Carboplatin and etoposide chemotherapy
Carboplatin and etoposide chemotherapy is used to treat small cell cancers, including small cell lung cancer and small cell bladder cancer.
This information should ideally be read with our general information about chemotherapy and the type of cancer you have.
The treatment involves two chemotherapy drugs:
How carboplatin and etoposide are givenBack to top
You have your treatment in the chemotherapy day unit or during a short stay in hospital.
A chemotherapy nurse will give it to you. During treatment, you will 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) takes a blood sample from you. This is to check that it is okay for you to have chemotherapy.
You will also see a doctor or nurse before you have chemotherapy. They will ask you about how you have been. If your blood results are alright on the day of your treatment, the pharmacist will prepare your chemotherapy. Your nurse will tell you when your treatment is likely to be ready.
Before giving you chemotherapy, your nurse will give you anti-sickness (anti-emetic) drugs as an injection into a vein or as tablets.
You will have the anti-sickness drugs, if given as an injection, and chemotherapy through one of the following:
- a short, thin tube put 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).
Your nurse will give you carboplatin (a colourless fluid) as a drip (infusion) over 30–60 minutes.
After this, they will give you etoposide (also a colourless fluid) as a drip over an hour. They usually run the drip through a pump, which gives you the treatment over a set time. You can also take etoposide as capsules.
When the chemotherapy is being given
Some people might have the following side effects while they are having the chemotherapy:
Pain along the vein
If you have this, tell your nurse straight away. They will check your drip site and slow the drip to ease the pain.
The drug leaks outside the vein
If this happens when you’re having etoposide, it can damage the tissue around the vein. This is called extravasation. Tell the nurse straight away if you have any stinging, pain, redness or swelling around the vein. Extravasation is not common, but if it happens it’s important that it’s dealt with quickly.
If you get any of these symptoms after you get home, contact the doctor or nurse straight away on the number they gave you.
Rarely, carboplatin or etoposide may cause an allergic reaction while it’s being given. Your nurse will check you for this. If you have a reaction, they will treat it quickly.
Signs of a reaction can include:
- a rash
- feeling itchy
- feeling flushed or short of breath
- swelling of your face or lips
- feeling dizzy
- having pain in your tummy, back or chest
- feeling unwell.
Tell your nurse straight away if you have any of these symptoms.
Your course of carboplatin and etoposide
You have chemotherapy as a course of several sessions (or cycles) of treatment over a few months. Carboplatin and etoposide chemotherapy can be given in different ways. Your doctor or nurse will be able to give you details of your individual treatment course.
Here is a description of one method of treatment:
Each cycle of carboplatin and etoposide takes 21 days (three weeks).
- On day 1 you have carboplatin and etoposide. Both drugs are given as a drip.
- On day 2 you will have either an infusion of etoposide or you will be given
- etoposide capsules.
- On day 3 you have an etoposide drip or capsules. The capsules are taken twice a day.
You will then have a rest period with no chemotherapy for 18 days.
At the end of the 21 days, you start your second cycle of treatment. This is exactly the same as the first cycle. Your doctor or nurse will tell you how many cycles you are likely to have.
Taking your chemotherapy capsules
Before you leave hospital, the nurse or pharmacist gives you chemotherapy capsules to take at home. Always take your capsules exactly as explained. This is important to make sure they work as well as possible. If you have difficulty swallowing the capsules, talk to your pharmacist.
If you are sick just after taking the capsules, contact the hospital. You may need to take another dose. If you forget to take a capsule, do not take a double dose.
Here are some other things to remember about your capsules:
- Take them whole, with water, on an empty stomach.
- Do not open the capsules.
- If the capsules leak, don’t touch their contents.
- Keep the capsules in the original package at room temperature away from heat and direct sunlight.
- Keep the capsules safe and out of the reach of children.
- Return any remaining capsules to the pharmacist if your treatment is stopped.
Before you go home, the nurse or pharmacist will give you anti-sickness (anti-emetic) drugs to take. They may also give you anti-diarrhoea tablets if you need them. Take all your tablets exactly as explained.
Possible side effects of carboplatin and etoposideBack to top
We explain the most common side effects of your treatment here. But we don’t include all the rare ones that are unlikely to affect you.
You may get some of the side effects we mention but you are very unlikely to get all of them. Always tell your doctor or nurse about the side effects you have. Your doctor can prescribe drugs to help control some of these. It is very important to take the drugs exactly as your nurse or pharmacist has explained. This means they will be more likely to work better for you.
Your nurse will give you advice about managing your side effects. After your treatment is over, the side effects will start to improve.
Serious and life-threatening side effects
Sometimes cancer drugs can result in very serious side effects, which rarely may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. You can call them if you feel unwell or need advice any time of day or night. Save these numbers in your phone or keep them somewhere safe.
More information about this drug
We’re not able to list every side effect for this treatment here, particularly the rarer ones. For more detailed information, you can visit the electronic Medicines Compendium (eMC).
Common side effects of carboplatin and etoposideBack to top
Risk of infection
Carboplatin and etoposide can reduce the number of white blood cells in your blood. This will make you more likely to get an infection. Your white blood cells start to reduce seven days after treatment and are usually at their lowest 10–14 days after. When the number of white blood cells is low, it’s called neutropenia.
Contact the hospital straight away on the contact number you’ve been given if:
- your temperature goes over 37.5°C (99.5°F) or over 38°C (100.4°F), depending on the advice given by your chemotherapy team
- you suddenly feel unwell, even with a normal temperature
- you have symptoms of an infection such as a cold, feeling shaky, a sore throat, a cough, diarrhoea or needing to pass urine a lot.
The number of white blood cells usually increases steadily and returns to normal before your next treatment. You will have a blood test before having more chemotherapy. If your white blood cells are still low, your doctor may delay your treatment for a short time.
Bruising and bleeding
This treatment can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any bruising or bleeding you can’t explain. This includes nosebleeds, bleeding gums, blood spots or rashes on the skin. Some people may need a drip to give them extra platelets.
Anaemia (low number of red blood cells)
Carboplatin and etoposide can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this. If you are very anaemic, you may need a drip to give you extra red blood cells (known as a blood transfusion).
This may happen in the first few days after chemotherapy. Your doctor will prescribe anti-sickness (anti-emetic) drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist explains to you. It’s easier to prevent sickness than to treat it after it has started.
If you are having etoposide capsules, it may be helpful to take the anti-sickness drugs at least half an hour before each dose of the capsule.
If you still feel sick or are vomiting, contact the hospital as soon as possible. They can give you advice and change the anti-sickness drug to one that works better for you.
Feeling very tired is a common side effect. It’s often worse towards the end of treatment and for some weeks after it’s finished. Try to pace yourself and get as much rest as you need. It helps to balance this with some gentle exercise, such as short walks. If you feel sleepy, don’t drive or operate machinery.
You usually lose all the hair on your head. Your eyelashes, eyebrows and other body hair may also thin or fall out. This usually starts after your first or second cycle of treatment. It is almost always temporary and your hair will grow back after chemotherapy ends. It is important to cover your head to protect your scalp when you are out in the sun until your hair grows back. Your nurse can give you advice about coping with hair loss.
Your doctor can prescribe drugs to control diarrhoea. Let them know if it is severe or if it doesn’t get better. Make sure you drink at least two litres (three and a half pints) of fluids every day if you have diarrhoea.
Changes in the way the kidneys and liver work
Carboplatin and etoposide can affect how your kidneys and liver work. This is usually mild and goes back to normal after treatment. You will have blood tests before chemotherapy to check how well your kidneys and liver are working.
Less common side effects of carboplatin and etoposideBack to top
Numb or tingling hands or feet
These symptoms are caused by the effect of carboplatin on nerves. It’s called peripheral neuropathy. You may also find it hard to fasten buttons or do other fiddly tasks.
It is important to tell your doctor or nurse if you have these symptoms. The dose of the chemotherapy drug may need to be lowered if it gets worse. Usually, the symptoms improve slowly after treatment finishes. But, in some people, they may never go away. Talk to your doctor if you are worried about this.
Your mouth may become sore and you may get ulcers. This can make you more likely to get an infection in your mouth. Gently clean your teeth or dentures every morning, evening and after meals using a soft-bristled or children’s toothbrush. Your nurse might ask you to rinse your mouth regularly or use mouthwashes. It’s important to follow any advice you are given and to drink plenty of fluids.
Tell your nurse or doctor if you have any problems with your mouth. They can prescribe medicines to prevent or treat mouth infections and reduce any soreness.
You may get a bitter or metallic taste in your mouth or find that food tastes different. This should go away when your treatment finishes. Try using herbs and spices (unless you have a sore mouth or ulcers) or strong-flavoured sauces to give your food more flavour. Sucking boiled sweets can sometimes help get rid of a bitter or metallic taste. Your nurse can give you more advice.
Loss of appetite
You may lose your appetite during your treatment. If you can’t face big meals, try to eat small, frequent meals or snacks instead of three meals a day. Don’t worry if you don’t eat much for a day or two.
If your appetite doesn’t improve after a few days, let your nurse or dietitian know. They can give you advice on getting more calories and protein in your diet. They may give you food supplements or meal replacement drinks to try. Your doctor can prescribe some of these and you can buy them from chemists.
Rarely, etoposide can increase the risk of developing a second cancer, usually leukaemia, later in life. But the benefits of treatment usually far outweigh this risk. Your doctor can talk to you more about this.
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.
Other information about carboplatin and etoposideBack to top
Blood clot risk
Cancer increases the chance of a blood clot (thrombosis) and chemotherapy can add to this.
A clot can cause symptoms such as pain, redness and swelling in a leg, breathlessness and chest pain. Contact your doctor straight away if you have any of these symptoms. A blood clot is serious but your doctor can treat it with drugs that thin the blood. Your doctor or nurse can give you more information.
Some medicines can interact with chemotherapy or be harmful when you are having chemotherapy. This includes medicines you can buy in a shop or chemist. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapies and herbal drugs. You may be advised to avoid eating grapefruit or drinking grapefruit juice.
Carboplatin and etoposide may affect your fertility (being able to get pregnant or father a child). If you are worried about this, you can talk to your doctor or nurse before treatment starts.
Your doctor will advise you not to become pregnant or to father a child during treatment. This is because the drugs may harm a developing baby. It’s important to use effective contraception during and for a few months after chemotherapy. You can talk to your doctor or nurse about this.
If you have sex within the first couple of days of having chemotherapy, you need to use a condom. This is to protect your partner in case there is any chemotherapy in semen or vaginal fluid.
Changes to your periods
Chemotherapy can sometimes stop the ovaries working. You may not get a period every month and they may eventually stop. In some women this is temporary, but for others it is permanent and they start the menopause.
Women are advised not to breastfeed during treatment and for a few months after. This is in case there is chemotherapy in their breast milk.
Medical and dental treatment
If you need to go into hospital for any reason other than cancer, always tell the doctors and nurses that you are having chemotherapy. Give them contact details for your cancer doctor.
Talk to your cancer doctor or nurse if you think you need dental treatment. Always tell your dentist you are having chemotherapy.
This page has been compiled using information from a number of reliable sources, including the electronic Medicines Compendium (eMC; medicines.org.uk). If you’d like further information on the sources we use, please feel free to contact us.
This information was reviewed by a medical professional.
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