This leaflet provides information on a course of chemotherapy called docetaxel or Taxotere and nintedanib. The leaflet will explain what both treatments are, 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 Taxotere 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 then please ask your nurse for a copy.
What is Taxotere chemotherapy?
Taxotere is a chemotherapy drug that originates from the leaves of the European Yew tree. Your doctor has prescribed Taxotere because it has been found to be effective in treating your type of cancer.
What is nintedanib?
Nintedanib is an anti cancer drug. It is not chemotherapy. It works by slowing down or stopping the cancer’s growth.
Nintedanib is given as capsules which are usually taken twice daily.
Why am I having nintedanib?
Your doctor has prescribed nintedanib because it has been found to be effective in controlling your type of cancer.
How often will I receive my Taxotere 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 a cycle of Taxotere every 3 weeks for up to 6 cycles. Your doctor will discuss with you the exact number of cycles you will receive.
How should I take the nintedanib capsules?
Nintedanib should be taken twice daily (apart from your day of chemotherapy). Nintedanib may be continued when the chemotherapy finishes.
Nintedanib capsules should be taken twelve hours apart, swallowed whole with a glass of water. Do not crush or chew. Try to take the capsules at approximately the same time each day. Nintedanib should be taken with food.
If you miss a dose, do not try to take it later, just take the next dose.
How many capsules will I need to take?
It is usual to have two capsules twice daily but this dose may be changed by your doctor. The amount you need to take will be clearly marked on the boxes.
How should I store the nintedanib capsules?
Your capsules should be stored in their original packaging in a safe place away from children. They should be kept in a cool dry place. Any unused capsules should be returned to the hospital pharmacy or your local chemist for safe disposal.
How often will I see the specialist team?
You will see the specialist team before each cycle. You will have regular blood tests 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.
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.
We will give you steroid tablets called dexamethasone. You must start taking them the day before your Taxotere chemotherapy. This is important to prevent some of the side effects of the Taxotere treatment. They should be taken with food, after breakfast and lunch.
How long will I be in the hospital?
Your chemotherapy appointment will usually be on a different day to your clinic appointment. The chemotherapy treatment will take about 1½ hours. Please allow an extra 30 minutes for your first treatment.
If you live far away your chemotherapy may be arranged for the same day as your clinic appointment. There is always a delay between seeing the doctor and being given your chemotherapy. If your chemotherapy is on the same day as your clinic appointment you should expect to be in the hospital for between four and six 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.
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.
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 10.
Unfortunately you will lose your hair with this chemotherapy. This is only temporary. Your hair will grow back when your treatment has finished. A method known as ‘scalp cooling’ or ‘cold capping’ can be used to prevent hair loss. We can arrange a wig if you would like one. If you would like more information about wigs or scalp cooling please speak to your nurse.
We have a leaflet that tells you more about coping with hair loss. Please ask your nurse for a copy.
Loss of appetite or sickness
You may experience a loss of appetite and some people may feel sick whilst taking Docetaxel and nintedanib but this can usually be well controlled with anti sickness medication. If you are sick more than once in 24 hours despite taking regular anti-sickness medicine, you should stop taking your nintedanib capsules and contact Velindre Cancer Centre for advice. The telephone number is on page 10.
Diarrhoea can occur with this treatment. Take the anti diarrhoea tablets after each loose motion as prescribed. 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 10.
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.
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.
You may experience fluid retention which can result in swelling of your ankles and legs. Rarely this can result in breathlessness because of fluid on the lungs. The steroid capsules usually prevent this from occurring. If it does occur it is usually mild, and will reverse when you finish your treatment. Please tell your doctor or nurse if this is a problem.
Myalgia (pain in the muscles)
Some patients may experience myalgia which is muscle or joint pain. This can sometimes be severe but will only last for a few days. If you already have painkillers at home you may find they relieve the pain. If this does not work please contact Velindre Cancer Centre. The telephone number is on page 8.
Allergic type reactions
A small number of patients have an allergic type reaction to Taxotere. The steroid capsules usually prevent this. If it does occur it is usually while the drip is infusing. Symptoms include feeling:
This can be easily treated. Please tell your nurse immediately if you experience any of these symptoms.
Inform your doctor if you have a peanut or soya allergy.
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
You may experience discolouration and ridging of your finger and toenails. A few patients may temporarily lose their nails.
Your hands and feet may become dry and flaky. This can usually be managed by using a non-perfumed moisturiser.
Very rarely this chemotherapy affects the nerves to your hands and feet. This results in a loss of sensation or altered sensation such as ‘pins and needles’ or ‘tingling’. In most cases the symptoms will resolve within a few months of finishing your treatment.
Nintedanib may cause bleeding problems. Tell your doctor if you take any medicines that may affect bleeding, such as aspirin, warfarin or vitamin E.
Is it alright to take other medicines with nintedanib?
Please tell your doctor, nurse or pharmacist if you take other medicines. There are a small number of medicines that you may have to avoid, for example St John’s Wort.
This chemotherapy can increase your skin’s sensitivity to the sun. It is best to avoid strong sunlight and wear a hat and use a sun block when in the sun.
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.
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
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. It has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.