Chemotherapy for primary liver cancer

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1 Chemotherapy for primary liver cancer This information is an extract from the booklet Understanding primary liver cancer (hepatocellular carcinoma or hepatoma). You may find the full booklet helpful. We can send you a copy free see page 5. Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. Chemotherapy is sometimes used to treat primary liver cancers that can t be removed by surgery. But in adults, chemotherapy will not usually cure the cancer. It can, however, help shrink the tumour and slow its progression, which may help control symptoms. Chemotherapy drugs may be given as tablets, injections into a vein (intravenously) or by injection directly into the hepatic artery (the main blood vessel that takes blood to the liver). It can sometimes be given as part of a treatment called chemoembolisation. Chemoembolisation aims to get rid of the cancer by giving chemotherapy directly into the affected part of the liver and by cutting off the blood supply to the tumour. There s no standard chemotherapy drug for the treatment of hepatocellular carcinoma (HCC). The most commonly used drug is doxorubicin. Other chemotherapy drugs that may be used include: cisplatin fluorouracil (5FU) gemcitabine (Gemzar ). A combination of chemotherapy drugs may be used. Macmillan and Cancerbackup have merged. Together we provide free, high quality information for all. Questions about cancer? Ask Macmillan Page 1 of 5

2 Chemotherapy treatment is not suitable for everyone because it can only be given if your liver functions well enough. How chemotherapy is given Chemotherapy is usually given as a session of treatments called cycles. Each cycle lasts a few days and is followed by a rest period of a few weeks to allow the body to recover from any side effects. The number of cycles you have will depend on the type of liver cancer you have and how well it s responding to the drugs. Our booklet Understanding chemotherapy discusses the treatment and its side effects in more detail. We also have fact sheets about individual chemotherapy drugs and their side effects. We can send you this free information call Chemotherapy is usually given in the hospital outpatient department or chemotherapy unit. Sometimes the chemotherapy is injected slowly into a vein (intravenously) or it may be given as a drip (infusion) over a few hours. You may need to stay in hospital for a few days. Occasionally, it s given as a continuous infusion through a small pump that you take home with you. Your doctor or nurse will explain how your chemotherapy will be given and what to expect. A number of research trials are being carried out to try to improve the results of treatment for primary liver cancer. You may be asked to take part in a trial. We can send you more information about clinical trials. Side effects Chemotherapy can sometimes cause unpleasant side effects, but it can also make you feel better by relieving the symptoms of the cancer. Most people have some side effects, but these can often be controlled well with medicines. Lowered resistance to infection (neutropenia) Chemotherapy can reduce the production of white blood cells by the bone marrow, making you more likely to get an infection. The number of white blood cells will usually have returned to normal before your next cycle of chemotherapy is Page 2 of 5 Questions about cancer? Ask Macmillan

3 due. You should contact your doctor or the hospital straight away if your temperature goes above 38 C (100.4 F) or you suddenly feel unwell, even with a normal temperature. Bruising or bleeding Chemotherapy can reduce the production of platelets, which help the blood to clot and stop bleeding. Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. Low number of red blood cells (anaemia) You may become anaemic, which can make you feel tired and breathless. Sore mouth Some chemotherapy drugs can make your mouth sore and cause small ulcers. Using mouthwashes regularly is important your nurses will show you how to use these properly. If you don t feel like eating during treatment, you could try replacing some meals with nutritious drinks or soft foods. Feeling sick (nausea) and being sick (vomiting) Some of the drugs may make you feel sick (nausea) and you may be sick (vomit). There are very effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting your doctor can prescribe these for you. Let your doctor or nurse know if your anti-sickness drugs aren t helping, as they can change them to a different type. Some antiemetics can cause constipation. Let your doctor or nurse know if this is a problem. Tiredness You are likely to find that you become very tired and have to take things much more slowly. Just do as much as you feel like doing and try not to overdo it. Hair loss Ask your doctor whether the drugs you are taking are likely to make your hair fall out. Not all chemotherapy drugs cause hair loss. If your hair does fall out, it will start to grow back once your treatment finishes. Questions about cancer? Ask Macmillan Page 3 of 5

4 Diarrhoea Some drugs used to treat liver cancer can irritate the lining of the digestive system and cause diarrhoea for a few days. Your doctor can give you medicine to slow down your bowel and reduce diarrhoea. You may be able to help to control it yourself by eating a low-fibre diet avoiding wholemeal bread and pasta, raw fruit, cereals and vegetables for a few days after each treatment. Skin Chemotherapy can affect the skin and nails causing dryness and flaking. Some drugs make your skin more sensitive to the sun, so it s important to cover up and use a suncream with a high sun protection factor (SPF). Numbness or tingling in the hands or feet Some chemotherapy drugs can affect the nerves causing numbness and tingling. This is known as peripheral neuropathy. Tell your doctor if you notice this. It usually improves slowly a few months after treatment finishes. Effects on the kidneys Some chemotherapy drugs can affect the way your kidneys work. Usually, this doesn t cause symptoms and the effect is mild. Rarely, it may cause permanent damage to the kidneys unless the treatment is stopped. Before and after each treatment, your kidneys will be checked by a blood test and you ll be given plenty of fluid through a drip to keep your kidneys working normally. It s important to drink plenty of fluids during and after your treatment. Your urine may also be measured to check that your kidneys are working properly. Changes in hearing Chemotherapy can cause ringing in the ears (tinnitus) and you may be unable to hear some high-pitched sounds. This usually improves when treatment finishes but can sometimes be permanent. Tell your doctor if you notice any loss of hearing or ringing in your ears. Although the side effects mentioned here may be hard to bear at the time, they will gradually disappear over a few weeks once your treatment has finished. Page 4 of 5 Questions about cancer? Ask Macmillan

5 We have more information about many of these side effects and how to cope with them, which we can send you. More information and support If you have any questions about cancer, ask Macmillan. If you need support, ask Macmillan. Or if you just want someone to talk to, ask Macmillan. Our cancer support specialists are here for everyone living with cancer, whatever you need. Call free on , Monday Friday, 9am 8pm To order a copy of Understanding primary liver cancer (hepatocellular carcinoma or hepatoma), or any other booklets we mention here, visit be.macmillan. org.uk To order the fact sheets mentioned in this information, call We make every effort to ensure that the information we provide is accurate but it should not be relied upon to reflect the current state of medical research, which is constantly changing. If you are concerned about your health, you should consult your doctor. Macmillan cannot accept liability for any loss or damage resulting from any inaccuracy in this information or third party information such as information on websites to which we link. Macmillan Cancer Support Registered charity in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604). Registered office 89 Albert Embankment, London, SE1 7UQ REVISED IN FEBRUARY 2012 Questions about cancer? Ask Macmillan Page 5 of 5