This leaflet provides information on a course of chemotherapy called ECF. It 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 ECF 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 ECF chemotherapy?
ECF chemotherapy consists of three drugs:
E = Epirubicin
C = Cisplatin
F = 5-Fluorouracil (5-FU)
When they are combined they are known as ECF for short.
Why am I having ECF chemotherapy?
Your doctor has recommended ECF 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 have 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 a cycle of ECF every three weeks for up to six cycles. Your doctor will discuss with you the exact number of cycles you will have will receive.
Will I need to stay in hospital for this treatment?
Yes, you will need to stay in hospital for five or six days for each cycle of chemotherapy. You will be admitted to one of the wards at Velindre Cancer Centre.
How will my treatment be given?
Your chemotherapy will be given through an infusion (drip). The drip will be connected to a small needle which will be put into the back of your hand or in your arm. It is important that you tell your nurse if the drip becomes uncomfortable or painful.
You will remain connected to the drip during your stay in hospital. The drip will be attached to a portable stand with wheels so you will be able to move around the ward area. If you need help a nurse will be available.
The epirubicin and cisplatin are given on the first day of each cycle. The 5-FU part of your chemotherapy is given over the next four days.
What are the possible side effects?
There are a number of possible side effects which can occur with ECF chemotherapy. The doctors, nurses and pharmacists can give you advice or answer any questions you may have.
Hair loss
Unfortunately ECF chemotherapy will cause complete hair loss. Your hair will grow back when your treatment has finished. A method know 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 on coping with hair loss. Please ask your nurse if you would like 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, then please 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
You may have diarrhoea with ECF 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 to carry out your normal activities if you feel able. Some people find it beneficial to take gentle exercise as well as taking 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. 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.
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 swelling, 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 7).
Other side effects
Epirubicin may cause some heart problems. If you have a heart condition or you take any heart medication please tell your doctor before you start chemotherapy.
Epirubicin will harmlessly discolour your urine red for a day after your chemotherapy. If this lasts for more than 24 hours please contact Velindre Cancer Centre.
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. 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.
ECF 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
7 days a week 8am – 8pm for general queries on cancer
Tenovus freephone 0808 808 1010
cancer helpline
7 days a week 8am – 8pm for general queries on cancer
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.