Cisplatin and vinorelbine TM 571

This leaflet provides information on a course of chemotherapy called cisplatin and vinorelbine. The leaflet will explain what this is and 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 on this chemotherapy are given at the end of the leaflet.

This leaflet should be read alongside the ‘General information for patients receiving chemotherapy’ leaflet. If you haven’t received this leaflet please ask your nurse for a copy.

What is cisplatin and vinorelbine chemotherapy?

This is a chemotherapy treatment which consists of two drugs:

Cisplatin (which is given as a drip)
Vinorelbine (which is given as capsules)

Why am I having cisplatin and vinorelbine 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 blood tests helps us to check that your kidneys are working well enough to cope with the chemotherapy.

How often will I receive my chemotherapy?

For this treatment to be most effective, it is given at specific time intervals. These are known as cycles. It is usual to have cisplatin and vinorelbine chemotherapy every three weeks for up to six cycles. Your doctor will discuss with you how many cycles you receive.

In each cycle you will receive two treatments, one week apart. On day 1 you will be given the cisplatin chemotherapy in a drip, and the vinorelbine as capsules. One week later, on day 8, you will have a telephone assessment and if after assessment you are well enough you will take your second dose of vinorelbine.

How will my cisplatin 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 line is inserted into one of the large veins in your upper arm. This line can remain in place for the whole of your treatment. Your doctor or nurse will discuss this with you. We have a leaflet that tells you more about PICC lines. Please ask your nurse for a copy.

When should I take the second dose of vinorelbine capsules?

The second dose of vinorelbine should be taken one week after your first dose. It is important that you do not take them until one of the Velindre team has telephoned you to assess that you are well enough.

How should I take the vinorelbine capsules?

You must take your anti sickness medication 30-60 minutes before you have your vinorelbine capsules. The capsules should be taken immediately after a light snack and with a glass of water. They must be swallowed whole. Do not chew or crush them.

It is important that you wash your hands thoroughly after handling your capsules.

Do not take any damaged or leaking capsules as they may irritate your mouth. Please contact Velindre Cancer Centre for advice. The telephone number is on page 8.

Damaged capsules should be placed in a waterproof bag or container and returned to the hospital.

How should I store the vinorelbine capsules?

Your capsules should be stored in the fridge in their original packaging. They are in a child proof wrapper but it is important that they are kept away from children.

Any unused capsules should be returned to the hospital pharmacy for safe disposal.

Information for people with fructose intolerance

You should not take vinorelbine capsules as they contain sorbitol.

How often will I have to visit the hospital?

To receive your chemotherapy treatment you will need to visit the hospital twice 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.

Chemotherapy appointment – you will spend approximately seven hours 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 in a drip 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. 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 may 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 when you are at home after your chemotherapy treatment, please contact Velindre Cancer Centre for advice. The telephone number is on page 9.

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 on page 8.

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 on page 8.

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.

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. We check your kidney function at the start of your 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.

Effects on your nerves

Rarely the nerves in your fingers and toes can be affected. This would result in numbness or pins and needles. The nerves to your bowel may also be affected. This may result in constipation. If you develop any of these problems please tell your doctor or nurse at your next visit to clinic. 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 damage the nerves responsible for hearing, although this is rare. If this occurs you may experience some loss of hearing which may be permanent.

Skin and tissue damage

Some chemotherapy drugs may damage the skin and surrounding area if they leak outside of your vein. This is known as extravasation. It is extremely rare but it is important that you tell us immediately if you notice any pain or burning at the site of the drip. If this occurs whilst the chemotherapy is being given, tell your nurse. If you notice pain, swelling or redness when you’re at home please contact us immediately (telephone number on page 8).

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

Women sometimes find that chemotherapy 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.

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:

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

This leaflet was written by Velindre Cancer Centre healthcare professionals in line with the approved Velindre Cancer Centre protocol. The information contained in this leaflet is evidence based. The leaflet has been approved by a Velindre Cancer Centre group of doctors, nurses, pharmacists and patient representatives. It will be reviewed and updated every 2 years.