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Cetuximab and cisplatin 5FU A1027

This leaflet provides information on a course of chemotherapy treatment known as cisplatin and 5 fluorouracil (5-FU) with Cetuximab. It will explain what this is, when and how it will be 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’ folder.  If you haven’t received this folder please ask your nurse for a copy.

What is cisplatin and 5 fluorouracil (5-FU) chemotherapy?

This is a course of treatment which consists of 2 drugs:

  • Cisplatin
  • 5 fluorouracil (5-FU)   

What is Cetuximab? 

Cetuximab is known as a targeted therapy, which is an artificially made antibody, it works by blocking the receptors on the cell. This stops the cancer cells from dividing and growing. It a targeted therapy not chemotherapy.

Why am I having this treatment?

Your doctor has prescribed this treatment because the combination of chemotherapy and Cetuximab targeted therapy has been found to be effective in treating your type of cancer. 

How often will I have my chemotherapy?

For this treatment to be most effective it will be given at specific time intervals.  These are known as cycles.  It is usual to have a cycle of cisplatin and 5-FU every 3 weeks for up to 6 cycles. Then you may continue with weekly Cetuximab only. Your doctor will discuss with you the exact number of cycles you will have. You will receive Cetuximab with Cisplatin and 5 FU, on day 1, and just Cetuximab on days 8 and 15. 

Will I need to stay in hospital for this treatment?

The Cetuximab will be given on the day unit in Velindre on days 1, 8 and 15. Every 3 weeks on day 1 you will need to stay in hospital for 1 day overnight for 6 cycles of chemotherapy for the Cisplatin and 5 Fu chemotherapy. You will be admitted to the chemotherapy inpatient chemotherapy unit at Velindre Cancer Centre . You will have a 5 Fu pump attached to your PICC line on the day after your infusional chemo completes, which stays on for 4 days. 

Will I need any tests before I have my chemotherapy?

You will need a series of blood tests before you start your chemotherapy.  One of these blood tests helps us to check that your kidneys are working well enough to cope with the chemotherapy. 

How will my chemotherapy be given?

To receive your chemotherapy you will need to have a fine tube put into a large vein in your upper arm.  This tube is called a PICC line.  Your PICC line is usually put in about a week before you start your chemotherapy.  It will stay in for the whole course of your treatment.  Your doctor will explain this to you in more detail.  We also have a leaflet that tells you more about PICC lines.

The Cetuximab will be administered as an infusion into your PICC line, whilst on the day unit. The Cisplatin will be administered as an infusion also, but whilst you are on the chemotherapy inpatient ward. You need to have fluids to help your kidneys to flush out the Cisplatin so you need to stay in overnight. The 5 FU is administered in a small portable pump. This is attached to your PICC line. The pump fits into a bag (bumbag) which you can wear around your waist or shoulder. This stays connected for 4 days, and you will come back to the day unit for disconnection after this time. 

How do I look after the portable pump?

We will tell you how your pump works and how to look after it.  We will also give you written information.

How often will I need to come to the hospital?

To receive this chemotherapy you will need to visit the hospital 5 times in every 3 week cycle.

1st visit - Outpatient clinic appointment  

You will have blood samples taken and we will check how you are feeling and discuss any problems you may have.  This is so we can check how the chemotherapy is affecting you.  If your blood results are satisfactory, your chemotherapy will be prescribed.  This appointment is usually a few days before your chemotherapy appointment.

2nd visit - Chemotherapy appointment

Cetuximab and chemotherapy appointment -  Cetuximab is given slowly and we will observe you after the infusion to check your reaction.  For the rest of your treatments this appointment will be shorter.  You will spend about 4 hours in one of the day case treatment areas for your first treatment. Then you will have the remainder of your chemotherapy on the Chemotherapy inpatient ward. The day after you will go home with your portable pump containing 5-FU.

3rd visit - Pump disconnection

This appointment is 4 days after your chemotherapy appointment.  You will return to one of the day case treatment areas to have your portable pump disconnected.  This should take about half an hour.

4th Visit – Day 8 – you will receive the Cetuximab over about 3.5 hours. 

5th visit – day 15 – you will receive the Cetuximab over about 3.5 hours. 

Can I bring relatives and friends with me? 

You are welcome to bring someone to stay with you during your treatment. Space is limited so there is not usually room for more than one person.  Treatment areas are not suitable for young children.

What are the possible side effects?

There are a number of possible side effects which can occur with this chemotherapy.  The doctors, nurses and pharmacists can give you advice or answer any questions you may have.

Hair loss

This chemotherapy should not make you lose your hair.  However, a small number of people experience some hair thinning.  


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 when you are at home after your chemotherapy treatment, contact Velindre Cancer Centre for advice.  The telephone number is at the end of the leaflet.


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 if your temperature is below 35.5°.  The telephone number is at the end of the leaflet.


You may have diarrhoea with this chemotherapy.  If this occurs it is important that you drink plenty of fluids. Take 2 anti-diarrhoea (loperamide) capsules after the 1st episode of  diarrhoea and then 1 capsule after each episode. If you have 4 or more bowel movements in 24 hours above what is normal for you please contact Velindre Cancer Centre immediately.  The telephone number is at the end of the leaflet.

Tiredness and fatigue

Chemotherapy 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. 

Effect on your kidneys

Cisplatin can affect the way your kidneys work.  The blood test which you have before your chemotherapy will check how well your kidneys are working at the start of treatment. We will also monitor you carefully by taking regular blood tests throughout your treatment. 

We always give cisplatin with plenty of fluids in the drip to reduce the effect on your kidneys.  It is also important that you drink plenty of fluids for at least 2 days after each 

treatment. We suggest a cup or glass of fluid every hour during the day and evening.

Skin reactions

Most people (more than 80%) experience a skin reaction with cetuximab.  This is usually an acne type rash which may be dry and itchy and cause mild discomfort.  For a small number of people this reaction may be more severe.  A severe rash would affect a large part of your body, may be painful and may become infected. 

To reduce the possibility of severe skin reaction we suggest that you:

  • use non-perfumed moisturising creams on your face and upper body from the start of your treatment.  Apply the cream on your body along the same direction as the hair growth.
  • Do not wet shave, use an electric razor. 
  • avoid exposure to the sun, wear a hat and use a high factor sunscreen.
  • don’t use hot water on your skin.
  • don’t use soap if your skin is dry - use a soap alternative such as aqueous cream, or a bath emollient such as oilatum.
  • Use a gentle shampoo, such as simple shampoo.  Do not use baby shampoo.
  • try not to rub your skin vigorously - pat gently dry 
  • try to wear gloves when washing dishes.
  • wear comfortable clothes and shoes that do not rub

Your hospital doctor will prescribe antibiotic tablets to help reduce the severity of your skin rash.    

If the spots become red and angry, your doctor may give you steroid cream and antibiotic cream to apply to the area.  If the spots start to look infected, contact Velindre Cancer Centre.

This skin reaction is temporary and will resolve completely after you have finished treatment.  If you develop a severe skin reaction which is causing you pain or stopping you carrying out your normal activities, please contact Velindre Cancer Centre for advice.  The telephone number is at the end of the leaflet.

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.

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 

Cisplatin may damage the nerves of your hands and feet.  You may experience some numbness or changes in sensation such as tingling or pins and needles.  Although this is very rare it is important that you tell your doctor if this happens so that we can modify your treatment before this side effect becomes permanent.

Cisplatin may also damage the nerves responsible for hearing, although this is rare.  If this occurs you may experience some loss of hearing which may be permanent. 

Very rarely people having this chemotherapy experience heart problems such as angina or palpitations.  If you have a heart condition or you take any heart medication, please tell your doctor before you start chemotherapy.

Some patients may experience infections in the nail bed, mention this to your doctor when in clinic . 

Your eyebrows, eyelashes and hair may become more course and grow longer.   

Women sometimes find that chemotherapy treatment affects their periods.  They could become heavier, lighter or even stop altogether.  

It is important you do not become pregnant or father a child whilst having chemotherapy treatment as chemotherapy could damage the unborn baby.  

This chemotherapy can increase your skin’s sensitivity to the sun.  It is best to avoid strong sunlight, wear a hat and use a sun block.

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

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.

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 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:

  • Are sick more than once in 24 hours
  • Have a temperature of 37.5°C or above or below 35.5°centigrade
  • Have diarrhoea

Pharmacy department 029 2061 5888 ext 6223

Monday – Friday 9am – 5pm for queries about your medicines

Tenovus freephone 0808 808 1010

cancer helpline 

Macmillan freephone Helpline 0808 808 0000


This information is also available in Welsh

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.