temozolomide
Information sheet on temozolomide chemotherapy
This leaflet provides information about a course of chemotherapy called temozolomide (sometimes called Temodal). He will explain what the treatment is 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 get more information about temozolomide are at the end of this leaflet.
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 temozolomide chemotherapy?
Temozolomide is a chemotherapy treatment that is given as tablets.
Why am I having temozolomide chemotherapy?
Your doctor has recommended this type of chemotherapy because research has shown that it can be effective in treating the type of cancer you have.
How often will I have my chemotherapy?
Temozolomide can be given in two ways. Your doctor or nurse will explain how your treatment will be given.
1. Combined radiotherapy and chemotherapy
You will have your radiotherapy every day of the week (Monday – Friday) for 6 weeks. We will give you a separate information leaflet which tells you more about your radiotherapy.
You should collect your temozolomide tablets from the pharmacy on the first day of your radiotherapy treatment. Go to the treatment machine first and they can refer you to the pharmacy.
During your radiotherapy treatment, you will take the temozolomide tablets every day (7 days a week) for 6 weeks. You will have a blood test every week and we will give you a supply of temozolomide tablets for that week.
We will also give you a course of antibiotics called septrin (also known as co-trimoxazole). This is to prevent a type of chest infection that could occur in patients receiving combined treatment. You need to take the antibiotics 3 times a week, usually on Monday, Wednesday and Friday. You should take them with food and plenty of water.
You should tell us if you are allergic to septrin so we can give you a different antibiotic.
After you have finished your radiotherapy, you will continue to take the temozolomide tablets as described below.
2. Chemotherapy alone
If you have finished your radiotherapy or are having chemotherapy alone, you will take the temozolomide tablets for five days then have a break from taking them for 23 days. This is known as a treatment cycle. You may have up to 6 cycles of treatment (24 weeks in total).
You may have an MRI scan during or after your treatment. This is to check the effect of the chemotherapy on your tumour. Your doctor will discuss this with you before you start your chemotherapy.
How often will I go to hospital?
You will see your nurse or doctor at the outpatient clinic once every 4 weeks. 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 fine, your chemotherapy may be recommended.
How long will I be in hospital?
You could be in hospital for up to 3 hours.
Where is my appointment?
Your appointment is in one of the outpatient departments at Velindre Cancer Centre.
How should I take the temozolomide tablets?
The tablets must be taken on an empty stomach, so one hour before or after eating. You should swallow them whole with a glass of water. You should not chew or crush them.
It is important that you wash your hands thoroughly after taking your tablets.
If you are having radiotherapy, you should take the temozolomide tablets one hour before your treatment. But if the time of your radiotherapy changes a lot every day, it would be best to take the tablets at around the same time every day. If you are concerned about what to do, discuss this with your specialist nurse or radiographer.
How should I store the temozolomide tablets?
You should store your tablets in their original packaging and in a safe place out of the reach of children. You should keep them in a dry and cool place.
You should return any unused tablets to the hospital Pharmacy or your local pharmacy for safe disposal.
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 have thinning hair. We have a leaflet that tells you more about coping with hair loss. Ask your nurse if you would like a copy.
Illness
This treatment causes nausea (feeling sick) or vomiting in some people. We will give you anti-nausea medicines, which are usually very effective.
If you vomit more than once in 24 hours, despite taking anti-nausea medication regularly, you should stop taking your temozolomide tablets and contact Felindre Cancer Center for advice. The phone number is on page 8.
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° centigrade. The phone number is on page 8.
Bruising
Temozolomide can reduce the number of platelets produced (which help the blood to clot). This will increase your risk of bruising or bleeding. If you notice any bruises on your body such as a bleeding nose or bleeding from your gums, you should contact Velindre Cancer Center for advice. The phone number is on page 8.
Effects on your gut
Temozolomide can cause constipation and diarrhoea. If you have constipation, it can be cured by drinking plenty of fluids and eating lots of fibre. Your doctor can prescribe medication to relieve constipation.
If you have diarrhoea, it is important that you drink plenty of fluids. Medicine is available to control diarrhoea. If you open your bowel four times more than you normally do in 24 hours, you should stop taking your temozolomide tablets and contact Velindre Cancer Center immediately. The phone number is on page 8.
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 exercise can be beneficial as well as rest. Temozolomide may make you want to sleep more than usual.
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.
Fertility
Your ability to have children can be affected during and after this treatment. You will have the opportunity to discuss this with your doctor before the treatment begins.
Women sometimes find that chemotherapy treatment can affect their periods. They could be heavier, lighter or even stop altogether.
It is important that you do not become pregnant or conceive a child while you are having chemotherapy treatment.
Other side effects
Some patients will have a headache. If you get a headache, try taking whatever painkillers you normally take for a headache. If this does not help, contact Velindre Cancer Center for more advice. The phone number is on page 8.
Some patients may develop a rash. If this happens, we recommend that you use a moisturizing cream. If the rash is itchy or uncomfortable, contact Velindre Cancer Centre. The phone number is on page 8.
A small number of patients develop a dry cough and feel slightly short of breath. If this happens, tell your doctor the next time you go to the clinic.
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 may be difficult to read. Please ask if you would like a copy.
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
- If you open your bowel four times more than what is normal for you in 24 hours
- If you get a headache that doesn't respond to painkillers
- If you have a rash that is itchy or uncomfortable
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. The leaflet was approved by doctors, nurses and patients. It is reviewed and updated every two years.
|
