This leaflet provides information on a course of chemotherapy given with radiotherapy. It 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’ leaflet, and the booklet about your radiotherapy. If you haven’t received these then please ask your nurse for copies.
What is cisplatin and capecitabine chemotherapy with radiotherapy?
This is a combined treatment. It consists of 2 chemotherapy drugs and a course of radiotherapy:
Why am I having this treatment?
Your doctor has prescribed this treatment because it has been found to be effective in treating your type of cancer.
Radiotherapy and chemotherapy treatments can give better results when given together than with either treatment given alone. The aim of the treatment is to destroy any cancer cells in or near your tumour, and any cancer cells that may have moved to other parts of your body.
How long will my treatment last?
For this treatment to be most effective it will be given at specific time intervals. These are known as cycles. A cycle of cisplatin and capecitabine chemotherapy lasts 3 weeks. The number of cycles you will have can vary. Your doctor will discuss this with you.
Your radiotherapy is given every day, Monday to Friday. Your doctor will discuss with you how long your treatment will last.
Your cisplatin chemotherapy (given as a drip) will be given on week 1, 4, 7 and 10.
Your capecitabine oral chemotherapy tablets are to be taken as clearly marked on the box.
Your radiotherapy will be given during week’s 7-11.
This is shown in the diagram.
| Weeks | |||||||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 |
| C | - | - | C | - | - | C | - | - | C | - | - |
| - | - | - | - | - | - | R | R | R | R | R | - |
C = chemotherapy
R = radiotherapy
How often will I need to visit the hospital?
To receive your chemotherapy you will need to visit the hospital twice in every 3 week cycle.
Outpatient clinic appointment – You will have blood samples taken 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.
Chemotherapy appointment – You will spend about 7 hours on one of the day case treatment areas. Please allow an hour longer for your first visit. We will give you anti sickness medicine, fluids and cisplatin in a drip. We will give you a supply of capecitabine tablets to take home.
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.
When you start your radiotherapy you will visit the hospital every day (Monday to Friday). You radiotherapy booklet tells you how your radiotherapy treatment is planned, how it is given and the possible side effects you may experience. If you would like further information about your radiotherapy please speak to your radiographers.
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 should I take the capecitabine tablets?
Capecitabine tablets should be taken twice a day (9-12 hours apart), You should take the tablets within 30 minutes of finishing your meal. The tablets should be swallowed whole with a glass of water. They must not be chewed or crushed
It is important that you wash your hands thoroughly after taking your tablets
How many tablets will I need to take?
This will vary for each person. There are 2 different strength tablets which are different sizes. The bigger tablets are 500mg and the smaller tablets are 150mg. You may have to take a combination of big and small tablets. The amount you need to take will be clearly marked on the boxes. Remember to check each box to see how many tablets to take.
What should I do if I forget to take my tablets?
Do not take the extra tablets when your treatment should have finished. It is important that even if you have missed any doses you should finish the treatment at the planned time.
What if I take too many tablets?
Please contact Velindre Cancer Centre immediately for advice. The telephone number is at the end of the leaflet.
How should I store the capecitabine tablets?
You should store your tablets in their original packaging in a safe place away from children. They should be kept in a cool dry place. Any unused tablets should be returned to the hospital Pharmacy or your local chemist for safe disposal.
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
Most people do not lose their hair with this treatment. However, some people experience some hair thinning.
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, stop taking your capecitabine tablets and contact Velindre Cancer Centre for advice.
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.
Diarrhoea
You may have diarrhoea. If this occurs it is important that you drink plenty of fluids. We will give you medication to take if you get diarrhoea.
You should stop taking your capecitabine tablets and contact Velindre Cancer Centre immediately if:
You should also contact us if you have any problems with diarrhoea or an increase in bowel movements which lasts for more than 3 days.
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 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 medication to prevent or clear any infection. If your mouth becomes very painful or you are finding eating and drinking difficult, you should stop taking the capecitabine tablets and contact Velindre Cancer Centre for advice.
Soreness to your hands and feet
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.
Skin problems
Some patients will develop dry skin or a rash. Usually this can be easily treated with some non perfumed cream or lotion. Very rarely this rash can be severe. If you have a rash with blisters or is painful you should stop taking your capecitabine tablets and telephone Velindre Cancer Centre immediately for advice. The telephone number is at the end of the leaflet.
Heart Problems
Very rarely some people having capecitabine chemotherapy experience heart problems. If you have a heart condition or you take any heart medication, please tell your doctor before you start chemotherapy. If you do have any chest pain you should stop taking your capecitabine tablets and seek urgent medical attention. Do not start taking your capecitabine again until you have spoken to the team at Velindre.
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 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 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.
Some patients may experience sore or watery eyes. Please tell your doctor or nurse at your next clinic visit if this occurs.
Women may find that chemotherapy treatment affects their periods. They could become heavier, lighter or even stop.
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 and wear a hat and use a sun block when in the sun.
Is it alright to take other medicines with capecitabine?
Please tell your doctor, nurse or pharmacist if you take other medicines. There are a small number of medicines that you may have to avoid. Please tell your doctor, nurse or pharmacist if you take warfarin tablets.
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 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
Mon – Fri 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.