Bleomycin, Mitomycin-C and
Cisplatin Chemotherapy (BMC)

This section is for patients who will receive BMC 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
Your treatment is given every 2 or 3 weeks for 4 or 6 courses and you will be in hospital overnight. Mitomycin-C is given every alternate visit.

The nurses give the treatment as an infusion (drip) into a vein in the back of your hand or forearm using a plastic needle called a cannula.

Your treatment should be pain free. However, if the area around the cannula causes any pain, stinging or burning, tell the nurse immediately.

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 you are 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

Flu-like Symptoms
For the first 24-hours following your treatment, you may experience fever and chills. If you are still in hospital, let the nurse looking after you know. If you are at home, take two paracetomol every 6 hours until the symptoms subside.

Your Hair
The treatment does not usually cause total hair loss although you may find your hair becomes thinner or more brittle. If you do experience hair loss, the nurse can arrange a wig for you. However, any hair loss or thinning is temporary and your hair will return when your treatment 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. salt to 1 pint boiled, cooled water). If your mouth continues to be very sore or becomes ulcerated, telephone for advice. You may also find that you get a metallic taste in your mouth. You can help yourself by sucking on strong flavoured sweets.

Your Bowels
You may experience diarrhoea (loose bowels) in the first 24-hours. If it lasts longer than this, your GP or pharmacist can advise you.

Your Fertility
We advise you not to become pregnant 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. The treatment may also affect your ability to become pregnant in the future.

Your Fingers and Toes
As treatment progresses, you may experience pins & needles in your fingers and toes. Although harmless, let the doctor know at your next visit, he/she may want to reduce or change the drug. In the meantime, be cautious with hot water and appliances. The sensation should disappear within 4-6 weeks of completing your chemotherapy.

Your Skin
The skin covering the veins of your arms, especially those used for chemotherapy, may become discoloured and your nails may become ridged. Both of these symptoms are harmless and will disappear some time after your treatment is complete.

Tiredness
You may feel tired at times. It is important that you do as much or as little as you feel like doing. You may need to take time off work.

Your Kidneys
The chemotherapy can affect your kidneys that produce urine (water, wee). We will give you plenty of fluids through the drip to help prevent this and will monitor your kidney function through blood tests each time you attend for treatment. If your kidneys are affected, the doctor may well decide to change you to a different type of chemotherapy.

Your Hearing
Sometimes the chemotherapy can affect your hearing. If you notice deafness, ringing or buzzing in your ears, let the nurse or doctor know at your next visit.

Your Lungs
Very rarely, the treatment may cause problems with your lungs and breathing. If you notice that you become short of breath or start wheezing, let the doctor know at your next visit.

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:
Sulby Ward 0151 604 7459

References:
1. Chemotherapy Protocols 2000. Clatterbridge centre for Oncology
2. Cytotoxic Chemotherapy. 5th ed. Eli Lilly Oncology.

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
  

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

Taxol

Taxol & Cisplatin

Taxol & Carboplatin

CAE

Adriamycin

BMC

Carboplatin

5FU & Folinic Acid

AC

CAV

Cisplatin

CMF

CMV

Epirubicin

Irinotecan

Mitozantrone