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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more| .
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This information is about a chemotherapy| treatment called cisplatin and topotecan (CT). It is used to treat cancer of the cervix and cancer of the ovary|. It describes the drugs used, how they are given and some of the possible side effects. If you have any further questions you can ask your doctor or nurse at the hospital where you are having your treatment or you can speak to one of our cancer support specialists|.
This treatment involves two chemotherapy drugs cisplatin| and topotecan (Hycamtin®)|.
Your chemotherapy treatment can usually be given to you as a day patient but occasionally you may need to stay in hospital overnight. Before you start treatment you will need to have a blood test, 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. All this may take a couple of hours.
The nurse will put a fine tube (cannula) into a vein in your hand or arm. You may find this uncomfortable or a little painful, but it shouldn’t last for long. Some people have chemotherapy given through a fine plastic tube (central line|) that is inserted under the skin and into a vein near the collarbone, or given through a fine plastic tube (PICC line|) passed up through a vein in your arm. This is usually done at the beginning of your treatment and remains in place until your chemotherapy is finished. Your doctor or nurse will explain more about this to you.
Once your chemotherapy is ready you will be given some anti-sickness (antiemetic) drugs. These are usually given by injection through the cannula or central or PICC line, which is connected to a drip (infusion). Some anti-sickness medicines are given as tablets.
Topotecan and cisplatin are both given to you separately as a drip. The topotecan procedure usually lasts for about 30 minutes and cisplatin is usually given over 1–2 hours. You’ll be given extra fluids through a drip before and after the cisplatin infusion. As this can all take several hours, you may need to stay in hospital overnight.
When your treatment is finished the cannula will be removed and you’ll be given a supply of anti-sickness drugs to take with you. It’s important to take these as directed even if you are not feeling sick. Some anti-sickness drugs are better at preventing sickness than at stopping it once it has started.
Your doctor may use the word ‘regimen’ (eg the CT regimen) when talking about your chemotherapy. This means the whole plan or schedule of the chemotherapy treatment that you are receiving.
On the first day of your treatment you will be given infusions of topotecan and cisplatin as described earlier. On the next two days (day 2 and day 3) you will be given topotecan only. Or, you may be given topotecan a week later on day 8 and then the following week on day 15.
After this you will have a rest period with no chemotherapy until the next cycle of your treatment. Each cycle lasts for three weeks.
After the rest period the same drugs will be given to you again to begin the next cycle of your treatment. You will be assessed during treatment and your doctor or nurse will advise you how many cycles of treatment you will require. Usually a minimum of four cycles 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 in this information will not affect everyone who is having this treatment. Side effects are usually temporary and will go away when your chemotherapy is over.
We have outlined the most common side effects so that you can be aware of them if they occur. However, we have not included those which are very rare and therefore extremely unlikely to affect you. If you notice any effects which you think may be due to the drugs, but which are not listed in here, please let your nurse or doctor know.
Lowered resistance to infection The chemotherapy drugs can reduce the production of white blood cells by the bone marrow, making you more prone to infection|. This effect can begin seven days after treatment has been given, and your resistance to infection usually reaches its lowest point around 10–14 days after chemotherapy. Your blood cells will then increase steadily, and will usually have returned to normal levels before your next cycle of chemotherapy is due.
Contact your doctor or the hospital straight away if:
You will have a blood test before having more chemotherapy, to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (the blood count) is still low.
Bruising or bleeding The chemotherapy can reduce the production of platelets, which help the blood to clot. Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, or bleeding gums.
Anaemia (low number of red blood cells) While having the treatment you may become anaemic. This can make you feel tired| and breathless|. Let your nurse or doctor know if these effects are a problem.
Feeling sick (nausea) or being sick Your doctor can prescribe very effective antisickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting|. If you do feel sick it may begin a few hours after the treatment is given and can last for a few days. Tell your doctor if the sickness is not controlled or if it continues. He or she can prescribe other anti-sickness drugs which may be more effective. Some anti-sickness drugs may cause constipation. Let your doctor or nurse know if this is a problem.
Loss of appetite A dietitian or specialist nurse at your hospital can give you advice about boosting your appetite, coping with eating difficulties| and maintaining your weight.
Hair loss This usually starts 3–4 weeks after the first dose of topotecan. Hair may be lost completely or may just become thinner. You may also have thinning and loss of eyelashes, eyebrows and other body hair. Hair loss| is temporary and your hair will start to grow again when your treatment is over.
Tiredness and a general feeling of weakness Many people feel extremely tired| during chemotherapy, particularly towards the end of treatment. It’s important to get as much rest as you need.
Changes to kidney function Cisplatin may affect your kidneys. Usually this doesn’t cause any symptoms, and the effect on the kidneys is mild. However, if the effect is severe the kidneys can be permanently damaged unless the treatment is stopped. To prevent any damage your kidneys will be checked by a blood test before each treatment.
You’ll be given fluid as a drip before and after the cisplatin to keep your kidneys working normally. You may be asked to measure and record what you drink and the amount of urine that you pass. If you pass less, or more, urine than usual it’s important to tell your nurse or doctor.
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, and it is important to do this. Let your doctor know if this is a problem, for example, if you’re feeling sick.
Numbness or tingling in the hands or feet This is due to the effect of cisplatin on nerves and is known as peripheral neuropathy|. You may notice that you have difficulty with fiddly tasks like doing up buttons. Tell your doctor if you notice any numbness or tingling in your hands or feet. The side effect usually slowly disappears up to a few months after the treatment ends.
Changes in hearing (due to cisplatin) You may have ringing in the ears (tinnitus) and you may lose the ability to hear some high-pitched sounds. This effect usually decreases when the treatment ends, but in a small number of cases it may be permanent. Tell your doctor if you notice any loss of hearing or tinnitus.
Taste changes You may notice that your food tastes different. Normal taste will usually come back after the treatment finishes. A dietitian or specialist nurse at your hospital can give advice about ways of coping with this side effect.
Sore mouth Your mouth may become sore| or you may notice small ulcers during this treatment. Drinking plenty of fluids and cleaning your teeth regularly and gently with a soft toothbrush can help to reduce the risk of this happening. Tell your nurse or doctor if you have any of these problems, as special mouthwashes and medicines to prevent or clear any mouth infection can be prescribed.
Diarrhoea If this is severe or continues let your doctor know. It’s important to drink plenty of fluids if you have diarrhoea|.
Allergic reaction Signs of an allergic reaction can include rashes, a high temperature, shivering, redness or darkening of the face, dizziness, headaches, breathlessness, anxiety and a need to pass urine. You will be monitored for any signs of an allergic reaction during the treatment. Tell your doctor or nurse if you have any of these.
Risk of blood clots Cancer can increase your risk of developing a blood clot (thrombosis), and having 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 is important to tell your doctor straight away if you have any of these symptoms. Most clots can be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.
Other medicines Some other medicines (including those you can buy from a shop or chemist) can be harmful to take when you are having chemotherapy. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies| and herbal drugs.
Fertility Your ability to become pregnant may be affected by this treatment. It’s important to discuss fertility| with your doctor before starting your chemotherapy.
Contraception It’s not advisable to become pregnant or father a child while taking this treatment, as the developing foetus may be harmed. It’s important to use effective contraception while taking these drugs, and for at least a few months afterwards. Again, discuss this with your doctor.
This section has been compiled using information from a number of reliable sources including:
For further references, please see general bibliography|.
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