This leaflet provides information on a course of capecitabine chemotherapy given with radiotherapy. It will explain what this is and when and how it is given. It will also tell you about common side effects that you may experience. Contact telephone numbers and details of how to obtain further information are given at the end of the leaflet.
This leaflet should be read alongside the ‘General information for patients receiving chemotherapy’ leaflet, and the booklet about your radiotherapy. If you haven’t received these please ask your nurse for copies.
What is capecitabine chemotherapy and radiotherapy treatment?
This is a combined treatment. It consists of chemotherapy tablets called capecitabine and a course of radiotherapy. The radiotherapy is given 5 days a week (Monday - Friday). The capecitabine tablets are taken twice a day 5 days a week (on the same days as radiotherapy)
If your radiotherapy is cancelled for any reason for example a machine breakdown or a bank holiday, you should not take your chemotherapy tablets. When your radiotherapy restarts you should start taking your tablets
Why am I having this treatment?
Your doctor has prescribed this treatment because it has been found to be effective in treating your type of cancer.
How long will my treatment last?
This treatment usually lasts for 5 weeks but can vary. Your doctor will discuss the exact length of your treatment.
How often will I see a doctor?
Your doctor will explain how often they need to see you. In between your visits to the doctor you will be seen at least weekly by a review radiographer. You will have weekly blood tests and we will check how you are feeling and discuss any problems you may have. This is so we can check how the treatment is affecting you.
Can I bring relatives and friends with me?
Currently due to the need to ensure 2m space between patients during COVID-19 we do not usually allow anyone to stay with you during your treatment. If you have any concerns about this please speak to your team before your treatment starts. We may be able to make some exceptions but we will need to be aware of this before the day of treatment.
How should I take the capecitabine tablets?
Capecitabine tablets should be taken twice a day (9-12 hours apart), You should take the tablets within 30 minutes of finishing your meal. The tablets should be swallowed whole with a glass of water. They must not be chewed or crushedFor some patients it is important that the tablets are taken at a particular time. We will advise you if this applies to you.
It is important that you wash your hands thoroughly after taking your tablets.
How many tablets will I need to take?
This will vary for each person. There are 2 different strength tablets which are different sizes. The bigger tablets are 500mg and the smaller tablets are 150mg. You may have to take a combination of big and small tablets. The amount you need to take will be clearly marked on the boxes. Remember to check each box to see how many tablets you need to take.
What should I do if I forget to take my tablets?
Do not take the extra tablets when your treatment should have finished. It is important that even if you have missed any doses you should finish the treatment at the planned time.
What if I take too many tablets?
Please contact Velindre Cancer Centre immediately for advice. The telephone number is on page 8.
How should I store my capecitabine tablets?
You should store your tablets in their original packaging in a safe place away from children. They should be kept in a cool dry place (below 30oC).
Any unused tablets should be returned to the hospital Pharmacy or your local chemist for safe disposal.
Extra information for patients being treated for pancreatic cancer
You will need to take an anti sickness tablet called ondansetron 30 to 60 minutes before each radiotherapy treatment. You will also be prescribed a capsule called lansoprozole which you will need to take for 12 weeks starting on the first day of radiotherapy. This will help to protect the lining of your gut from the effects of radiotherapy.
How will my radiotherapy be given?
You radiotherapy booklet contains information about how your radiotherapy treatment is planned, how it is given and the possible side effects you may experience. If you would like further information about your radiotherapy please speak to your radiographers.
What are the possible side effects?
There are a number of possible side effects which can occur. The doctor, nurses and pharmacists can give you advice or answer any questions you may have. Your radiotherapy booklet also lists possible side effects you may experience.
Hair loss
Most people do not lose their hair with this treatment. However some people experience some hair thinning.
Sickness
Nausea and vomiting are uncommon these days as we will give you anti-sickness medicines which are usually extremely effective. If you are sick more than once in 24 hours despite taking regular anti-sickness medicine, stop taking your capecitabine tablets and contact Velindre Cancer Centre for advice. The telephone number is on page 8 of this leaflet.
Infection
You are at an increased risk of picking up infections because your white blood cells which help fight infections can be reduced by this treatment.
If you develop an infection whilst your white blood cells are low, you are at risk of sepsis, this can be life threatening.
Contact Velindre Cancer Centre immediately if you develop any signs of infection, for example flu like symptoms or a temperature above 37.5°centigrade or below 35.5°centigrade. The telephone number is at the end of the leaflet.
Diarrhoea
You may have diarrhoea. If this occurs it is important that you drink plenty of fluids. We will give you medication to take if you get diarrhoea.
You should stop taking your capecitabine tablets and contact Velindre Cancer Centre immediately if:
You should also contact us if you have any problems with diarrhoea or an increase in bowel movements which lasts for more than 3 days.
Tiredness and fatigue
Chemotherapy and radiotherapy treatment can make you feel more tired than usual. It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able. Some people find it beneficial to take gentle exercise as well as taking rest.
Sore mouth
Your mouth may become sore or you may notice small ulcers. Please follow the advice on caring for your mouth in the general chemotherapy leaflet. Your doctor may prescribe mouthwashes or medication to prevent or clear any infection.
If your mouth becomes very painful, or you are finding it difficult to eat and drink, you should stop taking your capecitabine tablets and contact Velindre Cancer Centre for advice.
Soreness to your hands and feet
You may experience mild pain, redness and swelling of your hands or feet. If this occurs we recommend using a non perfumed cream or lotion regularly. Please contact Velindre Cancer Centre if your hands or feet become painful.
Skin problems
Some patients will develop dry skin or a rash. Usually this can be easily treated with some non perfumed cream or lotion. Very rarely this rash can be severe. If you have a rash with blisters or is painful you should stop taking your capecitabine tablets and telephone Velindre Cancer Centre immediately for advice. The telephone number is at the end of the leaflet.
Heart problems
Very rarely some people having capecitabine experience heart problems. If you have a heart condition or you take any heart medication, please tell your doctor before you start chemotherapy.
If you do have any chest pain you should stop taking your capecitabine tablets and seek urgent medical attention. Do not start taking your capecitabine again until you have spoken to the team at Velindre.
Blood clots
A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further. It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.
Other side effects and information
One side effect of radiotherapy can be infertility. But as this will not occur until later in your treatment it is important you do not become pregnant or father a child during your treatment. This is because chemotherapy could damage the unborn baby. If you have concerns please speak to your doctor, nurse or radiographer.
Women sometimes find that chemotherapy treatment affects their periods. They could become heavier, lighter or even stop altogether.
Some patients may experience sore or watery eyes. If this occurs please tell your doctor or nurse.
Chemotherapy can increase your skin’s sensitivity to the sun. It is best to avoid strong sunlight and wear a hat and use a sun block when in the sun.
Is it alright to take other medicines with capecitabine?
Please tell your doctor, nurse or pharmacist if you take other medicines. There are a small number of medicines that you may have to avoid. Please tell your doctor, nurse or pharmacist if you take warfarin tablets.
Sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects.
Manufacturer’s patient information leaflets
Velindre leaflets provide information about very common and commonly reported side-effects (we are unable to list all of the common side effects), for more information regarding these and the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy and/or on the internet at www.medicines.org.uk. Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from Velindre pharmacy
Contact telephone numbers
Velindre Cancer Centre 029 2061 5888
Ask for the treatment helpline if you are unwell at home and need immediate advice at any time of the day or night. For example you should phone if you:
Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines
Tenovus freephone 0808 808 1010
cancer support line
7
This leaflet was written by health professionals. The information contained in this leaflet is evidence based. It has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.
Reviewed November 2019