This leaflet provides information on a course of chemotherapy called cisplatin and gemcitabine. 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 on cisplatin and gemcitabine 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 gemcitabine chemotherapy?
Cisplatin and gemcitabine are chemotherapy treatments that have been used to treat cancer for many years.
Why am I having cisplatin and gemcitabine chemotherapy?
Your doctor has prescribed 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 tests helps us to check that your kidneys are working well enough to cope with the cisplatin chemotherapy.
How often will I receive my chemotherapy?
For this treatment to be most effective it is given at specific time intervals. These intervals are known as cycles. It is usual to have a cycle of cisplatin and gemcitabine every 3 weeks for up to 6 cycles. In each 3 week cycle you will receive chemotherapy on the 1st day and the 8th day. Your doctor will discuss with you the exact number of cycles you will receive.
This treatment can be given in two ways. We will tell you which way your treatment will be given.
How will my chemotherapy be given?
Your chemotherapy is given through a drip into a vein in the back of your hand or arm. Alternatively it may be suggested that a fine tube called a PICC is inserted into a large vein in your upper arm. This will remain in place throughout the course of your treatment. Your doctor or nurse will discuss this further with you.
We have a leaflet that tells you more about PICC lines. Please ask if you would like a copy.
How often will I have to visit the hospital?
You will need to visit the hospital three times in every three week cycle:
Outpatient clinic appointment – you will have a blood test 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.
Day 1 chemotherapy appointment – you will be treated in one of the day case treatment areas. Please allow up to an hour longer for your first visit. We will give you anti sickness medicine, fluids and your chemotherapy.
Day 8 chemotherapy appointment – you will need to have a blood test the day before your chemotherapy. We will check the result before pharmacy make your chemotherapy. We will give you anti sickness medicine, fluids and your chemotherapy.
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 doctor, nurses and pharmacy team can give you advice or answer any questions you may have.
Hair loss
You should not lose your hair with this chemotherapy. However, a small number of people experience some hair thinning. We have a leaflet that tells you more about coping with hair loss. Please ask your nurse for a copy.
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 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.
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 if your temperature is below 35.5°. The telephone number is at the end of the leaflet.
Diarrhoea
Diarrhoea is not common with this chemotherapy. However, 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.
Some patients find they are particularly tired after gemcitabine treatment. If this affects you, it is not advisable to drive.
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 two days after each treatment. We suggest a cup or glass of fluid every hour during the day and evening.
Flu like symptoms
Approximately 20% of patients experience flu like symptoms in the first 48 hours following gemcitabine treatment. This is usually mild and short lived. Symptoms may include fever, chills, muscle aching, headaches and tiredness. If your temperature is above 37.5oC please contact Velindre Cancer Centre immediately. The telephone number is at the end of the leaflet.
Skin changes
Gemcitabine may cause an itchy rash in some patients. Medication is available to treat this so please tell your doctor or nurse if this occurs.
Effects on your nerves
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 at your next clinic visit 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.
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
Driving and Using Machinery
Gemcitabine can sometimes make you feel sleepy or drowsy especially if you have drunk alcohol. Do not drive or use machinery for a few hours after you have received the gemcitabine.
Other side effects
You may also notice some swelling of your ankles. This is usually mild and will stop when your treatment is completed.
Some patients experience some discomfort along the vein when gemcitabine is being given as a drip. Please tell your nurse if this happens.
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.
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 attention 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
cancer helpline
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, pharmacists and patients. It is reviewed and updated every 2 years.
Prepared February 2004
Reviewed October 2019