This leaflet provides information on a course of chemotherapy called FEC-T. 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 FEC-T 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 then please ask your nurse for a copy.
What is FEC-T chemotherapy?
FEC-T chemotherapy consists of 2 different treatments. The first treatment is known as FEC, and consists of 3 drugs:
This is followed by a drug called Taxotere (this is also known as docetaxel). Together these 2 treatments are known as FEC-T.
Why am I having FEC-T chemotherapy?
Your doctor has prescribed this chemotherapy because it has been found to be particularly effective in treating your type of cancer.
How often will I receive my FEC-T 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 3 cycles of FEC followed by 3 cycles of Taxotere. Your doctor will discuss with you the exact number of cycles you will receive.
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 will my chemotherapy be given?
The chemotherapy will be given through a drip connected to a small needle which is placed in your hand or arm. Alternatively it may be suggested that a fine tube called a PICC line 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 explain this in more detail.
We have a leaflet that tells you more about PICC lines. Please ask if you would like a copy.
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. Please allow an extra 30 minutes for your first treatment.
If you live far away your chemotherapy may be arranged for the same day as your clinic appointment. There is always a delay between seeing the doctor and being given your chemotherapy. If your chemotherapy is on the same day as your clinic appointment you should expect to be in the hospital for between four and six hours.
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 doctors, nurses and pharmacists can give you advice or answer any questions you may have.
The FEC and Taxotere treatments will have some side effects that are the same and some which are specific to that part of the treatment.
Side effects for both FEC and Taxotere
Hair loss
Hair loss is usually temporary. Your hair will usually grow back after treatment ends. Very rarely, hair may not grow back. Or it may grow back thinner than before. If you are worried about this, talk to your cancer team
A method know as ‘scalp cooling’ or ‘cold capping’ can sometimes be used to prevent hair loss. If you would like a wig more information is provided in the coping with hair loss leaflet. 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 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, 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 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 on page 8.
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 mouthwashes or medication to prevent or clear any infection.
Skin and tissue damage
Some chemotherapy drugs may damage the skin and surrounding area if they leak outside of your vein. This is known as extravasation. It is extremely rare but it is important that you tell us immediately if you notice any swelling, pain or burning at the site of the drip. If this occurs whilst the chemotherapy is being given, tell your nurse. If you notice pain, swelling or redness when you’re at home please contact us immediately. The telephone number is at the end of the leaflet.
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
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.
FEC-T can increase your skin’s sensitivity to the sun. It is best to avoid strong sunlight, wear a hat and use a sun block.
Side effects with FEC
Epirubicin may cause some heart problems. If you have a heart condition or you take any heart medication, please tell your doctor before you start chemotherapy.
Epirubicin will harmlessly discolour your urine red for a day after your chemotherapy. If this lasts for more than 24 hours please contact your doctor or nurse.
Side effects with Taxotere
We will give you steroid tablets called dexamethasone. You must take them for three days, starting the day before your Taxotere chemotherapy. They should be taken with food, after breakfast and lunch.
The dexamethasone tablets prevent some of the side effects of the Taxotere chemotherapy. It is very important that you take the tablets exactly as instructed.
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. If it does occur it is usually mild, and will reverse when 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 will only last 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 hot and flushed, itchy, light headed or generally unwell. This can be easily treated. Please tell your nurse immediately if you experience any of these symptoms.
You may experience discolouration and ridging of your finger and toenails. A few patients may temporarily lose their nails.
Your hands and feet may become dry and flaky. This can usually be managed by using a non-perfumed moisturiser.
Very rarely this chemotherapy affects the nerves to your hands and feet. This results in a loss of sensation or altered sensation such as ‘pins and needles’ or ‘tingling’. In most cases the symptoms will resolve within a few months of finishing your treatment.
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
Monday – Friday 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.
Reviewed August 2015