(Navelbine) Vinorelbine & Cisplatin
Your doctor has explained that you have breast
cancer and has recommended treatment with chemotherapy. This drug, Vinorelbine,
has been chosen because it has shown some promising results in previous studies
and is a well-established treatment in the rest of Europe. In addition, you will
also receive another drug called Cisplatin
which is an established treatment for lung cancer. This combination of drugs has
already been used in four small studies and has been shown to be of some
and is a well-established treatment in the rest of Europe. In addition, you will also receive another drug called Cisplatin which is an established treatment for lung cancer. This combination of drugs has already been used in four small studies and has been shown to be of some benefit.
Both drugs are given on the first day of your treatment, one by intravenous injection and the other by a drip. The intravenous injection is repeated one week later. This cycle of treatment is repeated every three weeks.
You will usually receive a total of six courses of treatment depending on whether the treatment is thought to be working, and whether you experience any unwanted side-effects.
Before each course of chemotherapy you will see a doctor and have a blood test. If your blood count is low then chemotherapy may be delayed a few days.
The side-effects described below will not affect
everyone. We have outlined those that you may experience during treatment. Your
clinic staff will usually work with you to keep your side-effects to a minimum.
It is important that you feel free to ask questions so that you understand what
is happening, what to do and what to expect. Occasionally people have rare
side-effects, which are not expected or mentioned on this sheet. If
in doubt ask!
Nausea & sickness; Despite the anti-sickness medication given with your chemotherapy and for a few days afterwards, some nausea may occur. This is usually associated with reduced appetite and in some cases vomiting. If marked you should contact the cancer unit for help as its important you do not get dehydrated. Some cancer units prescribe anti-sickness suppository to take home and should be used if sickness occurs. In general, anti-sickness tablets should be taken regularly and are usually successful, but if you do have problems, different tablets can be prescribed for the next cycle. Some self help tips may also be useful.If your blood counts falls you may experience the following:
White Blood Cells (WBC) Shivering or shaking attacks of fever (flu like symptoms). If you feel hot or unwell check your temperature. A raised temperature indicates you have an infection which could be life threatening. A normal temperature is between 36oC and 37.2oC. If it is 38°C (100F) telephone the Hospital or cancer unit immediately and they will advise you. Do not take Paracetamol or Aspirin as this will bring your temperature down and mask the signs of infection. This is most likely to happen in the middle week (7-14 days) between cycles.
Haemoglobin (Hb) Tiredness, lethargy, breathlessness, dizziness (particularly on standing) and pale facial colour. Occasionally patients require a blood transfusion at some point during the whole course.
If you notice any bleeding, i.e. nose
bleeds, unexplained bleeding, bruising or persistent headaches contact the
Other advice on paracetamol; As mentioned above, if you have a temperature and feel unwell you may have an infection and may need treatment in hospital, we advise not to take paracetamol in this situation as it may mask your temperature, give false reassurance and delay you presenting to hospital for treatment. Taking paracetamol can otherwise be used with discretion. If for example you have a headache or a mild pain but otherwise feel well and your temperature is normal paracetamol can be used provided you check your temperature before each dose and allow a full six hours before each administration.
Contact to chicken pox; If you can't remember whether you've had Chicken Pox as a child and you come in contact with a person who as it or shingles you should contact your oncology team. They will arrange a blood test to find out if you are immune to chicken pox (the varcella virus). If not a series of injections can be administered to offer you temporary immunity
Fatigue; All chemotherapy can cause fatigue. As your treatment progresses you will experience this. You may find that gentle exercise such as a short walk each day (if you are not working) may help. Fatigue and malaise may last up to 2-3 months (or longer) after the end of chemotherapy.
Weight gain; Over the entire course of chemotherapy many patients complain of weight gain. This is caused by a combination of the steroids increasing the appetite, the fatigue causing lack of mobility and the mild nausea often encouraging to nibble rather than eating correct meals - In order to prevent this we recommend regular light exercise and be aware of your calorie intake.
Weight loss may also be experienced by some patients during their course of chemotherapy particularly if there is more advances disease or other medical problems, in these cases dietary advice should be sought.
mouth; You may have a sore
mouth after chemotherapy and it is important that you maintain good
oral hygiene. A soft, baby toothbrush may help and you may be given a mouthwash.
If you develop mouth ulcers
you should contact your clinic and they can prescribe special mouthwashes to
Hair loss; This chemotherapy may sometimes cause hair loss. This usually occurs following 2-3 cycles. You may also experience thinning and loss of eyelashes, eyebrows and other body hair. This is temporary and your hair will regrow after treatment, although it may at first be a different texture, very like a baby's hair. Some departments use a cold cap system to minimise hair loss. Your clinic nurse can arrange for you to have a wig before your treatment starts (NHS prescription charge, prices are approximately £55 for an acrylic wig, £140 for half real hair wig and £205 for a full real hair wig).
Premature menopause; For pre-menopausal women, chemotherapy may affect your periods. They may become heavier, lighter or may stop. In some women this may be permanent causing menopausal symptoms. You should not become pregnant during chemotherapy, as chemotherapy will damage a growing baby. You should still take contraceptive precautions even if your periods have stopped, as you could still become pregnant.
Constipation: Some patients experience constipation which may be due to the anti-sickness tablets. You should drink plenty of fluids, eat a high fibre diet and take gentle exercise. If this is severe you should contact your clinic or GP.
Steroids; The Prednisolone tablets are a form of steroid and some people feel hyperactive and have trouble sleeping while they are taking them. Taking the tablets earlier in the day will help prevent this. If you normally have indigestion your doctor may give you tablets to prevent indigestion with steroids.
Altered sensation; This
chemotherapy can irritate the nerve endings and some people notice altered
sensation with slight numbness, or pins and needles
in the fingers or toes. This comes on slowly, is usually mild and will usually
get better slowly after chemotherapy has finished. If the numbness is severe it
may interfere with fine movement (e.g. fastening buttons). If you develop
sudden numbness or weakness this should always be reported immediately.
Hearing damage; This
chemotherapy can rarely damage the hearing. If you develop any hearing
difficulties and particularly ringing in the ears please inform your clinician
before your next cycle of chemotherapy.
Altered taste; You may
also experience an alteration in your taste.
Food may taste slightly more salty, bitter or metallic. Normal taste will return
once you treatment has finished, but may take several months to do so.
Increase risk of blood clots - during chemotherapy there is an increased risk of blood clots, most commonly in the legs (deep vein thrombosis) or more seriously to the lungs (pulmonary embolus). If you get unexplained swelling and discomfort in the calf report this to the oncology unit. Likewise if you start experiencing unexplained breathlessness, cough up any blood or have a pain in the chest particularly when you breath contact the clinic as soon as possible. To avoid clots its important to stay as active as possible and (exercise & chemotherapy) taking light walks two to three times a day and avoid sitting around for long periods of time. If you are required to sit (for example while receiving the chemotherapy drugs) try to move your legs and ankles regularly. Occasionally, if your doctor feels you are at high risk of developing clots you may be started on drugs to thin your blood during chemotherapy.
Sore eyes; The front of the eyes (cornea) can occasionally feel dry and sticky, especially first thing in the morning. This usually comes on later in the course and can cause some redness and discomfort. Eye drops such artificial tears can be bought over the counter or prescribed by your medical team.
Nails; The grow of the nails can be impaired by chemotherapy. The amount of damage can vary but in most case there will be some slight discolouration and indentation seen in ridges across the nail beds - a bit like the rings of a tree, each representing an individual chemotherapy cycle. Occasionally the damage can be more troublesome, causing pain and breakdown of the nail bed causing it to lift and separate, possibly even leading to a total loss of the nail. Eventually after chemotherapy has finished the nail will grow back normally.
Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.