This leaflet provides information about a course of chemotherapy called cisplatin and capecitabine. It will explain what this means and when and how it will be given. It will also let you know about any common side effects you may experience. Contact telephone numbers and details of how to get more information are at the end of this leaflet.
This leaflet should be read alongside the 'General information for patients undergoing chemotherapy' leaflet. If you have not received this leaflet, ask your nurse for a copy.
What is cisplatin and capecitabine chemotherapy?
This is a course of treatment consisting of two drugs:
Why am I having cisplatin and capecitabine chemotherapy?
Your doctor has prescribed this chemotherapy because it is effective in treating the type of cancer you have.
How often will I have my chemotherapy?
In order for this treatment to be most effective, it is given at specific time intervals. These are called circles. It is usual to have a cycle of cisplatin and capecitabine every three weeks for up to six cycles. This can vary. Your doctor will discuss the exact number of cycles you will have.
In each week cycle, you will receive the cisplatin treatment once. You should take the capecitabine tablets twice a day throughout your treatment.
How often will I need to visit the hospital?
In order to have your chemotherapy treatment, you will need to visit the hospital twice in each three-week cycle.
Appointment at the outpatient clinic - we will take blood samples. We will see how you are doing and discuss any problems you may have. This is to enable us to see how the chemotherapy is affecting you. If your blood results are satisfactory, we will prescribe chemotherapy for you. This appointment will usually be a few days before your chemotherapy appointment.
Chemotherapy appointment – you will spend around seven hours in one of the day case treatment areas. You should allow up to an extra hour for your first visit. We will give you anti-nausea medicine, fluids and your cisplatin chemotherapy in a drip. We will give you capecitabine tablets, to take home with you.
You are welcome to bring someone to stay with you during your treatment. Space is limited, so there is usually no room for more than one person. Treatment areas are not suitable for small children.
How should I take the capecitabine tablets?
You should take capecitabine tablets twice a day (9-12 hours apart). You should take them within 30 minutes of finishing your meal. You should swallow the tablets whole with a glass of water. You should not chew or crush them.
It is important to wash your hands thoroughly after taking your tablets.
How many tablets will I need to take?
This varies. Tablets of two different strengths are available. The larger tablets are 500mg and the smaller tablets are 150mg. You will probably need to take a combination of large and small tablets. The number you need to take will be clearly marked on the boxes. Remember to check each box to see how many tablets you will 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 finish the treatment at the planned time.
What if I take too many tablets?
Contact Velindre Cancer Center for advice. The telephone number is at the end of this leaflet.
How should I store the capecitabine tablets?
You should store your tablets in their original packaging in a safe place out of the reach of children. You should store them in a cool and dry place. You should return any unused tablets to the hospital pharmacy or your local pharmacy for safe disposal.
What are the possible side effects?
There are a number of possible side effects that can arise with this treatment. The doctors, nurses and pharmacists can give you advice or answer any questions you may have.
Loss of hair
You should not lose your hair with this chemotherapy, but some patients will notice some thinning of their hair.
Illness
Nausea and vomiting are now uncommon, as we will give you anti-nausea medications, which are usually very effective. If you vomit more than once in 24 hours, even though you are taking anti-nausea medication, stop taking your capecitabine tablets, and contact Velindre Cancer Center for advice.
Infections
Your risk of getting infections will be higher, as this treatment can reduce your white blood cells which help fight infections. If you catch an infection while your white blood cells are low, you are at risk of sepsis, which can be life-threatening. Contact Velindre Cancer Center immediately if you develop any signs of infection, for example, flu-like symptoms or a temperature above 37.5° or below 35.5°. The phone number is at the end of this leaflet.
Diarrhea
You may get diarrhoea. If this happens, it is important to drink plenty of fluids. We will give you medicine to take if you get diarrhoea.
You should stop taking your capecitabine tablets and contact Velindre Cancer Center immediately if:
You should also contact us if you have any problems with diarrhea or an increase in the number of times you open your bowels that lasts more than three days.
Fatigue and fatigue
You may feel more tired than usual. It is important to listen to your body and rest if you need to, but you should continue with your normal activities if you are able to. For some people, a little light exercise can be beneficial as well as rest.
Sore mouth
Your mouth may be sore or you may notice small ulcers. Follow the advice on looking after your mouth in the general chemotherapy leaflet. Your doctor may give you a prescription for mouthwash or medication to prevent or clear up any infection.
If your mouth becomes very sore, or if you find it difficult to eat and drink, you should stop taking your capecitabine tablets and contact Velindre Cancer Center for advice. The phone number is at the end of this leaflet.
Sore hands and feet
You may experience mild pain, redness and swelling of your hands or feet. If this happens, we recommend that you regularly use an unscented lotion or potion. Contact Velindre Cancer Center if your hands or feet are painful.
Skin problems
Some patients will develop dry skin or a rash. This can usually be easily treated with some unscented lotion or cream. Very rarely, this rash can be serious. If you develop a rash with blisters or a rash that is painful, you should stop taking your capecitabine tablets and call Velindre Cancer Center immediately for advice. The phone number is at the end of this leaflet.
Heart problems
Very rarely, some people receiving capecitabine chemotherapy have heart problems. If you have a heart condition or are taking any heart medicine, tell your doctor before starting chemotherapy. If you have any chest pain, you should stop taking your capecitabine tablets and seek urgent medical attention. Do not take your capecitabine again until you have spoken to the team at Velindre.
Effect on your kidneys
Cisplatin chemotherapy can affect the way your kidneys work. The blood test you will 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 minimize the effect on your kidneys. It is important that you drink plenty of fluids for at least two days after each treatment as well. We suggest having a cup or glass of liquid every hour during the day and at night.
Blood clots
A cancer diagnosis can increase your risk of developing a blood clot (thrombosis), and cancer treatment can further increase this risk. It is important to tell your doctor straight away if you have symptoms such as pain, redness and swelling in your leg, or if you suffer from shortness of breath and chest pain.
Blood clots can be very serious but usually, most clots can be treated successfully with blood thinning drugs. Your doctor or nurse can give you more information.
Other side effects
Cisplatin can damage the nerves in your hands and feet. You may lose feeling or have changes in sensation such as tingling or pins and needles. Although this is very rare, it is important to tell your doctor if this happens, so that we can adjust your treatment before this side effect becomes permanent.
Cisplatin can also damage the nerves responsible for hearing, but this is rare. If this happens, you may experience some degree of hearing loss, which may be permanent.
Chemotherapy treatment sometimes affects women's periods. They could get heavier, lighter or even stop altogether.
It is important that you do not become pregnant or become a father while you are having chemotherapy treatment, as chemotherapy may harm the unborn baby.
This chemotherapy can increase your skin's sensitivity to the sun. The best thing to do is to avoid strong sunlight, wear a hat and use sunscreen.
Is it ok to take other medicines with capecitabine?
Tell your doctor, nurse or pharmacist if you are taking other medicines. There are a small number of medicines that you may need to avoid. Tell your doctor, nurse or pharmacist if you are taking warfarin tablets.
Sometimes, cancer drugs can have very serious side effects, which sometimes, but not very often, can be life-threatening. It is important to let Velindre Cancer Center know if you are concerned about any side effects.
Manufacturer's information leaflets for patients
Felindre leaflets provide information about common side effects, and some that have been recorded as being very common (we cannot list all common side effects). For more information about these and the less common side effects, you should refer to the manufacturers' patient information leaflets, which are available from Felindre pharmacy and/or on the internet at www.medicines.org.uk . Patients can sometimes find it difficult to read these leaflets. Ask if you would like a copy from your doctor or Velindre pharmacy.
Contact telephone numbers
Felindre Cancer Center 029 2061 5888
Ask for the treatment helpline if you get sick at home and need immediate attention at any time of the day or night. For example, you should call in the case of:
Pharmaceutical department 029 2061 5888 ext. 6223
Monday – Friday 9am – 5pm for inquiries about your medicines
Macmillan freephone helpline 0808 808 0000
7 days a week 8am – 8pm for general cancer enquiries
Cancer helpline
Tenovus freephone 0808 808 1010
7 days a week 8am – 8pm for general cancer enquiries
This leaflet has been written by health professionals. The information found in this leaflet is based on evidence, and has been approved by doctors, nurses and patients. The information is reviewed and updated every two years.
Revised November 2015