- and post-hydration. After this, you'll also start an infusion of 5FU that lasts for four days. If you have a central or PICC line, you can go home with a portable pump attached. You'll need to return to the hospital on the fifth day to have the pump disconnected, although it may be possible for a nurse to visit you at home to disconnect the pump. If you don't have a line, you will need to stay in hospital until the infusion is finished.
After this you'll have a rest period,with no chemotherapy for 17 days. This completes what is called a cycle of your chemotherapy treatment.
You'll start the next cycle after the rest period, which will be three weeks after you began your treatment. Usually, 2–6 cycles are given.
For anal cancer, two cycles of this treatment can be given with radiotherapy.
On the first day of your treatment, you'll be given an infusion of cisplatin with pre- and post-hydration. You'll also be given an infusion of 5FU that lasts for 22 hours. Over the next three days (days two, three and four), you'll repeat the 22-hour infusions of 5FU. Unless you have a central or PICC line, you will need to stay in hospital until the fifth day, when the infusions have finished. If you have a line, this part of the treatment can be given to you through a small, portable pump, so that you can go home and return the next day for the 5FU infusion to be changed. Once the 5FU infusions have finished, you'll have a rest period, with no chemotherapy for 17 days. This completes a cycle of your treatment.
You will begin the next cycle after the rest period, which will be three weeks after you started your treatment. Usually 2–6 cycles of chemotherapy are given.
On the first day of your treatment you'll be given an infusion of cisplatin with pre- and post-hydration. You'll also start a continuous infusion of 5FU that lasts for 21 days, using a small, portable pump. Usually the pump is changed every seven days (you will have a pump on day one, a new pump on day eight, and a new pump on day 15). You will need to have either a central line or a PICC line for this treatment. This completes the cycle of your treatment.
Your next cycle will begin when the 5FU is finished, which will be three weeks after you started your treatment. Usually 2–6 cycles of chemotherapy are given.
Each person’s reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described here won't affect everyone who is having this treatment.
We have outlined the most common side effects but haven't included those that are rare and therefore unlikely to affect you. If you notice any effects that aren't listed here, discuss them with your doctor, chemotherapy nurse or pharmacist.
This is common and may begin soon after the treatment is given and last for a few days. Occasionally it may last longer. Your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent, or greatly reduce, nausea or vomiting. If the sickness isn't controlled, or if it continues, tell your doctor; they can prescribe other anti-sickness drugs that may be more effective. Some anti-sickness drugs can cause constipation. Let your doctor or nurse know if this is a problem.
The 5FU in the pump is very unlikely to make you feel sick and it is unlikely that you will need anti-sickness medicines for more than a few days after your visit to the hospital.
Cisplatin and 5FU chemotherapy can reduce the number of white blood cells, which help to fight infection. White blood cells are produced by the bone marrow|. If the number of your white cells is low you will be more prone to infections|. A low white cell count is called neutropenia. This begins seven days after treatment and your resistance to infection is usually at its lowest 10–14 days after chemotherapy. The number of your white blood cells will then increase steadily and usually return to normal before your next cycle of chemotherapy is due.
You'll have a blood test before having more chemotherapy to check the number of white blood cells. Occasionally, your treatment may need to be delayed if your number of blood cells (blood count) is still low.
Cisplatin and 5FU chemotherapy can reduce the production of platelets, which help the blood to clot. Tell your doctor if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. You can have a platelet transfusion| if your platelet count is low.
Cisplatin and 5FU can reduce the number of red blood cells, which carry oxygen around the body. A low red blood cell count is called anaemia. This may make you feel tired and breathless|. Tell your doctor or nurse if you have these symptoms. You may need to have a blood transfusion| if the number of red blood cells becomes too low.
Your mouth may become sore| or dry, or you may notice small ulcers during this treatment. Some people find that sucking on ice may be soothing. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush, can help reduce the risk of this happening. Tell your nurse or doctor if you have any of these problems, as they can prescribe mouthwashes and medicine to prevent or clear mouth infections.
You may get constipated. This can usually be helped by drinking plenty of fluids, eating more fibre in your diet and doing some gentle exercise. You may need to take medicine to help (laxative). Your doctor can prescribe these or you can buy them at a pharmacy.
5FU can cause diarrhoea|. This can usually be easily controlled with medicine but tell your doctor if it is severe or continues. It's important to drink plenty of fluids if you have diarrhoea.
This is due to the effect of cisplatin and 5FU on the nerves and is known as peripheral neuropathy|. You may also notice that you have difficulty doing up buttons or similar fiddly tasks.
Tell your doctor if you notice any numbness or tingling in your hands or feet. It's important to report your symptoms to your doctor as they may be controlled by slightly lowering the dose of the drug.
This side effect usually improves slowly, a few months after the treatment has finished. Sometimes symptoms can persist, talk to your doctor if this happens.
Feeling tired| is a common side effect of chemotherapy, especially towards the end of treatment and for some weeks after it’s over. It’s important to try to pace yourself and get as much rest as you need. Try to balance this with doing some gentle exercise, such as short walks, which will help. If tiredness is making you feel sleepy, don’t drive or operate machinery.
5FU may cause an inflammation of the lining of the eyelids (conjunctiva) that makes your eyes feel sore, red and itchy. Let your doctor know so they can prescribe soothing eye drops if necessary.
This is rare, but your hair may thin or occasionally fall out completely. If this happens, it usually begins about 3–4 weeks after starting treatment, although it may occur earlier. This is temporary and your hair will start to grow back once the treatment has finished. Your hair may grow back straighter, curlier, finer, or a slightly different colour than it was before. Your nurse can give you advice about coping with hair loss.
You may have ringing in the ears (tinnitus) and you may lose the ability to hear some high-pitched sounds. Hearing loss can be more severe with higher doses and longer courses of treatment. Very occasionally your sense of balance may be affected. Any hearing loss, and balance changes, if they occur, may be permanent. However tinnitus usually improves when treatment ends. Tell your doctor if you notice any loss of hearing or tinnitus.
Occasionally during treatment you may get a strange, metallic or bitter taste in your mouth. Some people find sucking on a strongly flavoured sweet or mint helps disguise this. You may also notice that food tastes different|, but your normal taste will usually come back after treatment is over.
Some people lose their appetite| while they’re having chemotherapy. This can be mild and may only last a few days. If it doesn’t improve, you can ask to see a dietitian or specialist nurse at your hospital. They can give you advice on improving your appetite and keeping to a healthy weight|.
Cisplatin can affect your kidneys|. This doesn't usually cause any symptoms and the effect is generally mild. Rarely, it may cause permanent damage to the kidneys unless the treatment is stopped.
Before each treatment, your kidneys will be checked by a blood test. You’ll be given fluid through a drip (infusion) before and after the treatment to keep your kidneys working normally. You may be asked to measure and record what you drink and the amount of urine you pass. It’s important to tell your nurse or doctor if you pass less urine than usual.
If necessary, you may be given medicine to help you to pass urine. You may be asked to drink extra fluid before and after treatment. It's important to do this so let your doctor know if this is a problem, for example, if you are feeling sick.
A skin rash can sometimes occur while you are having treatment with Cisplatin and 5FU. It’s important to let your doctor know if this happens. Your doctor can prescribe medicine to help with this.
Rarely, your skin may darken. If it does, it usually goes back to normal a few months after the treatment has finished. During treatment and for several months afterwards, you'll be more sensitive to the sun and your skin may burn more easily than normal. You can still go out in the sun, but should wear a suncream with a high sun protection factor (SPF) and cover up with clothing and a hat.
Your nails may become brittle, chipped and ridged. These changes grow out slowly over a few months once the treatment has ended.
5FU may affect the way your heart works. Some people can experience chest pain and tightening across the centre of the chest while taking it. Chest pain can be caused by many things other than chemotherapy. If you develop any of these symptoms, contact your doctor immediately.
It’s important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they’re not mentioned above.
Cancer can increase the risk of developing a blood clot (thrombosis), and chemotherapy may increase this risk further.
A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain. Blood clots can be very serious so it’s important to tell your doctor straight away if you notice any of these symptoms. Most clots can be treated with drugs that thin the blood. The doctor or nurse can give you more information.
5FU interacts with the drugs phenytoin (Epanutin®), allopurinol (Zyloric®) and interferon| (IntronA®, Roferon-A®). It may also affect the action of some medicines given to thin the blood (anti-coagulants) such as warfarin. Let your doctor know if you are taking any of these.
You should also tell your doctor if you’re taking folic acid because it might increase the side effects of 5FU.
Some other medicines, including those you can buy in a shop or chemist, can be harmful to take when you are having chemotherapy. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapies| and herbal drugs|.
Your ability to become pregnant or father a child may be affected by having this treatment. It's important to discuss fertility| with your doctor before starting treatment.
It's not advisable to become pregnant or father a child while having Cisplatin or 5FU, as it may harm the developing baby. It’s important to use effective contraception while having this drug, and for at least a few months afterwards. You can discuss this with your doctor.
It’s not known whether chemotherapy drugs can be present in semen or vaginal fluids. To protect your partner it’s safest to either avoid sex or use a barrier form of contraception for about 48 hours after chemotherapy.
There is a risk that chemotherapy drugs may be present in breast milk so women are advised not to breastfeed during chemotherapy and for a few months afterwards.
If you’re admitted to hospital for a reason not related to the cancer, it’s important to tell the doctors and nurses looking after you that you are having chemotherapy treatment. You should tell them the name of your cancer specialist so that they can ask for advice.
It’s a good idea to know who you should contact if you have any problems or troublesome side effects when you’re at home. Your chemotherapy nurse or doctor will give you details of who to contact for advice. This should include ‘out-of hours’ contact details if you need to call someone at evenings, overnight or at the weekend.
This section is based upon our cisplatin and fluorouracil (5FU) chemotherapy fact sheet, which has been compiled using information from a number of reliable sources including:
Content last reviewed: 1 December 2011
Next planned review: 2013
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
Watch our slideshow with tips for coping with a poor appetite
Watch our slideshow with tips for coping with a sore mouth
Watch our video about coping with fatigue
Watch our slideshow about avoiding infection when you have reduced immunity
If you have any questions about Macmillan we would love to hear from you| .
You can also follow us| on Facebook, Twitter, Flickr or YouTube.
© Macmillan Cancer Support 2013
what are these?|