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It is most common to have two or more chemotherapy drugs together to treat cancer. You may hear this called combination chemotherapy. Using two or more drugs together is often more effective than using one drug. The main drugs used in the treatment of nasopharyngeal cancers are Cisplatin Fluorouracil (5-FU) Other chemotherapy drugs that have been used more recently for nasopharyngeal cancers include Docetaxel (Taxotere) Paclitaxel (Taxol) Gemcitabine These links will take you to information about the specific side effects of each drug.
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Chemoradiation drugs
If you have stage 3 or 4 nasopharyngeal cancer you are likely to have chemotherapy and radiotherapy at the same time (known as chemoradiation or synchronous treatment). Some people with stage 2 nasopharyngeal cancer may also have this treatment. You may have one of the following chemotherapy drugs Cisplatin Cisplatin and 5FU Carboplatin Paclitaxel (Taxol) Docetaxel (Taxotere) Some of this treatment is experimental and you may have it as part of a clinical trial. Doctors use the results from clinical trials to improve treatment for head and neck cancers in the future. There is information about the side effects of chemoradiation on the next page in this section.
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What cisplatin is
Cisplatin is a chemotherapy drug that is used to treat different types of cancer, including testicular cancer, germ cell cancer, head and neck cancer, bladder cancer, cervical cancer, and non small cell lung cancer. At the centre of this drug is an atom of the metal platinum.
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infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery Tiredness and breathlessness due to a drop in red blood cells (anaemia) you may need a blood transfusion Bruising more easily due to a drop in platelets you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia) Some of these side effects can be life threatening, particularly infections. You should contact your treatment centre if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working. Other common side effects include
Tiredness (fatigue) during and after treatment most people find their energy levels are back
to normal within 6 months to a year Feeling or being sick can be severe it may begin a few hours after treatment and last for a few days. It is usually possible to control this side effect with anti sickness injections and tablets but if you are still being sick, tell your doctor or nurse Cisplatin can cause kidney damage you will have blood tests before your treatment, to make sure your kidneys are able to cope with the drug. To help prevent damage it is important to drink plenty of water and you will have fluids into your vein before and after your treatment You may have some hearing loss, especially with high pitched sounds This drug may have a harmful effect on a developing baby you should not become pregnant or father a child while taking this drug. Discuss contraception with your doctor or nurse before having the treatment, if there is any possibility that you or your partner could become pregnant.
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this drug. It is important to talk to your doctor about your fertility before starting treatment
Loss of appetite may occur a few days after your treatment Numbness or tingling in fingers and toes can cause difficulty with fiddly things such as doing
up buttons this starts within a few days or weeks and usually goes within a few months of finishing treatment. Some people may have permanent numbness Ringing in the ears (tinnitus) happens in about 3 in 10 people (30%), but nearly always gets better on its own Loss of taste or a metallic taste may occur
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Blurred vision can be a side effect of high doses of cisplatin. This will go back to normal once the treatment has finished. Or you may notice that you find it difficult to tell the difference between certain colours. This may carry on for a while after treatment has finished, but will usually get better on its own eventually.
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Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse, clinic or ward nurse will give you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them. Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies some drugs can react together.
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This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website atwww.medicines.org.uk. If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at www.mhra.gov.uk.
What fluorouracil is
Fluorouracil is also known as FU or 5FU and is one of the most commonly used drugs to treat cancer. It is used to treat many types of cancer including, breast cancer, head and neck cancers, anal cancer, stomach cancer, colon cancer and some skin cancers.
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The side effects associated with intravenous fluorouracil are listed below. You can use the links (underlined) to find out more about each side effect. Where there is no link, please see our cancer drugs side effects section or use the search box at the top of the page.
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infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery Tiredness and breathlessness due to a drop in red blood cells (anaemia) you may need a blood transfusion Bruising more easily due to a drop in platelets you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia) Some of these side effects can be life threatening, particularly infections. You should contact your doctor if you have any of these side effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working. Other common side effects include
Tiredness (fatigue) during and after treatment most people find their energy levels are back
to normal from 6 months to a year after their treatment finishes Feeling or being sick, which is usually mild Mouth sores and ulcers Diarrhoea you need to drink plenty of fluids. If the diarrhoea becomes severe or continues you could get dehydrated so tell your doctor or nurse Heart problems, such as angina, heart failure or a heart attack let your doctor or nurse know if you have any chest pain This drug may have a harmful effect on a baby developing in the womb. It is not advisable to become pregnant or father a child while having chemotherapy. It is important to talk to your doctor or nurse about contraception before having the treatment
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Brittle, chipped and ridged nails Sensitivity of the skin to sunlight you should not use sunbeds or sit in the sun if having
fluorouracil. Cover up or use a sun block Rashes, which may be itchy Watery eyes from increased production of tears Gritty eyes and blurred vision Loss of appetite Brown marking on the skin following the line of the vein where fluorouracil has been injected Continuous infusion of fluorouracil can occasionally cause soreness, redness and peeling on the palms of the hands and soles of the feet (palmar plantar syndrome) which may cause tingling, numbness, pain and dryness
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this drug. It is important to talk to your doctor about your fertility before starting treatment
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Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse will give you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them. Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies some drugs can react together.
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You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine). You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine. It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
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What docetaxel is
Docetaxel is one of the taxane type drugs that were originally developed from the yew tree. Docetaxel is a man made drug that was first made from yew tree needles. It is also known by its brand name, Taxotere. It works by stopping the cancer cells from separating into 2 new cells, so it blocks the growth of cancer. It is a treatment for
Breast cancer Lung cancer Head and neck cancer Prostate cancer Stomach cancer
You may also have it as part of trials for other types of cancer such as ovarian cancer and bladder cancers.
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infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery Tiredness and breathlessness due to a drop in red blood cells (anaemia) you may need a blood transfusion Bruising more easily due to a drop in platelets you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia) Some of these side effects can be life threatening, particularly infections. You should contact your treatment centre if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.
to normal from 6 months to a year after their treatment finishes Hair loss your hair normally falls out completely and this affects 8 out of 10 people treated. A cold cap may help to stop your hair falling out, but you need to talk to your doctor about whether this is advisable with your type of cancer Fluid retention occurs in about 5 out of 10 people you may have swelling of the hands and feet, breathlessness, and weight gain. The steroids you have with the drug can help to prevent this side effect A rash, which may be itchy, in about 5 out of 10 people
Discoloured fingernails but they will go back to normal a few months after the treatment ends Soreness, redness and peeling on the palms of the hands and soles of the feet (palmar
plantar syndrome), which may cause tingling, numbness, pain and dryness A sore mouth in about 4 out of every 10 people Diarrhoea in about 4 out of every 10 people Numbness and tingling in hands and feet you may have a change in how things feel when you touch them, which can make doing fiddly things difficult (for example doing up buttons) An allergic reaction during the infusion more than 2 out of 10 people have an allergic reaction to docetaxel. This nearly always happens in the first 10 minutes. If you are going to have a reaction, it is most likely the first or second time you have the drug. Your chemotherapy nurse will monitor you closely Watery eyes let your doctor or nurse know if you have watery eyes as they may be able to prescribe medicines to help
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menopause in some women. It is important to talk to your doctor before starting treatment if having a baby is important to you Aching muscles and joints A high temperature (fever) Inflammation around the drip site if you notice any signs of redness, swelling or leaking at your drip site, tell your doctor or chemotherapy nurse immediately
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Other medicines
Docetaxel can interact with some other medicines and herbal products. Tell your doctor about any medicines you are taking, including vitamins, herbal supplements and over the counter remedies.
Breastfeeding
Breastfeeding is not advisable during docetaxel treatment because the drug may come through in the breast milk.
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these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
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