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Dactinomycin is a chemotherapy drug| usually given to treat cancers that occur in children, such as Wilms' tumours| and germ cell tumours|, although it may sometimes be used to treat adults. It's sometimes called actinomycin D.
This information should ideally be read with our general information on chemotherapy| and your type of cancer|.
You'll see your hospital doctor regularly while you have this treatment so they can monitor the effects of the chemotherapy.
Dactinomycin is a yellow fluid.
Dactinomycin can be given by slow injection in one of the following ways:
Your doctor or nurse will explain more about this to you.
Chemotherapy| is usually given as a course of several sessions (cycles) of treatment over a few months. The length of your treatment and the number of cycles you have will depend on the type of cancer| you're being treated for. Your nurse or doctor will discuss your treatment plan| with you.
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 has dactinomycin and may be different if you're having more than one type of chemotherapy drug|.
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.
This may begin soon after the treatment is given and can last for up to 24 hours. Your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce nausea and 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.
Your hair may thin or fall out completely. This usually starts 3-4 weeks after starting treatment, although it may occur earlier. You may also have thinning and loss of eyelashes, eyebrows and hair in other areas of the body. Hair loss| is temporary and your hair will 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.
Dactinomycin can reduce the number of white blood cells, which help 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. Your resistance to infection will reach its lowest point around 21 days after you start chemotherapy. The number of white blood cells will then increase gradually, with levels usually returning to normal before your next treatment is due.
You'll have a blood test before having more dactinomycin, to check the number of white blood cells in your blood. Occasionally, it may be necessary to delay your treatment if the number of your blood cells (blood count) is still low.
Dactinomycin 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 may need to have a platelet transfusion| if your platelet count is low.
Dactinomycin 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.
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|. You might find our section on eating well| useful.
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 some gentle exercise, such as short walks, which will help. If tiredness is making you feel sleepy, don’t drive or operate machinery.
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 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. You may find our section on mouth care during chemotherapy| helpful
Some people have a strange taste| in their mouth and at the back of their throat while the chemotherapy is being given. This usually passes once the chemotherapy drip or injection has finished. Sucking a sweet or a mint while having the treatment can help.
Dactinomycin can cause diarrhoea|. This can usually be easily controlled with medicine, but tell your doctor if it's severe or continues. It's important to drink plenty of fluids if you have diarrhoea.
These may occur from the time your treatment is given, but they don’t usually last long. Your doctor may prescribe medicines to reduce these effects.
Dactinomycin can cause an acne-like rash. Your doctor can prescribe medicine to help with this. The skin will go back to normal after treatment finishes.
If you’ve previously had radiotherapy|, the areas where you were treated may sometimes become red and sore during chemotherapy.
This is known as radiation recall. Let your doctor know if this happens. It's harmless and will go away after the chemotherapy has finished.
Treatment with dactinomycin may cause changes in the way your liver works, although it will return to normal when the treatment finishes. You're very unlikely to notice any problems, but your doctor will take regular blood samples to check your liver is working properly.
Tell your doctor if you have problems with swallowing.
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 here.
If this happens when dactinomycin is being given, the tissue in that area can become 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, or through an implantable port.
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're 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 you can buy in a shop or chemist, can be harmful to take when you're having chemotherapy. Tell your doctor about any medicines you're 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 taking dactinomycin as it may harm the developing baby. It's important to use effective contraception while taking this drug and for at least a few months 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're 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 Dactinomycin factsheet 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
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© Macmillan Cancer Support 2013
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