This leaflet provides information about a chemotherapy treatment called irinotecan and vincristine. 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 on this chemotherapy 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 irinotecan and vincristine chemotherapy?
Irinotecan and vincristine is a chemotherapy which are given as a drip
Why am I having irinotecan and vincristine 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. Your doctor will discuss with you the exact number of cycles you will receive. Each cycle is given on days 1 to 5, every 3 weeks.
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 be having. 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 irinotecan and vincristine chemotherapy be given?
First we will give you anti sickness medicine. Then we will give you an injection of a medicine called atropine. The atropine is given to prevent some of the side effects which can occur with irinotecan. This is explained in more detail later in this leaflet. You will also be given anti-sickness medication to take each morning before you come for your treatment, from day 2 - it is important that you take this.
The irinotecan and vincristine is given through a drip connected to a small needle which is placed in your hand or arm. If needed, 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, if required, and will give you a leaflet if needed.
How long will I be in the hospital?
Your chemotherapy appointment will usually be on a different day to your clinic appointment. Please allow an extra 30 minutes for your first chemotherapy treatment. Then, the chemotherapy treatment on day 1 and 5 will take approximately 2.5 hours. On days 2 to 4 the treatment will take approximately 2 hours. This is because you will receive both irinotecan and vincristine on days 1 and 5 and only irinotecan on days 2 to 4. If you are having scalp cooling, please allow approximately one and a half hours extra for your treatment. This will be explained further in the leaflet.
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
You may lose your hair with irinotecan chemotherapy. This is temporary and your hair will grow back when you finish your chemotherapy. We can arrange a wig if you would like one, please ask your nurse for more information.
We have a leaflet on coping with hair loss. Please ask your nurse if you would like a copy. A method known as ‘scalp cooling’ or ‘cold capping’ can sometimes be used to prevent hair loss.
Sickness
Nausea and vomiting are uncommon these days as we 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 contact Velindre Cancer Centre. 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 a recognised side effect of irinotecan and vincristine. This can either occur within 24 hours following treatment or from about five days after starting treatment.
Diarrhoea within 24 hours of irinotecan
Diarrhoea which occurs at the time of treatment or up to 24 hours after irinotecan can come with other symptoms. For example sweating, stomach pains, watering eyes, blurred vision or dizziness. The atropine injection we give you before your treatment usually stops these symptoms.
We do not recommend that you take anti-diarrhoeal tablets with this type of diarrhoea. If you develop diarrhoea or any of the symptoms described within the first 24 hours after treatment please contact Velindre Cancer Centre immediately for advice. The telephone number is at the end of the leaflet.
Diarrhoea starting more than 24 hours after irinotecan and vincristine
We will have given you medication to help stop diarrhoea. These are called loperamide. You should take these as follows:
It is important that you drink plenty of water and salty type liquids if you have diarrhoea. These include soda water, carbonated water and soups.
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.
Effects on your nerves
Vincristine can affect the nerves in your fingers and toes giving the feeling of numbness or pins and needles. The nerves to your bowel may also be affected. This may result in constipation. Some patients may also have jaw pain or headaches if the nerves to the head are affected. If you develop any of these problems please tell your doctor or nurse at your next visit to clinic.
Constipation
The nerves to your bowel may also be affected. This may result in constipation. If this occurs please contact Velindre Cancer Centre for advice.
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.
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
Macmillan freephone Helpline 0808 808 0000
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.