Dacarbazine

Dacarbazine (DTIC) is a chemotherapy drug used to treat Hodgkin lymphoma, melanoma and soft tissue sarcoma. Dacarbazine may also be used to treat certain types of cancer as part of a clinical trial.

It is best to read this information with our general information about chemotherapy and the type of cancer you have.

Dacarbazine is usually given into a vein. You usually have it as an outpatient or during a hospital stay. Your cancer doctor or nurse will tell you how often you will have it.

Like all chemotherapy drugs, dacarbazine can cause side effects. Some of the side effects can be serious, so it is important to read the detailed information below.

Your healthcare team can give you advice on how to manage any side effects. Tell your doctor or nurse straight away if you:

  • have a temperature
  • feel unwell
  • have severe side effects, including any we do not mention here.

Rarely, side effects may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

If you need medical attention for any reason other than cancer, always tell the healthcare staff that you are having this treatment.

What is dacarbazine?

Dacarbazine, also called DTIC, is a chemotherapy drug used to treat Hodgkin lymphoma, melanoma and soft tissue sarcoma.

This information should ideally be read with our general information about chemotherapy and the type of cancer you have.


How dacarbazine is given

You usually have dacarbazine in the chemotherapy day unit or during a stay in hospital. A chemotherapy nurse will give it to you. It may be given on its own or with other chemotherapy drugs. 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. If your blood results are all right 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.

Your nurse will give you anti-sickness drugs before you start. They will give you these and the chemotherapy through one of the following:

  • a short thin tube that the nurse puts 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 gives you dacarbazine as a drip (infusion) into your cannula or line over 1 to 2 hours. They usually run the drip through a pump, which gives you the treatment over a set time. It is sometimes given into your vein over a shorter period of time.

When the chemotherapy is being given

Some people might have side effects while they are having the chemotherapy.

Pain along the vein

If you have pain along the vein, tell your nurse straight away. The nurses may give the drug more slowly or dilute it with more fluid.

The drug leaks outside the vein

If this happens when you’re having dacarbazine, 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.

Facial flushing

You may suddenly feel warm and your face may get red while the drug is being given. This should only last a few minutes.

Allergic reaction

Rarely, dacarbazine 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
  • a 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 chemotherapy

You have chemotherapy as a course of several sessions (or cycles) of treatment over a few months. The length of the course will depend on the type of cancer you have. Your doctor or nurse will tell you more about this and the number of cycles you are likely to have.

Going home

Before you go home, the nurse or pharmacist will give you anti-sickness drugs to take. Take all your tablets exactly as your nurse or pharmacist explained to you.


Possible side effects of dacarbazine

We explain the most common side effects of dacarbazine 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.

If you are having other chemotherapy drugs as well, you may have some side effects that we don’t list here. Always tell your doctor or nurse about the 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 result in very serious side effects, which may rarely be life threatening. Your cancer doctor and 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 mobile phone or keep them somewhere safe.

More information about this drug

We’re not able to list every side effect of this treatment here, particularly the rarer ones. For more detailed information you can visit the electronic medicines compendium (eMC).

Risk of infection

Dacarbazine 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 after 21 to 28 days.

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.

These can include:

  • feeling shaky
  • a sore throat
  • a cough
  • needing to pass urine often.

The number of white blood cells will usually steadily increase and return to normal before your next chemotherapy. 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

Dacarbazine 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)

Dacarbazine 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 (blood transfusion).

Feeling sick

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. They may also give you a steroid drug to help. Take the drugs exactly as your nurse or pharmacist explained to you. It’s easier to prevent sickness than to treat it after it has started.

If you still feel sick, or vomit twice or more in 24 hours, contact the hospital on the numbers they gave you as soon as possible. They will give you advice and may change the anti-sickness drug to one that works better for you. Some people may need to go to hospital for a short time so the doctors and nurses can control their sickness.

Some anti-sickness drugs can make you constipated. Tell your doctor or nurse if this is a problem.

Loss of appetite

You may lose your appetite during your treatment. Try to eat small meals regularly. 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.

Tiredness

Feeling very tired is a common side effect. It’s often worse towards the end of treatment and for some weeks after it’s over. 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.


Less common side effects of dacarbazine

Flu-like symptoms

Dacarbazine may cause flu-like symptoms such as feeling hot or cold and/or shivery, having a headache and aching. You may have these symptoms while the drug is being given or in the days 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.

Diarrhoea

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.

Hair loss

Your hair will thin or you may 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. It is important to cover your head to protect your scalp when you are out in the sun. Your nurse can give you advice about coping with hair loss.

Changes in the way the liver works

Dacarbazine may affect how your liver works. This is usually mild and goes back to normal after treatment. You will have blood tests to check how well your liver is working.

Sensitivity to the sun

During treatment and for several months afterwards, you'll be more sensitive to the sun and your skin may burn more easily than usual. You can still go out in the sun, but use a suncream with a sun protection factor (SPF) of at least 30, and cover up with clothing and a hat.


Other information about dacarbazine

Blood clot risk

Cancer increases the chances 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.

Other medicines

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.

Fertility

Dacarbazine can affect your fertility (being able to get pregnant or father a child). If you are worried about this, you can talk to your doctor before treatment starts.

Contraception

Your doctor will advise you not to become pregnant or father a child during treatment. This is because the drugs may harm a developing baby. It’s important to use contraception during and for a few months after chemotherapy. You can talk to your doctor or nurse about this.

Sex

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.

Breastfeeding

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.