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Gemcitabine and carboplatin 322 and 658

This leaflet provides information on a course of chemotherapy called gemcitabine and carboplatin.  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 gemcitabine and carboplatin chemotherapy?

This is a chemotherapy treatment which consists of two drugs which are given in a drip:

  • Gemcitabine 
  • Carboplatin 

Why am I having gemcitabine and carboplatin  chemotherapy? 

Your doctor has prescribed this chemotherapy because it has been found to be effective in treating your type of cancer.

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 a cycle of carboplatin and gemcitabine every three weeks for up to six cycles.  Your doctor will discuss with you the exact number of cycles you will receive. 

In each cycle you will receive chemotherapy twice.  On the first day you will be given both gemcitabine and carboplatin in a drip. 1 week later you will be given the gemcitabine again. 

How often will I have to visit the hospital?

Your chemotherapy treatment will usually be on a different day to your clinic appointment.  You will usually 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.

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. 

Day 1 chemotherapy appointment - you will spend up to 1½ hours in one of the day case treatment areas.  Please allow 30 minutes longer for your first visit.  We will give you anti sickness medicine and your chemotherapy.  

Day 8 chemotherapy appointment - you will need to allow 1 hour for this visit.  You will have a blood sample taken the day before.  The result will be checked before pharmacy can make your chemotherapy.  We will give you anti sickness medication 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.

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 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 further with you.

We have a leaflet that tells you more about PICC lines.  Please ask your nurse for a copy.

What are the possible side effects?

There are a number of possible side effects which can occur with this chemotherapy.  The doctor, nurses and pharmacists 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, you should 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 below 35.5°centigrade.  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 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.

Flu like symptoms

Approximately 20% of patients may 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. 

You may also notice some swelling of your ankles.  This is usually mild and will stop when your treatment is completed. 

Allergic type reaction

A small number of patients experience an allergic type reaction to carboplatin.  If this occurs you may feel hot or flushed, itchy, light-headed or generally unwell whilst receiving your carboplatin.  This can be easily treated. Please tell your nurse immediately if you experience any of these symptoms.

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. 

 

Alcohol content of gemcitabine  

Gemcitabine contains alcohol. If having alcohol is a problem for you, tell your doctor, nurse or pharmacist. It is possible that your blood alcohol level may be above the legal limit after you have gemcitabine. Do not drive or operate machinery for a few hours after having this treatment, even if you feel okay.  

Other side effects

Some patients experience some discomfort along the vein when gemcitabine is being given as a drip.  This problem may occur more frequently as you have more treatments. Having a PICC line inserted will prevent this problem from occurring.  If you would like more information please speak to your nurse or doctor. 

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 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

Tenovus freephone 0808 808 1010

cancer helpline 

 

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.

Prepared September 2004    
Reviewed August 2019