This leaflet provides information on a course of chemotherapy called topotecan and cisplatin. 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 topotecan and cisplatin 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 topotecan and cisplatin?
Topotecan and cisplatin are both chemotherapy drugs that are given through a drip.
Why am I having topotecan and cisplatin?
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 treatment?
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 topotecan and cispaltin chemotherapy every 3 weeks for up to 4 cycles. Your doctor will discuss with you the exact number of cycles you will receive.
In each 3 week cycle you will be given topotecan for 5 days in a row. On the fifth day you will also be given the cisplatin, followed by 16 days rest.
How often will I see the specialist team?
You will see the specialist team before each cycle. 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.
How long will I be in the hospital?
Your chemotherapy appointment will usually be on a different day to your clinic appointment. The chemotherapy treatment will take about an hour for the first four days of each cycle and on day 5 you should expect to be in the hospital for up to 8 hours. Please allow an extra 30 minutes for your first treatment.
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 (cannula) into a vein in the back of your hand or arm. It may be possible to leave the cannula in place for a few days if you would prefer not to have a new one every day. Alternatively 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.
We have a leaflet that tells you more about PICC lines. Please ask your nurse for a copy.
Where will my treatment be given?
Your treatment may be given at Velindre, in a local hospital, or the mobile chemotherapy unit. We will discuss this with you.
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 may experience hair thinning with topotecan chemotherapy. We have a leaflet that tells you more about coping with hair loss. Please ask your nurse if you would like 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, please 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. Contact Velindre Cancer Centre immediately if you develop any signs of infection, for example flu like symptoms or a temperature above 37.5°centigrade. The telephone number is at the end of the leaflet.
.Diarrhoea
You may have diarrhoea with this chemotherapy. If this occurs it is important that you drink plenty of fluids. Medication is available to control diarrhoea. 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 treatment 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 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.
Effect on your kidneys
Cisplatin can affect the way your kidneys work. The blood test which you have before your chemotherapy will check how well your kidneys are working at the start of 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 2 days after each treatment. We suggest a cup or glass of fluid every hour during the day and evening.
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
Other side effects
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 or nurse at your next clinic appointment 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. Please tell your doctor or nurse if you experience hearing loss or ringing in the ears.
Topotecan may sometimes cause a rash in some patients. If this occurs please contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
This chemotherapy can increase your skin’s sensitivity to the sun. It is best to avoid strong sunlight, wear a hat and use a sun block.
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.
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
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:
Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines
Tenovus freephone 0808 808 1010
cancer helpline
This information is also available in Welsh
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 December 2014
Updated September 2017