This leaflet provides information on a course of chemotherapy called gemcitabine and docetaxel (docetaxel is also known as Taxotere). The leaflet 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 gemcitabine and docetaxel 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 gemcitabine and docetaxel chemotherapy?
This is a chemotherapy treatment which consists of 2 drugs which are given through a drip:
Why am I having this 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 gemcitabine and docetaxel every 3 weeks for up to 6 cycles. Your doctor will discuss with you the exact number of cycles you will receive.
How often will I have to visit the hospital?
You will need to visit the hospital 3 times in every 3 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.
Day 1 chemotherapy appointment – you will be treated in one of the day case treatment areas. We will give you anti sickness medicine and your gemcitabine chemotherapy. Your treatment will take about 1 hour. Please allow 30 minutes longer for your first visit.
Day 8 chemotherapy appointment – you will need to have a blood test the day before your chemotherapy. We will check the result before pharmacy makes your chemotherapy. Please allow approximately 2 hours for your treatment. We will give you anti sickness medicine and your gemcitabine and docetaxel 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. If we have difficulty finding a vein 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 and we have a leaflet that tells you more about PICC lines if needed.
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.
It is very important that you take the dexamethasone steroid tablets to reduce some of the side effects associated with docetaxel chemotherapy. You must start the dexamethasone the day before you have your day 8 docetaxel chemotherapy. It is very important to take them exactly as instructed.
Hair loss
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.
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, contact Velindre Cancer Centre for advice. The telephone number is on page 8.
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 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.
Fluid retention
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 tablets 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 docetaxel. The steroid tablets 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.
Flu like symptoms
Approximately 20% of patients experience flu like symptoms in the first 48 hours after gemcitabine treatment. This is usually mild and short lived. Symptoms may include fever, chills, aching muscles, headaches and tiredness. If your temperature is above 37.5oC please contact Velindre Cancer Centre immediately. The telephone number is on page 8.
Skin changes
Gemcitabine may cause an itchy rash in some patients. Medication is available to treat this. If this occurs please contact Velindre Cancer Centre for advice.
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 and information
Some patients experience some discomfort along the vein when gemcitabine is being given as a drip. If needed, having a PICC line inserted will prevent this problem from occurring. If you would like more information please speak to your nurse or doctor.
You may experience discolouration and ridging of your finger and toenails. A few patients may temporarily lose their nails. If your nails are affected, they will return to normal after you have finished your treatment.
Your hands and feet may become dry and flaky. This can usually be managed by using a non-perfumed moisturiser.
You may notice some swelling of your ankles. This is usually mild and will stop when you finish your treatment.
Very rarely docetaxel 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.
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 may 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.
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 common side-effects: for more information regarding 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 attention 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
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 2012
Reviewed March 2016