Irinotecan Chemotherapy

This section is for patients receiving Irinotecan 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 by the nurses and will take about an hour. It is given as an infusion (drip) into a vein in the back of your hand or forearm using a plastic needle called a cannula, every 2 - 3 weeks at the clinic for up to 6 months 1.

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

Early Diarrhoea (loose stools / bowels)
Some patients will experience mild diarrhoea, abdominal (tummy / belly) pain and sweating within 24-hours of the treatment. However, we will give you a small injection in your arm before your chemotherapy to help prevent this. If you have more than 3 episodes of diarrhoea during this time, or if you are at all concerned about it, please telephone for more advice. In the meantime, you can help yourself by drinking plenty of fluids to stop you becoming dehydrated.

Delayed Diarrhoea
If your diarrhoea starts more than 24-hours after your chemotherapy, please follow the additional written instructions given to you by the nurse. It is important that you follow the instructions exactly.

Your Hair
You will probably lose the hair on your head and other body hair may thin out. The nurse will arrange a wig for you. 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. If your mouth continues to be very sore or ulcerated, telephone for advice.

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. The treatment may also affect your fertility in the future.

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 skin
You may experience some mild skin reactions. However, they are normally harmless.

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 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 ed. Eli Lilly Oncology.

Further Reading:
CCO Patient Information Series:

• Chemotherapy (No.8)
• Sex and Chemotherapy (No.10)
  

CancerBACUP leaflets.

• Chemotherapy
• Sexuality and Cancer
  

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