This leaflet provides information on etoposide, doxorubicin and cisplatin chemotherapy. It will explain what this is and when and how it is given. It will also tell you about possible side effects. Contact telephone numbers and details of how to obtain further information on etoposide, doxorubicin and cisplatin 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.
Your ‘specialist team’ refers to your oncology team at Velindre Cancer Centre which includes doctors, specialist nurses and nursing or pharmacist prescribers
Etoposide, doxorubicin and cisplatin are three chemotherapies that are given in a drip.
Your doctor has prescribed this chemotherapy because it has been found to be effective in treating your type of cancer.
For this treatment to be most effective it is given at specific time intervals. These are known as cycles.
You will have your treatment over 4 days on the day units.
Your team will explain how many cycles you will have.
You will be reviewed by your specialist team before each cycle. You will either see your specialist team in clinic or you will speak to them on the telephone.
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.
Your treatment will usually be on a different day to your clinic appointment. The chemotherapy treatment will take different length of times on each days. The approximate times are:
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.
Etoposide, doxorubicin and cisplatin are given through a drip into a vein in the back of your hand or arm. If needed we may suggest that a fine tube called a PICC is inserted into a large vein in your upper arm. This will remain in place throughout your treatment. Your doctor or nurse will discuss this with you and give you a leaflet, if required.
There are a number of possible side effects which can occur. The doctor, nurses and pharmacy team can give you advice or answer any questions you may have.
The etoposide and the doxorubicin will unfortunately cause hair loss/ will cause hair thinning. This is only temporary. Your hair will grow back when your treatment has finished.
We have a leaflet that tells you more about coping with hair loss. Please ask your nurse for a copy.
Nausea and vomiting are uncommon these days as we 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 contact Velindre Cancer Centre. The telephone number is at the end of the leaflet.
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.
Doxorubicin 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.
Doxorubicin can cause heart problems. If you have an existing heart problem please tell your doctor before you start treatment. Please tell your doctor if you notice any breathlessness, palpitations or chest pain.
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.
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 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.
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. The telephone number is at the end of the leaflet.
Diarrhoea is not common with this treatment. However, if you have 4 or more bowel movements in 24 hours above what is normal for you, contact Velindre Cancer Centre immediately. The telephone number is at the end of the leaflet.
You may 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.
This treatment can cause you to become anaemic, it is common for patients receiving etoposide, doxorubicin and cisplatin to require a blood transfusion. Your team will monitor your bloods to check for anaemia.
It is important that you do not become pregnant or father a child during your course of chemotherapy treatment, or for at least six months after treatment. This is because chemotherapy can harm an unborn child.
Breastfeeding during chemotherapy is not advised as the drugs could be passed to a baby through breast milk.
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
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
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 35.5°centigrade
• Have diarrhoea
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
This information is also available in Welsh
This leaflet was written by health professionals. The information is evidence based and has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.