Bleomycin

Bleomycin is a chemotherapy drug used to treat testicular cancer, lymphoma, cervical cancer, and cancers of the head and neck. It may also be used to treat other cancers.

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

Bleomycin is usually given into a vein. You may 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, bleomycin 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 bleomycin

Bleomycin is a chemotherapy drug used to treat testicular cancer, lymphoma, cervical cancer and cancers of the head and neck.

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

Bleomycin can also be used to treat a condition where fluid builds up between the layers covering the lungs. This is called a pleural effusion. To treat a pleural effusion, the doctor injects bleomycin into the space between the layers to stop the fluid building up again. This information doesn’t cover the use of bleomycin for a pleural effusion.


How bleomycin is given

You usually have bleomycin in the chemotherapy day unit or during a stay in hospital. A chemotherapy nurse will give it to you. It is often given with other chemotherapy drugs. 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) 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.

The nurse may give you bleomycin as an injection into a vein or as an injection into a muscle.

If you’re having chemotherapy into a vein, your nurse may give you anti-sickness drugs before the treatment. They will then give you the bleomycin in one of the following ways: 

  • 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 will give you bleomycin as a drip (infusion) into your cannula or line. This will take about 30 minutes.

If you are having bleomycin as an injection into a muscle, your chemotherapy nurse will give it to you. They will explain more about this.


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. They will check your drip site and slow the drip to ease the pain.

Flu-like symptoms

Bleomycin 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 several hours afterwards. 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. Your nurse may give you a drug before your chemotherapy to reduce the risk of flu-like symptoms occurring.

Contact the hospital if the symptoms are severe or don’t improve within 24 hours.

Your course of chemotherapy

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

Going home

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


Possible side effects of bleomycin

We explain the most common side effects of bleomycin 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 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.

It is 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.

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 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 phone or keep them somewhere safe.

More information about this drug

We are 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).

Risk of infection

Bleomycin can reduce the number of white blood cells in your blood, although this is rare if you have bleomycin on its own. Having a low number of white blood cells will make you more likely to get an infection. 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)
  • you suddenly feel unwell, even with a normal temperature
  • you have symptoms of an infection.

Symptoms of an infection include:

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

The number of white blood cells will usually steadily increase and return 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

Chemotherapy 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. Bruising and bleeding includes:

  • nosebleeds
  • bleeding gums
  • blood spots
  • rashes on the skin.

Some people may need a drip to give them extra platelets.

Anaemia (low number of red blood cells)

Chemotherapy 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. 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. 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.

Skin changes

Chemotherapy may affect your skin. If your skin feels dry, try using an unperfumed moisturising cream every day. Your skin may darken during treatment. Occasionally, bleomycin causes long thin streaks that look a bit like scratches to appear on one or more areas of skin. Your doctor or nurse can tell you what to expect. 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 will improve when treatment finishes.

Nail changes

Your nails may become brittle and break easily. They may get darker or discoloured, and/or you may get lines or ridges on them. These changes will grow out after treatment finishes. Wearing gloves when washing dishes or using detergents will help protect your nails during treatment.

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.

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.

Sore mouth

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 and/or dentures morning and night and after meals. Use 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.

Effects on the lungs

Bleomycin can cause changes to the lungs. This can happen during the treatment or afterwards. Your doctor can tell you more about this side effect.

Always tell your doctor if you smoke or if you:

  • are wheezing
  • develop a cough
  • have a fever
  • feel breathless.

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. You’ll probably have a chest x-ray before starting treatment and may have them regularly during your treatment and a few weeks afterwards.

If you need an operation after having bleomycin, always tell the anaesthetist that you’ve had bleomycin treatment.

If sub-aqua diving is an activity you’re involved in, you may need to be careful about it for a while after treatment with bleomycin. Talk to your doctor about this.

Headache

Some people find that bleomycin causes headaches. Let your doctor know if you have headaches or feel dizzy. Your doctor or nurse can give you painkillers to relieve headaches.

 


Other information about bleomycin

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
  • 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

Bleomycin 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. Men may be able to store sperm before starting treatment.

Contraception

Your doctor will advise you not to become pregnant or father a child during treatment. This is because the chemotherapy 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.