Taxotere (Docetaxol)

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Your doctor has recommended a chemotherapy regimen including Taxotere. It is licensed to be given alone or in combination with other chemotherapy drugs for a number of cancers including those originating from breast, prostate and lung.

Taxotere is given every three weeks as an infusion (drip) into a vein in your arm for approximately 1 hour. It is given along with other drugs to prevent an allergic reaction (antihistamines, steroids and anti-indigestion medication called H-2 antagonist such as ranitidine) along with drugs to prevent nausea. Between cycles you may also be given a low dose of the steroid prednisolone. Occasionally it is difficult to access the veins in the arm so a central or PICC line is inserted.

The side-effects described below will not affect everyone.  It is important that you feel free to ask questions so that you understand what is happening. Occasionally people have rare side-effects which are not expected or mentioned on this sheet. If in doubt please ask. 

Side effects

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:

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.

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. 

Hair loss; This chemotherapy does cause 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. 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).  

 

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.

Weight gain or weight loss; Over the entire course of chemotherapy some men 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. Other individuals may actually complain of  weight loss  particularly if there is more advances disease or other medical problems, in these cases dietary advice should be sought.

Sore 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 help.   

Lips: In over 70% of patients on taxotere the lips can get S dry and sore (chapped) - we recommend a natural lip balm.

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; This chemotherapy is given with steroids (e.g. Dexamethasone) 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 patients are prone to "spots" or acne this can be made worse. Likewise they can temporarily upset diabetes or high blood pressure.

Skin  After several treatment cycles you may experience discolouration (a change in the colour) of your nails.  Your hands and feet may become dry and flaky, but this can be managed by using a glycerine-based hand cream, which your nurse can supply.

Your veins Three types of damage can occur, listed in order of seriousness:

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 is usually 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. Quite commonly 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. There is some anecdotal evidence that amercing the tips of your fingers in cold water during the 1 hour infusion can reduce the damage to the nails  - see the relevant chapter in Lifestyle and Cancer. There are also reports of patients massaging natural oils into the nail beds - see nail care guidelines

Aching muscles and joints; You may experience pain in the muscles and joints within two to three days of having your cabazitaxel infusion, but usually resolves quite quickly. Pain-killers can be used as advised.

Other useful links and further resources:

What is cancerAbout specific cancers; Breast | Prostate | Bowel.  Cancer treatments; Chemotherapy | Radiotherapy | Hormones | Biological agents | Complementary.  Lifestyle advice; Exercise | Diet | Smoking | Sunbathing | Alcohol.  Cope with symptomsTraveling | Insurance | Making a will | Support groups  | Tests for cancer | Clinical trials. ...site map
An excess or a deficiency of vitamins and trace mineral can lead to an increased risk of cancer, other illnesses and troublesome symptoms. A reliable way to ensure you have the correct amounts is to measure them. You will then be a to make able to make informed dietary decisions including and whether to take specific supplements in order to restore your nutritional balance. ...read more / order online
This 21 minute DVD explains chemotherapy & radiotherapy. The only preparatory film which was evaluated in a randomised study and shown to reduce anxiety and improve well-being during treatments. Available in English, Italian, Urdu, Bengali, Gujarati & Hindi   ... read more / order online
Cracked and sore lips are common during chemotherapy and afterwards. There is evidence that natural oil based creams are better than petroleum based creams. Nature-medical lip balm  contains only  natural waxes and essential oils selected for their anti-inflammatory and DNA stabilizing properties.. read more..order

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