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Cyclophosphamide
Adriamycin & Etoposide (CAE) Chemotherapy
This section assumes
you have already talked about other treatment options with your doctor
and have agreed to a course of CAE chemotherapy.
It will explain:
- the treatment
plan;
- the most common
side effects you may have and ways in which you can reduce or even overcome
them when you are at home;
- any serious side
effects that may affect your life-style;
- who to contact
when you need advice about the chemotherapy.
It will also be helpful
for family and friends who may be worried at how the treatment may affect
you and ways in which they can help.
Treatment
Plan 1
The nurses will give you your treatment and takes about 45 minutes. It
is given every three weeks as an infusion (drip) into a vein in the back
of your hand or forearm using a plastic needle called a cannula for a
maximum of 6 cycles1. Your treatment should be pain free. However, if
the skin around the cannula causes any pain, stinging or burning, tell
the nurse immediately.
We will also give you some tablets (etoposide) to take on the 2nd &
3rd day. Do not ask your GP for any more.
Side
Effects 2
Nausea and Vomiting (feeling sick and being sick)
This may start a few hours to 48 hours after treatment unless you take
your anti-emetics (anti-sickness) tablets as prescribed. You can help
by eating small, frequent meals and avoiding rich, spicy foods and alcohol
for 48 hours after treatment. If sickness lasts longer than this, telephone
for advice and let your nurse or doctor know at the next hospital visit.
A different anti-emetic may help. Some anti-emetics may cause drowsiness.
If affected, it is important you do not drive or operate machinery.
Your Bone Marrow
Chemotherapy
affects the bone marrow where blood cells are made and may temporarily
lower the three main types of blood cells.
- Your white cells
leaving you more prone to infection.
- Your red cells
causing anaemia.
- Your platelets
which may leave you prone to bruising or bleeding.
Because of this we
will require blood tests each time you attend and in between at your nearest
hospital. Telephone for advice if:
- your temperature
rises above 37.5ºC (100ºF) which may mean an infection. The
nurse will show you how to take your
own temperature if you do not know;
- you have any bruising
or bleeding you cannot account for;
- you feel tired
or short of breath, which may mean you are anaemic and need a blood
transfusion; or
- you feel generally
unwell
Your
Hair
Unfortunately, you will lose your hair and other body hair may thin out.
The nurse will arrange a wig for you if you wish. However, hair loss is
temporary and your hair will return once the chemotherapy is complete.
Your Mouth
Your mouth is prone to ulcers and infection so clean your teeth &
gums after each meal. Avoid mouthwashes containing alcohol, because they
increase dryness in your mouth. Salt water is good (1 tsp. to 1 pint boiled,
cooled water). If your mouth continues to be very sore or ulcerated, telephone
for advice. You may experience taste changes which is unpleasant but harmless.
Tiredness
You may feel tired at times. It is important that you do as much or as
little as you feel like doing.
Your
Fertility
We advise you not to become pregnant or father a child during chemotherapy
and for 2 months after the last treatment because the drugs may harm the
developing baby. So, before starting treatment discuss methods of contraception
with your partner and, if necessary, a nurse or doctor. However, your
fertility in the future may be affected or you may become infertile. For
men - you may want to discuss sperm banking, with either your nurse or
doctor who will arrange it for you.
Your skin
For several months after chemotherapy has finished, your skin may burn
more easily. When in the sun, wear a high factor sun-cream (SPF 20 or
more) and protective clothing.
Your
Urine (waterworks)
You may find that for the first 24 hours following treatment your urine
is red, but this is harmless. Very rarely, the chemotherapy can irritate
the lining of your bladder. You can help by drinking at least 2 litres
of fluid a day, but if you have pain, burning or notice blood when passing
water, telephone for advice.
Your
Heart
Very rarely, the chemotherapy can affect the muscle of the heart and if
you already have heart problems, the doctor will monitor you carefully.
Occasionally your doctor may arrange a special heart scan if there are
any concerns.
It is hard to say
which side effects will affect you and to what extent. Be guided by how
you feel each day.
Who
to Contact:
Delamere Day Case Unit 0151 604 7498. Mon - Fri, 9-5
Sulby Ward 0151 604 7459 all other times
References:
1. CCO 1999. Chemotherapy Protocols. Clatterbridge Centre for Oncology.
2. Cytotoxic Chemotherapy. 5th Edition. Eli Lilly Limited.
Further
Reading:
CCO
Patient Information Series:
- Chemotherapy
(No.8)
- Sex and Chemotherapy
(No.10)
- Hair Care Advice
(No. 8D)
CancerBACUP leaflets.
- Chemotherapy
- Sexuality and
Cancer
- Coping with Hair
Loss
- Lung (Understanding
Cancer Series)
Other Sources of Information:
Cancer Information Centre
Clatterbridge Centre for Oncology,
Bebington, Wirral CH63 4JY
Tel: 0151 482 7722.
www.ccotrust.co.uk
BACUP
3 Bath Place
Rivington St
London EC2A 3JR Tel.0800 181199
www.cancerbacup.org.uk
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