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CANCER-TREATMENT-CURE
 
CHEMOTHERAPY DRUGS SIDE EFFECTS 
Chemotherapy Medications and their Side Effects (Mi - V)

Mitoxantrone (Novantrone): approved for administration as an infusion into a freely running intravenous line of a period of not less than 3 minutes. This drug has also been administered as a continuous infusion. Novantrone is generally believed to not be a vesicant (such as Daunorubicin and Doxorubicin). However, every precaution should be made to prevent extravasation of the solution. Extravasation usually results in a blue discoloration of the skin, which slowly fades.

The limiting toxicity for this drug is bone marrow suppression.

Other side effects include nausea and vomiting (occurring in up to 50% of patients) and stomatitis. Abdominal pain, constipation, diarrhea and hair loss are infrequent.

Cardiac toxicity may also occur. In order to prevent this from happening the cumulative dose should not exceed 160 mg/m2. In patients with prior therapy with Novantrone, adriamycin or Daunorubicin and in individuals with prior radiotherapy the total dose should not exceed 120 mg/m2. Diagnostic indications for stopping Novantrone therapy are a decrease in ejection fraction (a measure of the ability of the heart to pump blood) by at least 10-20%.

Oxaliplatin: administered intravenously as either a short infusion or as a prolonged (120 hour) continuous infusion. Peripheral neuropathy (tingling and numbness of the hands and feet and sometimes the lips) is the dose limiting toxicity of this medication. Mild decreases in the white count and platelet count are also seen. However, in contrast to Cis-platin renal and liver effects have not been reported. Additionally, the neurotoxic effects of Oxaliplatin are relatively, rapidly reversible, in contrast to the effects of other platinum containing compounds. Cardiac toxicity has not been observed, nor has hair loss or hearing toxicity.

Paclitaxel (Taxol): Brian is using this one along with Carboplatin  (Systemic)  see Below. . administered as an intravenous infusion. Anaphylactic-like (hypersensitivity) reactions have been seen with administration of the drug. The reactions are characterized by wheezing, shortness of breath, facial flushing, facial swelling and decreased blood pressure. The reaction is thought to occur because of histamine release caused by the fluid (Chemophor) Taxol is dissolved in. Premedication with steroid, Benadryl and Cimetidine will help minimize this adverse effect.

The dose limiting side effect of Taxol is bone marrow suppression. Decreases in the white count are more predominant than platelet or red blood cell effects. Neuropathy, characterized by numbness, tingling and pain has also been seen. The neuropathy is typically reversible when the agent is discontinued. Symptom resolution usually occurs over several months. Heart side effects have been seen. Slowing of the heart rate (bradycardia) occurs but is usually short lived. However, rarely, the slowing is progressive leading to complete heart block.

Other effects   include nausea and vomiting, diarrhea, mouth sores, hair loss and flu-like symptoms consisting of joint and muscle aches (arthralgia and myalgia), fever, rash, headache and fatigue.

Procarbazine (Matulane): administered orally or by slow intravenous infusion over 10-15 minutes. Procarbazine may interact with certain foods and medications and these should be discontinued during therapy with this medication to decrease the risk of adverse reaction. Below is a list of potential reactive drugs and foods. Food or medication possible interaction - Ethanol (alcohol) severe gastrointestinal toxicity with nausea, vomiting. Possible visual problems; headache. Sympathomimetics Ephedrine, epinephrine, etc. severe gastrointestinal toxicity with nausea, vomiting. Possible visual problems; headache. Antidepressants Tricyclics (i.e. Amitriptyline) Monoamine oxidase inhibitors extremely high blood pressure, tremor, excitation. Additionally heart problems such as chest pain and abnormal heart rate. Tyramine rich foods Dark beer, cheese, wine, bananas, etc. extremely high blood pressure, tremor, excitation. Additionally, heart problems such as chest pain and abnormal heart rate. Central nervous system depressants Narcotics (morphine, etc.) Barbiturates Antihistamines (Benadryl, etc.) Phenothiazines High blood pressure medications (Clonidine, etc. ) potential respiratory depression secondary to additive effects.

Bone marrow suppression is the main toxic effect of this drug; platelets are selectively affected leading to an increased risk of bleeding. Other effects include nausea and vomiting, diarrhea and flu-like symptoms consisting of fever, chills, sweating, tiredness and joint and muscle aches. Skin reactions are rare but include hair loss, itchiness and rash. Nervous system toxicity includes dizziness, problems with walking, headache and numbness or tingling of the hands and feet. Additionally, double vision, eye sensitivity to light and swelling of the retina have been observed. Hormonally, loss of periods and absence of sperm production occur while on Procarbazine.

Rituxin (Rituximap): administered intravenously; however intravenous bolus or push administration is not recommended. Adverse reactions include an infusion related symptom complex of fever and chills. Other reactions include nausea and vomiting, fatigue, itchiness, wheezing, shortness of breath, low blood pressure and sensation of tongue or throat swelling (angioedema). Flushing and pain at disease sites may also occur. Because of the risk of low blood pressure it is recommended that anti-hypertensive medications be held for 12 hours prior to administration of Rituxin.

Immunologically, B-cell lymphocytes are depleted in the majority of patients but risk of infection does not appear to be increased. Bone marrow suppression with lowered platelet counts, white blood counts and anemia occurs in 1-2% of patients. Cardiotoxicity as manifested by irregular and/or fast heart rates have been noted. Reactions occurring between 1-5% of the time include joint aches, diarrhea, high blood pressure, chest pain, loss of appetite, anxiety, tiredness, nervousness and taste perversion.

Semustine (Methyl-CCNU): administered orally. The drug may be taken on an empty stomach to help lessen the severity of nausea and vomiting. The major side effect is of bone marrow suppression, which may be prolonged (thus leading to increased risk of infection and bleeding). Other effects include nausea and vomiting (commonly occurring 4-6 hours after ingestion), and loss of appetite.

Tomudex (Raltitrexed): administered as an intravenous infusion over 15 minutes. The major toxicities thus far reported include fatigue, diarrhea, liver function abnormalities and bone marrow suppression.

Topotecan (Hycamtin): administered intravenously. The major side effect is the development of neutropenia (leading to increased risk of infection). Lowered platelets and anemia have also been noted. 30% of patients experience nausea and vomiting. One third (33%) of patients experience fever greater than 101 degrees. Microscopic blood in the urine has occurred in 10-12% of patients.

Vinblastine (Velban): administered as an intravenous push with the total dose of medication delivered over approximately 1 minute. This drug is very irritating and should not be given underneath the skin (subcutaneously) or into the muscle (intramuscularly). Extravasation (leakage into the tissues around the vein) must be avoided. If it should occur, local injection of hyaluronidase into the area should be performed. An alternative method of treating extravasation is with injection of a steroid, along with saline, into the area followed by application of cold compresses.

Bone marrow suppression is the major side effect. This leads to lowered white blood cell, red blood cell and platelet counts. These decreases lead to increased risk of infection; increased risk of bleeding and decreased exercise tolerance with increased shortness of breath. Rarely, nausea and vomiting occur. However, constipation and abdominal pain have been seen. Neurotoxicity as manifested by depression, headache, malaise, jaw pain, urinary retention, and convulsions have been noted. Other side effects include hair loss (mild), rash, mouth sores and increased sensitivity of the skin to the sun.

Vincristine (Oncovin): administered by intravenous push technique with the entire dose delivered over 1 minute. Alternatively, the drug may be delivered as an infusion over 15 minutes. Vincristine is highly neurotoxic and must not be administered intrathecally (into the brain). It should be noted that inadvertent intrathecal injection of Vincristine is uniformly fatal and must be avoided at all costs.

Extravasation must be avoided.(more commonly known as “IV burns) If it should occur, local injection of hyaluronidase and saline (sodium chloride) into the area should be performed. Followed by application of mild heat to the area to disperse the drug.

Neurotoxicity constitutes the common dose limiting toxicity with Vincristine. Symptoms include jaw pain, seizures, constipation, and bladder dysfunction.

Vinorelbine (Navelbine): typically administered as a brief intravenous infusion over 20-30 minutes. Oral capsules are available. The major side effect is the development of bone marrow suppression. This includes decreased white blood counts and anemia (seen in 2% of patients). Neurotoxicity has been reported to occur in up to 30% of patients with symptoms of constipation and tingling and numbness of the extremities. Hair loss occurs in about one quarter of individuals.

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Carboplatin  (Systemic) 
Brian is using this along with Paclitaxel (Taxol): see above.

Brand Names

In the U.S.— Paraplatin

In Canada— Paraplatin  Paraplatin-AQ

Category -Antineoplastic

Description

Carboplatin ( KAR-boe-pla-tin) belongs to the group of medicines known as alkylating agents. It is used to treat cancer of the ovaries. It may also be used to treat other kinds of cancer, as determined by your doctor.

Carboplatin interferes with the growth of cancer cells, which eventually are destroyed. Since the growth of normal body cells may also be affected by carboplatin, other effects also will occur. Some of these may be serious and must be reported to your doctor. Other effects may not be serious but may cause concern. Some effects may not occur until months or years after the medicine is used.

Before you begin treatment with carboplatin, you and your doctor should talk about the good this medicine will do as well as the risks of using it.

Carboplatin is to be administered only by or under the immediate supervision of your doctor. It is available in the following dosage form:

    Parenteral -Injection (U.S. and Canada)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For carboplatin, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to carboplatin, cisplatin, or any other platinum-containing substance.

Pregnancy—There is a chance that this medicine may cause birth defects if either the male or female is taking it at the time of conception or if it is taken during pregnancy. Carboplatin causes toxic or harmful effects and birth defects in rats. In addition, many cancer medicines may cause sterility that could be permanent. Although sterility has not been reported with this medicine, the possibility should be kept in mind.

Be sure that you have discussed these possible effects with your doctor before receiving this medicine. Before receiving carboplatin, make sure your doctor knows if you are pregnant or if you may become pregnant. It is best to use some kind of birth control while you are receiving carboplatin. Tell your doctor right away if you think you have become pregnant while receiving carboplatin.

Breast-feeding—Because carboplatin may cause serious side effects, breast-feeding generally is not recommended while you are receiving this medicine.

Children—Studies on this medicine have been done only in adult patients and there is no specific information comparing use of carboplatin in children with use in other age groups.

Older adults—Some side effects of carboplatin (especially blood problems or numbness or tingling in fingers or toes) may be more likely to occur in the elderly.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When receiving carboplatin it is especially important that your health care professional know if you are taking any of the following:

  • Amphotericin B by injection (e.g., Fungizone) or
  • Antithyroid agents (medicine for overactive thyroid) or
  • Azathioprine (e.g., Imuran) or
  • Chloramphenicol (e.g., Chloromycetin) or
  • Colchicine or
  • Flucytosine (e.g., Ancobon) or
  • Ganciclovir (e.g., Cytovene) or
  • Interferon (e.g., Intron A, Roferon-A) or
  • Plicamycin (e.g., Mithracin) or
  • Zidovudine (e.g., AZT, Retrovir)
  • If you have ever been treated with radiation or cancer medicines—Carboplatin may increase the effects of these medicines or radiation therapy on the blood
Other medical problems—The presence of other medical problems may affect the use of carboplatin. Make sure you tell your doctor if you have any other medical problems, especially:
  • Chickenpox (including recent exposure) or
  • Herpes zoster (shingles)—Risk of severe disease affecting other parts of the body
  • Hearing problems—May be worsened by carboplatin
  • Infection—Carboplatin decreases your body's ability to fight infection
  • Kidney disease—Effects may be increased because of slower removal from the body

Proper Use of This Medicine

This medicine is sometimes given together with certain other medicines. If you are using a combination of medicines, it is important that you receive each one at the proper time. If you are taking some of these medicines by mouth, ask your health care professional to help you plan a way to take them at the right times.

This medicine usually causes nausea and vomiting that sometimes may be severe. However, it is very important that you continue to receive the medicine, even if you begin to feel ill. Ask your health care professional for ways to lessen these effects, especially if they are severe.

Dosing—

The dose of carboplatin will be different for different patients. The dose that is used may depend on a number of things, including what the medicine is being used for, the patient's size, and whether or not other medicines are also being taken. If you are receiving carboplatin at home, follow your doctor's orders or the directions on the label. If you have any questions about the proper dose of carboplatin, ask your doctor.

Precautions While Using This Medicine

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

While you are being treated with carboplatin, and after you stop treatment with it, do not have any immunizations (vaccinations) without your doctor's approval. Carboplatin may lower your body's resistance and there is a chance you might get the infection the immunization is meant to prevent. In addition, other persons living in your household should not take oral polio vaccine since there is a chance they could pass the polio virus on to you. Also, avoid persons who have taken oral polio vaccine within the last several months. Do not get close to them, and do not stay in the same room with them for very long. If you cannot take these precautions, you should consider wearing a protective face mask that covers the nose and mouth.
Carboplatin can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in urine or stools; or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your health care professional before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.
Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years after the medicine is used. These delayed effects may include certain types of cancer, such as leukemia. Discuss these possible effects with your doctor.

Check with your doctor as soon as possible if any of the following side effects occur:

  • More common
    • Pain at place of injection 

    Less common

    • Black, tarry stools;  blood in urine or stools;  cough or hoarseness, accompanied by fever or chills;  fever or chills;  lower back or side pain, accompanied by fever or chills;  numbness or tingling in fingers or toes;  painful or difficult urination, accompanied by fever or chills;  pinpoint red spots on skin;  skin rash or itching ;  unusual bleeding or bruising;  unusual tiredness or weakness 
  • Rare
    • Blurred vision;  ringing in ears;  sores in mouth and on lips;  wheezing  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

  • More common
    • Nausea and vomiting;  unusual tiredness or weakness 
  • Less common
    • Constipation or diarrhea;  loss of appetite  

This medicine may cause a temporary loss of hair in some people. After treatment with carboplatin has ended, normal hair growth should return.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Additional Information

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, carboplatin is used in certain patients with the following medical conditions:
  • Cancer of the bladder
  • Cancer of the breast
  • Cancer of the esophagus, including the junction between the esophagus and stomach
  • Cancer of the fallopian tube or lining of the abdomen (spreading from the ovary)
  • Cancers of the head and neck
  • Cancer of the testicles (including seminoma)
  • Cancers of the lymph system
  • Cancer of the lung
  • Cancer of the endometrium (the lining of the uterus)
  • Cancer of unknown origin (primary site)
  • Malignant melanoma (a certain type of skin cancer)
  • Retinoblastoma (a certain type of eye cancer)
  • Tumors in the brain

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.

Developed: 09/02/1999        Revised: 04/23/2004
 

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The Basics of Chemotherapy

Chemotherapy is a treatment option for many cancer patients. Many times, chemotherapy is a combination of drugs referred as "anti-cancer" medications.

How Does Chemotherapy Work

We know that cancer is caused by the out of control multiplication of cells. When these cells break free from the original site, the cancer metastasizes, or spreads. Chemotherapy interrupts the process of the multiplication.

How is Chemotherapy Given?

It is administered intravenously, in a pill form, by injection, or even applied to the skin. The frequency or duration of chemotherapy all depends on the type of cancer you have. It varies from patient to patient and often the treatment schedule is according to successes in trial studies.

Is Chemotherapy Expensive? The cost of chemotherapy can depend on what medication you are prescribed. Some pill form medications cost up to $16 a pill. This can be costly if you are prescribed frequent dosages. Check with your doctor to see if a medication can be prescribed that your insurance company covers. If not, the hospital social worker can refer you to agencies that may be able to provide assistance or grants.
 

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What is Cancer and How Does It Spread?

We all have heard the word "cancer" many times, however very few people understand the disease and how it develops. Cancer is a complex group of over 100 different diseases.

How Does Cancer Develop?

The organs in our body are made up of cells. Cells divide and multiply as the body needs them. When these cells continue multiplying when the body doesn't need them, the result is a mass or growth, also called a tumor.

These growths are consider either benign or malignant. Benign is considered non-cancerous and malignant is cancerous.

Benign tumors rarely are life threatening and do not spread to other parts of the body. They can often be removed.

How Does Cancer Spread to Other Parts of the Body?

The cells within malignant tumors have the ability to invade neighboring tissues and organs, thus spreading the disease.

It is also possible for cancerous cells to break free from the tumor and enter the blood stream, thus spreading the disease to other organs. This process of spreading is called metastasis.

When cancer has metastasized and has affected other areas of the body, the disease is still referred to the organ of origination. For instance, if cervical cancer spreads to the lungs, it is still called cervical cancer, not lung cancer.

Although most cancers develop this way, diseases like leukemia do not. They affect the blood and the organs that form blood and then invade nearby tissues.

All cancers are different, and require different treatment. What may be effective for prostate cancer, probably will not be for bladder cancer. Diagnosing cancer will vary as well, depending on the organ affected.

 

Cancer Diagnosis-Important Questions to Ask Your Doctor

   

What is Important to Ask When Being Diagnosed with Cancer?

Being diagnosed with cancer can make you feel a great amount of frustration and confusion. There are so many thoughts running through your mind, it is easy to forget important questions and information you need to know when you consult your physician about treatment.

I suggest bringing a notepad to your visit with a list of any questions you have. You can also write down the answers to these questions to review at a later time. Some even prefer to bring a small tape recorder.

Here are some questions that are often forgotten, but very important to ask:
 

  • What is the extent or stage of the cancer I have?
     
  • What are my treatment options?
     
  • What treatment do you suggest?
     
  • How long do you think my treatment will last and when will it start?
     
  • Can I continue working?
     
  • Would a clinical trial be appropriate for me?
     
  • What will happen if I choose not to have treatment?
     
  • How long will I have regular check ups after treatment?

It is important to have a physician that will take the time to address your concerns.

Cancer is never easy, and having a physician with a good bed side manner makes the journey much simpler.

 

 

Q. I have just been diagnosed with cancer.
Is it necessary to get a second opinion?

A. Getting a second opinion is a must when being diagnosed with cancer. During the initial diagnosis period, many people feel doubt. The second opinion will confirm any concerns about whether you were correctly diagnosed.

Sometimes it is difficult to discern between benign and malignant tumors in the pathology lab. For example, in bladder cancer, cancerous and non cancerous tumors look very much alike under the microscope. It takes a very experienced, trained eye to tell the difference.

In 1999, Johns Hopkins Hospital conducted a study of 6,171 slides of patients referred for treatment. Of those slides, 86 were wrongly diagnosed. That is a 1.4% error rate. 20 of the 86 patients they found to be wrongly diagnosed, received unnecessary cancer treatment. That is just how much of a difference getting a second opinion can make.

Many people feel a second opinion will be costly.

However, this is quite the contrary. Many insurance companies require a second opinion. Although there are some that don't require it, they may cover a second opinion consultation. Check with your insurance company to see what is covered.

If you know beforehand that you intend to get a second opinion, inform your physician before the slides or tests go to the pathology lab. He can recommend another specialist to you, and the process of sending the slides and findings to the specialist will in place. At times, slides are destroyed after the pathology report comes back if there is no indication to save them. This will spare you from repeating biopsies or tests.

Rare cancers absolutely require a second opinion by a specialist in that form of cancer. Also, specialists can often provide different treatment plans that the diagnosing physician was not aware of. You may have to travel to seek treatment from these specialists, but it is well worth it.

 
 
Hopefully this website will help you.  You run across  something on this topic from friends or from the internet  If you would like us to enter the article on this page we can usually do so.
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Houston, TX  77024
713-467-3025
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