GemCarbo is a chemotherapy treatment used to treat lung, bladder, ovarian and some breast cancers.
This information should ideally be read with our general information about chemotherapy and the type of cancer you have.
The drugs used in GemCarboBack to top
GemCarbo is named after the drugs used in this treatment, which are:
You have GemCarbo in the chemotherapy day unit or during a short stay in hospital. A chemotherapy nurse will give it to you. During treatment, you 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) will take 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 feeling. 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 your chemotherapy, your nurse will give you anti-sickness (anti-emetic) drugs as an injection into a vein or as tablets. You will have these drugs 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 gemcitabine as a drip (infusion) that lasts around half an hour. After this, they give you carboplatin as a drip for about 30–60 minutes. The nurses usually run the drip through a pump, which gives you the treatment over a set time.
When the chemotherapy is being given
Some people might have the following side effects while they are having the chemotherapy:
Rarely, GemCarbo may cause an allergic reaction while it’s being given. Your nurse will check you for this and if you have a reaction, they will treat it quickly. Signs of a reaction can include:
- a rash
- feeling itchy, 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.
GemCarbo may cause flu-like symptoms such as:
- feeling hot or cold
- feeling shivery
- aching joints or muscles.
You may have these symptoms while the drug is being given or for several hours after. Your nurse will tell you if this is likely to happen. They may advise you to take paracetamol. Drinking plenty of fluids will also help.
If the symptoms are severe or don’t improve after 24 hours, contact the hospital.
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.
Your course of GemCarbo
You will have chemotherapy as a course of several sessions (cycles) of treatment over a few months.
Each cycle takes 21 days (three weeks):
- On day 1, you will have gemcitabine and carboplatin.
- On day 8, you’ll have a drip of gemcitabine only.
- After this, you’ll then have a rest period of 13 days.
At the end of the 21 days, you will start your second cycle of GemCarbo. This is exactly the same as the first cycle. Your doctor or nurse will tell you the number of cycles that you are likely to have.
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 they have told you.
Possible side effects of GemCarboBack to top
We explain the most common side effects of GemCarbo 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 any side effects you have.
Your doctor can prescribe drugs to help control some side effects. It is very important to take them 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 cause 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 at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.
More information about these drugs
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 GemCarboBack to top
Risk of infection
GemCarbo can reduce your white blood cell count. This will make you more likely to get an infection. Your nurse can tell you when your white blood cells are likely to be at their lowest. When they are low, this is 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
GemCarbo 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)
GemCarbo can reduce your red blood cell count. These cells carry oxygen around the body. If they are 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 nausea and vomiting. Take the drugs exactly as your nurse or pharmacist explains. It’s easier to prevent sickness than to treat it after it has started.
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.
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.
Gemcitabine can cause changes to the lungs. Always tell your doctor if you develop:
- a cough
- a fever
You should also let them know if any existing breathing problems get worse. If necessary, they can arrange for you to have tests to check your lungs.
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.
Chemotherapy may affect your skin. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day.
Always tell your doctor or nurse about any skin changes. They can give you advice and may prescribe creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.
Fluid build-up (oedema)
Sometimes fluid can build up in your legs and ankles, which can cause swelling. This is known as oedema. Tell your doctor or nurse if fluid builds up. If your ankles and legs swell, it can help to put your legs up on a foot stool or cushion. The swelling usually gets better after your treatment ends.
Changes in the way the kidneys and liver work
GemCarbo can affect how your kidneys and liver work. This is usually mild and goes back to normal after treatment finishes. You will have blood tests before chemotherapy to check how well your kidneys and liver are working.
Less common side effects of GemCarboBack to top
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.
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.
GemCarbo may make you constipated. Drinking at least two litres (three and a half pints) of fluids every day will help. Try to eat more foods that contain fibre such as fruit, vegetables and wholemeal bread. Doing some regular, gentle exercise can also help.
Your hair may thin but you’re unlikely to lose all the hair from your head. This usually starts after your first or second cycle of chemotherapy. It is almost always temporary and your hair will grow back after chemotherapy ends. Your nurse can give you advice about coping with hair loss.
Numb or tingling hands or feet
These symptoms are caused by the effect of carboplatin on your nerves. It’s called peripheral neuropathy. You may also find it hard to fasten buttons or do other fiddly tasks.
Tell your doctor if you have these symptoms. They sometimes need to lower the dose of the drug. The symptoms usually improve slowly after treatment finishes but, in some people, they may never go away. Talk to your doctor if you are worried about this.
It’s important to tell your doctor or nurse straight away if you feel ill or have severe side effects. This includes any we don’t mention here.
Other information about GemCarboBack to top
Gemcitabine may cause drowsiness. Take care if you are driving or operating machinery following the treatment.
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
- 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, including ones that you can buy in a shop or chemist, can be harmful when you are having chemotherapy. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Gemcitabine contains alcohol. Tell your doctor, nurse or pharmacist if this is a problem for you. This treatment may affect your ability to drive or operate machinery.
GemCarbo 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 will 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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