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This information is about a chemotherapy| treatment for non-small cell lung cancer| using vinorelbine| and carboplatin|.
The treatment involves two chemotherapy drugs called vinorelbine, which is also known as Navelbine®, and carboplatin.
Vinorelbine and carboplatin chemotherapy can usually be given to you as a day patient. 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 have tests to check how well your kidneys are working as the chemotherapy can affect them. These may include collecting your urine for 24 hours, or having a specific blood test known as an EDTA test. You will also be seen by a doctor, specialist nurse or pharmacist.
If the results of your tests are normal, the pharmacy will prepare your chemotherapy drugs|. All of this may take a couple of hours.
The nurse will then put 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 through a thin, plastic tube, which is inserted under the skin and into a vein near their collarbone (central line|), or passed through a vein in the crook of their arm (PICC line|). Your doctor or nurse will explain more about this to you.
Before the chemotherapy you will be given some anti-sickness (anti-emetic)| medicines. 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 are given as tablets.
The chemotherapy drugs are then given separately:
If you are having your treatment as a day patient you can then go home, 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 will be shown how to look after the line.
You will be given a supply of anti-sickness medicines to take home with you. It is important to take these as directed, even if you aren't feeling sick. This is because some anti-sickness medication is better at preventing sickness than at stopping it once it starts.
Your doctor may use the word 'regimen|' (eg the vinorelbine carboplatin regimen) when talking about your chemotherapy. This means the whole plan or schedule of the chemotherapy treatment that you are being given.
On the first day of your treatment (day one) you'll be given both the vinorelbine and the carboplatin as described. One week later (day eight) you will be given another dose of vinorelbine. After this you will have a rest with no chemotherapy for two weeks. This completes what is called a cycle of treatment. Each cycle lasts for three weeks.
You start the next cycle of your treatment after the rest period, which is three weeks after your first infusion. Usually six cycles are given over a period of four months. This makes up a course of treatment.
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 unlikely to affect you. If you notice any effects that are not listed here, discuss them with your doctor, chemotherapy nurse or pharmacist.
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.
Vinorelbine and carboplatin 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 blood cells is low you will be more prone to infections|. A low white blood cell count is called neutropenia.
Neutropenia 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 will 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.
Vinorelbine and carboplatin 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.
Vinorelbine and carboplatin 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.
This doesn't usually cause any symptoms and the effect is generally mild. If the effect is severe, however, the kidneys| can be permanently damaged unless the treatment is stopped. For this reason your kidneys will be checked by a blood test before each treatment.
If necessary, you may be given medicine to help you 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.
You may get constipated. This can usually be helped by drinking plenty of fluids, eating more fibre and doing some exercise. You may need to take medicine to help (laxatives). Your doctor can prescribe these or you can buy them at a pharmacy.
Vinorelbine and carboplatin 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.
Your mouth may become sore or dry|, 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. Some people may find sucking on ice soothing. 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.
Vinorelbine can cause pain along the vein that is used to give you your chemotherapy. If you feel any pain, tell your doctor or nurse straight away so that they can check the infusion site. They may slow the infusion down to reduce pain.
This is due to the effect of carboplatin or vinorelbine on nerves and is known as peripheral neuropathy|. You may also notice that you have difficulty doing up buttons, or doing other fiddly tasks.
Peripheral neuropathy is very rare if you receive normal doses of carboplatin, but may occur if you have high-dose treatment. 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 effect usually begins to improve slowly a few months after the treatment is finished. Sometimes symptoms can persist; talk to your doctor if this happens.
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 notice that food tastes different|. Normal taste usually comes back after treatment finishes. A dietitian or specialist nurse at your hospital can give you advice about ways of coping with this side effect.
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|.
Signs of an allergic reaction include skin rashes and itching, a high temperature, shivering, reddening of the face, dizziness, a headache, breathlessness, anxiety, and a feeling that you want to pass urine. You will be monitored for any signs of an allergic reaction during the treatment. Tell your doctor or nurse about any side effects you have.
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.
If this happens when vinorelbine is being given, the tissue in that area can be damaged. Tell the doctor or nurse immediately if you notice any stinging or burning around the vein while the drug is being given. This is unlikely to happen if the chemotherapy is given through a central or PICC line.
If the area around the injection site becomes red or swollen at any time, you should tell the doctor or nurse on the ward. If you are at home, ring the clinic or ward and ask to speak to the doctor or nurse.
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.
Some medicines, including those that 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 vinorelbine and carboplatin chemotherapy, as it may harm the developing baby. It's important to use effective contraception while taking this drug, and for up to a year afterwards. You can discuss this with your doctor or nurse.
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.
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 on our vinorelbine and carboplatin chemotherapy fact sheet, which has been compiled using information from a number of reliable sources including:
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