This leaflet provides information on a course of chemotherapy called cisplatin and etoposide. The leaflet will explain what this is and when and how it is 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. If you haven’t received this leaflet please ask your nurse for a copy.
What is cisplatin and etoposide chemotherapy?
This is a course of treatment which consists of two drugs:
Why am I having cisplatin and etoposide chemotherapy?
Your doctor has prescribed this chemotherapy because it has been found to be effective in treating your type of cancer.
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 often will I have my chemotherapy?
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 cisplatin and etoposide every three weeks for up to six cycles. Your doctor will discuss with you the exact number of cycles you will receive.
Once every three weeks you will be given the cisplatin and the etoposide in a drip. We will also give you some etoposide capsules to take for the following two days at home.
How will my chemotherapy be given?
Your chemotherapy is given through a drip into a vein in the back of your hand or arm. Alternatively it may be suggested that a fine tube called a PICC is inserted into one of the large veins in your upper arm. This line can remain in place for the whole 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.
How should I take the etoposide capsules?
Etoposide capsules should be taken twice a day. You should take the first capsule in the morning and the second capsule in the evening. The amount you need to take will be clearly marked on the box.
They should be taken on an empty stomach, so an hour before or two hours after eating. The capsules should be swallowed whole with a glass of water. They must not be chewed or crushed. If you have any difficulty swallowing please speak to your doctor, nurse or pharmacist for advice.
It is important that you wash your hands thoroughly after handling your capsules.
What should I do if I forget to take my tablets?
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 etoposide capsules?
Store your capsules in their original packaging in a safe place away from children. They should be kept in a cool dry place.
Any unused capsules should be returned to the hospital Pharmacy or your local chemist for safe disposal.
How often will I have to visit the hospital?
To receive your chemotherapy treatment you will need to visit the hospital twice in every three week cycle:
Outpatient clinic appointment – 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 satisfactory, your chemotherapy will be prescribed. This appointment is usually a few days before your chemotherapy appointment.
Day 1 chemotherapy appointment – you will spend approximately seven hours in one of the day case treatment areas. Please allow up to an hour longer for your first visit. We will give you anti sickness medicine, fluids in a drip and your chemotherapy. This is followed by more fluids through the drip.
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.
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
Unfortunately you will lose your hair with this chemotherapy. This is only temporary. Your hair will grow back when your treatment has finished. We can arrange a wig if you would like one, please ask your nurse for more information.
We have a leaflet that tells you more about coping with hair loss. Please ask your nurse for 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 please contact Velindre Cancer Centre for advice. The telephone number is on page 8.
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
Diarrhoea is not common with this chemotherapy. However, 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 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 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. We check your kidney function at the start of your 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 two days after each treatment. We suggest a cup or glass of fluid every hour during the day and evening.
Effects on your nerves
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 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.
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 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
Tenovus freephone 0808 808 1010
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.