Information leaflet on cisplatin and
5 fluorouracil chemotherapy (day unit ambulatory pump)
This leaflet provides information on a course of chemotherapy called cisplatin and 5 fluorouracil (5-FU). This is sometimes called Leeds schedule. The leaflet 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’ folder. If you haven’t received this folder please ask your nurse for a copy.
Your ‘specialist team’ refers to your oncology team at Velindre Cancer Centre which includes doctors, specialist nurses and non-medical independent prescribers which may be a nurse or a pharmacist.
What is cisplatin and 5-FU chemotherapy?
This is a chemotherapy treatment which consists of two drugs:
Why am I having cisplatin and 5-FU chemotherapy?
Your doctor has recommended this chemotherapy because it has been found to be effective in treating your type of cancer.
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. One blood test which you have before starting your treatment is to check if your body is able to breakdown the 5FU safely. Further information is in the ‘DPD testing for patients receiving 5FU or capecitabine’ leaflet. Your team will give you more information about this test.
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 have a leaflet that tells you more about PICC lines. Please ask if you would like a copy.
How often will I have my chemotherapy?
For the treatment to be most effective, it is usually given at specific time intervals. These are known as cycles.
The cisplatin chemotherapy is given through your PICC line once every three weeks for up to four cycles. Your doctor will discuss with you the exact number of cycles you receive.
. The 5-FU is put into a bag which fits into a small portable pump.
How do I look after the portable pump?
We will explain all about the pump, how it works and how to look after it. We will also give you written information.
How often will I need to visit the hospital?
To receive your chemotherapy treatment you will need to visit the hospital a number of times in every three week cycle.
Outpatient clinic appointment – you will have blood samples taken and we will check how you are feeling and discuss any problems you may have. You may either see your specialist team or speak to them on the telephone. 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.
Day 1 chemotherapy appointment – you will spend approximately seven hours in one of the day case treatment areas. Please allow an extra 30 minutes for your first visit. We will give you anti sickness medicine, fluids and your chemotherapy. These are given through a drip which is connected to your PICC line. You will go home with the 5FU pump attached to your PICC line.
The 5FU pump may be given in 2 different ways, your team will let you know which version you will be given;
You will either have:
. Each weekly visit for a pump change should be no longer than an hour.
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 pharmacy team can give you advice or answer any questions you may have.
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. Medication is available to control diarrhoea. If you have four 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 rest.
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. We will check your kidney function at the start of your treatment. We will also monitor you carefully by taking regular blood tests throughout your treatment.
It is important that you drink 2 litres (31/2 pints) in the 24 hours before and 24 hours after your chemotherapy. If you are worried that you may not be able to drink this amount please discuss with your team
Other side effects
Cisplatin may damage the nerves of your hands and feet. You may experience 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.
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. Contraception needs to be used for at least 6 months after the treatment has finished.
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 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
Macmillan freephone Helpline 0808 808 0000
Tenovus freephone 0808 808 1010
This information is also available in Welsh
This leaflet was written by health professionals. The information contained in this leaflet is evidence based.
The leaflet has been approved by a team of doctors, nurses and patients. It is reviewed and updated every 2 years.