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Information sheet about modified deGramont chemotherapy
This leaflet provides information about a course of chemotherapy called modified deGramont. The leaflet will explain what this means and when and how it will be given. It will also tell you about common side effects you may experience. Contact telephone numbers and details of how to find out more about deGramont are at the end of this booklet.
You should read this leaflet alongside the ' General information for patients undergoing chemotherapy' leaflet. If you have not received this leaflet, ask your nurse for a copy.
What is modified deGramont chemotherapy?
This is a chemotherapy treatment named after Professor deGramont. Professor deGramont invented a method of administering chemotherapy. That method has since been modified and renamed modified deGramont.
This chemotherapy treatment contains two drugs:
- 5-Fluorouracil (5-FU)
- Folinic acid
These two drugs are often called MdG for short.
Why do I get MdG?
Your doctor has prescribed this chemotherapy because it is effective in treating the type of cancer you have.
How often will I get MdG?
In order for the treatment to be most effective, it is given at specific time intervals. These are called circles. It is normal to have a cycle of MdG every two weeks for between 6 and 12 cycles. Your doctor will discuss with you the exact number of cycles you will have.
How will my chemotherapy be given?
In order to receive your chemotherapy, we will need to insert a small tube into a large vein in your upper arm. This tube is called a PICC line. Your PICC line will be placed about a week before the start of your treatment. It will remain in place throughout your treatment. Your doctor will explain this to you in more detail. We also have a leaflet that tells you more about PICC lines.
The folinic acid is given to you through a drip over a period of two hours. The drip is connected to your PICC line. The folinic acid helps make the 5-FU part of your treatment work better.
The 5-FU is given to you in two parts:
- First, it is given as an injection into your PICC cord. This takes a few minutes.
- The second part of your 5-FU is given in a small portable pump.
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- The pump is attached to your PICC line
- The pump fits into a bag that you wear around your waist on a belt
- The pump is set to evacuate over a period of 46 hours
- You will return so we can disconnect the pump.
How do I care for the portable pump?
We will tell you how your pump works and how to look after it. We will also give you written information.
How often will I need to come to the hospital?
In order to have this chemotherapy, you will need to visit the hospital three times in each two-week cycle.
First visit – Appointment at the outpatient clinic
We will take blood samples and we will check how you are doing and discuss any problems you may have. This is so we can see how the chemotherapy is affecting you. If your blood results are satisfactory, we will prescribe chemotherapy for you. This appointment is usually a few days before your chemotherapy appointment.
Second visit – Chemotherapy appointment
At this appointment, you will spend approximately three hours in one of the day case treatment areas. You should allow up to an hour longer for your first visit. We will give you your chemotherapy in a drip. You will go home with your portable pump.
Third visit – Disconnect the pump
This appointment will be two days after your chemotherapy appointment. You will return to one of the day case treatment areas for us to disconnect your pump. This should take about half an hour.
You are welcome to bring someone to stay with you during your treatment. Space is limited so there is usually no room for more than one person. Treatment areas are not suitable for small children.
What are the possible side effects?
Most patients do not experience many side effects with this type of chemotherapy. The doctors, nurses and pharmacists can give you advice or answer any questions you may have.
Loss of hair
You should not lose your hair with this chemotherapy. However, some patients will notice their hair thinning somewhat. We have a leaflet that tells you more about coping with hair loss. Ask your nurse for a copy.
Illness
This chemotherapy does not usually make people feel sick. However, we will give you anti-nausea tablets just in case this happens.
If you vomit more than once in 24 hours, even though you are taking anti-nausea medication when you are home after your chemotherapy treatment, contact Velindre Cancer Center for advice. The phone number is on page 7.
Infections
Your risk of catching infections will be higher as this treatment can reduce your white blood cells which help fight infections. Contact Velindre Cancer Center immediately if you develop any signs of infection, for example, flu-like symptoms or a temperature above 37.5°. The phone number is on page 7.
Diarrhea
You may get diarrhea with this chemotherapy. If this happens, it is important to drink plenty of fluids. Medicine is available to control diarrhoea. If you open your bowel four times or more than is normal for you over a 24-hour period, contact Velindre Cancer Center immediately. The phone number is on page 7.
Fatigue 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 you should continue with your normal activities if you feel able to do so. For some people, a little light exercise can be beneficial as well as rest.
Sore mouth
Your mouth may be sore or you may notice small ulcers. Follow the advice on looking after your mouth in the general chemotherapy leaflet. Your doctor may give you a prescription for mouthwash or medication to prevent or clear up any infection.
Sore hands and feet
You may experience mild pain, redness and swelling of your hands or feet. If this happens, we recommend that you regularly use an unscented lotion or potion. Contact Velindre Cancer Center if your hands or feet are sore.
Other side effects
Some patients have sore or watery eyes. Tell your doctor or nurse if this happens.
Quite rarely, people receiving this chemotherapy have heart problems such as angina or heart palpitations. If you want to discuss this further, talk to your doctor.
Chemotherapy treatment sometimes affects women's periods. They could get heavier, lighter or even stop altogether.
It is important that you do not become pregnant or become a father while you are having chemotherapy treatment as chemotherapy could harm the unborn baby.
This chemotherapy can increase your skin's sensitivity to the sun. The best thing to do is to avoid strong sunlight, wear a hat and use sunscreen.
Patient information leaflets from manufacturers
Copies of patient information leaflets from drug manufacturers are available from Felindre Pharmacy, or on the internet at www.medicines.org.uk These leaflets give detailed information about individual drugs. We do not routinely distribute them as they do not usually provide information on drug combinations and can be difficult to read. Please ask if you would like a copy.
Contact telephone numbers
Felindre Cancer Center 029 2061 5888
Ask for the chemotherapy pager if you get sick at home and need immediate attention at any time of the day or night. For example, you should call in the case of:
- If you vomit more than once over a 24 hour period
- That you have a temperature of 37.5°C or higher
- That you have diarrhoea
Pharmaceutical department 029 2061 5888 ext. 6223
Monday – Friday 9am – 5pm for inquiries about your medicines
Cancer helpline
Tenovus freephone 0808 808 1010
Monday – Friday 9am – 4.30pm for general cancer enquiries
This leaflet has been written by health professionals. The information in this leaflet is based on evidence. It was endorsed by doctors, nurses and patients. It is reviewed and updated every two years.
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