This leaflet provides information on a course of chemotherapy treatment with docetaxel (Taxotere™), cisplatin and 5 fluorouracil. This is usually called TPF. 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 are given at the end of the leaflet.
This leaflet should be read alongside the ‘General information for patients receiving chemotherapy’ folder. If you haven’t received this folder please ask your nurse for a copy.
What is TPF chemotherapy?
This is a course of treatment which consists of 3 drugs:
When combined they are known as TPF.
Why am I having TPF 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 have my chemotherapy?
For this treatment to be most effective it will be given at specific time intervals. These are known as cycles. It is usual to have a cycle of TPF every 3 weeks for up to 4 cycles. Your doctor will discuss with you the exact number of cycles you will have.
Will I need to stay in hospital for this treatment?
To receive this treatment you will need to stay in hospital for
5 - 6 days for each cycle of chemotherapy. You will be admitted to one of the wards at Velindre Cancer Centre.
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.
Will I need any tests before I have my chemotherapy?
You will need a series of blood tests before you start your chemotherapy. One of these blood tests helps us to check that your kidneys are working well enough to cope with the chemotherapy.
How will my treatment be given?
Your chemotherapy is given through a drip into a vein in the back of your hand or arm. You will remain connected to the drip during your stay in hospital. The drip will be attached to a portable stand with wheels so you will be able to move around the ward area. If you need help a nurse will be available.
We will give you steroid tablets called dexamethasone. You must start taking them the day before you are admitted to hospital. This is important to prevent some of the side effects of the Taxotere treatment. They should be taken with food, after breakfast and lunch.
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 Taxotere chemotherapy. You must take the tablets for 3 days, starting the day before you are admitted to hospital. It is very important to take them exactly as instructed.
Hair loss
Unfortunately you will lose your hair with this chemotherapy. 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. If you would like more information about scalp cooling or wigs please speak to your nurse.
We have a leaflet that tells you more on 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 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 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 if your temperature is below 35.5°. 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 4 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 to 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.
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.
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 once your treatment is completed. 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 usually only lasts 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 at the end of the leaflet
Allergic type reactions
A small number of patients have an allergic type reaction to Taxotere. The steroid tablets usually prevent this from occurring. 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. We will move you to one of the day units to be given the Taxotere so we can monitor you closely for any allergic reaction.
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
You may experience discolouration and ridging of your finger and toenails. A few patients may temporarily lose their nails.
Soreness to your hands and feet
Your hands and feet may become dry and flaky, or you may experience mild pain, redness and swelling of your hands or feet. If this occurs we recommend using a non perfumed cream or lotion regularly. Please contact Velindre Cancer Centre if your hands or feet become painful.
This treatment may damage the nerves of your hands and feet. You may experience numbness or changes in sensation such as tingling or pins and needles. Although this is rare it is important that you tell your doctor 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 tinnitus (ringing in the ears) or very occasionally, some loss of hearing which may be permanent.
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.
This chemotherapy can increase your skin’s sensitivity to the sun. It is best to avoid strong sunlight, wear a hat and use a high factor sun block.
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:
Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines
Macmillan freephone Helpline 0808 808 0000
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.