The chemotherapy treatment you are to receive is called Taxol (Paclitaxel). Taxol is administered via an infusion (drip) into a vein through a small and very thin plastic tube called a cannula. It is usually given over 3 hours every 3 weeks as an out-patient. (Click here for the history of taxol)
You will be carefully monitored by the chemotherapy nurses, and a member of the medical team. You will be usually given 4 to 6 cycles of Taxol, and response to treatment assessed using blood tests and scans performed usually after the 3rd and/or 6th cycles.
We have outlined side-effects you may experience. It is important
that you feel free to ask questions so that you understand what to expect and what to do.
Occasionally people have rare side-effects which are not expected or mentioned on this
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 count falls you may experience the following:
Blood Cells (WBC). Shivering or shaking
attacks of fever. If you feel hot or unwell check your temperature. If
it is 38°C (100F) telephone the Hospital and they will advise you. Do not
take Paracetamol or Aspirin if you have a temperature.
temperature indicates infection which could be life threatening. If
you have a temperature or feel unwell contact your hospital immediately.
(Hb) Tiredness, lethargy,
breathlessness, dizziness (particularly on standing) and pale facial colour.
Occasionally patients require a blood transfusion.
Platelets If you notice any bleeding, i.e. nose bleeds, unexplained bleeding, bruising or persistent headaches contact the Hospital immediately.
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 are 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.
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 dietary intake.
Weight loss may also be experienced by some patients during their course of chemotherapy , in these cases dietary advice should be sought.
Hair loss; This chemotherapy causes hair loss. It usually starts 3-4 weeks after the first course and may be lost completely. 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 . 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).Sore mouth; You may have a sore mouth after chemotherapy and it is important that you maintain good oral hygiene. A soft, baby toothbrush and a mouthwash may help. If you develop mouth ulcers you must contact your clinic and they will prescribe special mouthwashes to help.
Fertility may be affected by chemotherapy, in both men and women. It is important to discuss fertility with your doctor before starting treatment. 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 it will damage a growing baby. You should still take contraceptive precautions even if your periods have stopped, as you could still become pregnant. Men must also use a barrier contraceptive whilst receiving chemotherapy as sperm is damaged by chemotherapy.
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.
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.
Diarrhoea; Taxol can cause diarrhoea, this usually occurs 3-4 days following the infusion and can last up to 10 days. Diarrhoea can be easily controlled with medicine, but you should inform your doctor if it is severe or continues. It is important to drink plenty of fluids if you do get diarrhoea. If you have any alteration in bowel pattern tell your doctor.
Steroids; This chemotherapy is given with steroids to help prevent sickness. Steroids have some side effects, including fluid retention, weight gain, wakefulness and sometimes agitation. If you suffer from indigestion you may be given tablets to prevent this. If prone to "spots" or acne or diabetes or high blood pressure this can be made worse.
Allergic reaction; Despite steroids, very occasionally people may have an allergic reaction to Taxol on the first or second infusion. If you feel hot, shivery, breathless or develop an itchy rash then let the chemotherapy nurse know immediately.
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.
Altered sensation; 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 get better slowly after chemotherapy has finished. If the numbness is severe and stops you doing things (e.g. fastening buttons) your doctor may need to change your drugs or alter the dose. If you develop sudden numbness or weakness this should always be reported immediately.
Aching muscles and joints; You may experience pain in the muscles and joints within two to three days of having your Taxol infusion, but usually resolves quite quickly. Pain-killers can be used as advised.
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.