Chemotherapy for non-small cell lung cancer

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1 Chemotherapy for non-small cell lung cancer This information is an extract from the booklet Understanding lung cancer. You may find the full booklet helpful. We can send you a free copy see page 3. Contents How chemotherapy is given The drugs that are used Side effects Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The drugs work by disrupting the growth of cancer cells. In the treatment of non-small cell lung cancer, chemotherapy is sometimes given after surgery to reduce the risk of the cancer coming back. It also may help to shrink tumours before surgery or relieve symptoms if surgery isn t possible. How chemotherapy is given The drugs are given by injection into a vein (intravenously) or sometimes as tablets (orally). Each session of chemotherapy may last a few days, followed by a rest period of a few weeks. This is known as a cycle of treatment. The number of cycles you have will depend on the type of cancer you have and how well it is responding to the treatment. You may have your chemotherapy in the outpatient department, or you may be given tablets to take at home. Sometimes you may need to spend a night or two in hospital to have your treatment. Doctors are always looking to improve the treatment of lung cancer, so you may be asked to take part in a clinical trial. Questions about cancer? Ask Macmillan Page 1 of 5

2 The drugs that are used The most commonly used drugs used to treat non-small cell lung cancer are: cisplatin carboplatin gemcitabine (Gemzar ) vinorelbine (Navelbine ) paclitaxel (Taxol ) docetaxel (Taxotere ) pemetrexed (Alimta ). Different types of non-small cell lung cancer may be treated using a single chemotherapy drug or different combinations of drugs. Our booklet Understanding chemotherapy discusses the treatment and its side effects in detail. We can send you a copy. We also have fact sheets about the individual chemotherapy drugs and their particular side effects. Side effects Chemotherapy can cause unpleasant side effects. However, many people have few side effects, and those that occur can often be controlled well with medicine. Some main side effects are described here along with some of the ways they can be reduced. Risk of infection This treatment can reduce the number of white blood cells, which help to fight infection. White blood cells are produced by the bone marrow. If the number of your white blood cells is low you ll be more prone to infections. A low white blood cell count is called neutropenia. Page 2 of 5 Questions about cancer? Ask Macmillan

3 This begins seven days after treatment and your resistance to infection is usually at its lowest days after chemotherapy. The number of your white blood cells will then increase steadily and usually return to normal before your next cycle of chemotherapy is due. Contact your doctor or the hospital straight away if: your temperature goes above 38 C (100.4 F) you suddenly feel unwell, even with a normal temperature. You ll have a blood test before having more chemotherapy to check the number of white blood cells. Occasionally, your treatment may need to be delayed if your number of blood cells (blood count) is still low. Bruising and bleeding Chemotherapy can reduce the production of platelets, which help the blood to clot. Tell your doctor if you have any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin. Anaemia (low number of red blood cells) Chemotherapy can reduce the number of red blood cells, which carry oxygen around the body. A low red blood cell count is called anaemia. This may make you feel tired and breathless. You may need to have a blood transfusion if the number of red blood cells becomes too low. Feeling sick (nausea) or being sick (vomiting) Your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent, or greatly reduce, nausea or vomiting. If the sickness isn t controlled or if it continues, tell your doctor; they can prescribe other anti-sickness drugs that may be more effective. We have a fact sheet about controlling nausea and vomiting. Sore mouth Your mouth may become sore or dry, or you may notice small ulcers during this treatment. Drinking plenty of fluids, and cleaning your teeth regularly and gently with a soft toothbrush, can help to reduce the risk of this happening. Some people find sucking on ice soothing. Questions about cancer? Ask Macmillan Page 3 of 5

4 Hair loss This usually starts 3 4 weeks after starting treatment, although it may occur earlier. Hair usually falls out completely. You may also have thinning and loss of eyelashes, eyebrows and other body hair. This is temporary and your hair will start to grow again once the treatment has finished. We have a booklet called Coping with hair loss, which we can send you. Numbness or tingling in the hands or feet This is due to the effect of some drugs on nerves and is known as peripheral neuropathy. You may also notice that you have difficulty doing up buttons or similar fiddly tasks. This side effect usually improves slowly, a few months after the treatment has finished. But sometimes symptoms can persist. We have a fact sheet about peripheral neuropathy that we can send you. Changes to your hearing You may have ringing in the ears (tinnitus), and you may lose the ability to hear some high-pitched sounds. Hearing loss can be more severe with higher doses and longer courses of treatment. Any hearing loss, and balance changes if they occur, may be permanent. However, tinnitus usually improves when treatment ends. Fatigue Feeling tired is a common side effect of chemotherapy, especially towards the end of treatment and for some weeks after it s over. It s important to try to pace yourself and get as much rest as you need. Try to balance this with taking some gentle exercise such as short walks. Chemotherapy affects different people in different ways. Some people are able to lead a normal life during their treatment; others find they become very tired and have to take things more slowly. Page 4 of 5 Questions about cancer? Ask Macmillan

5 Although they may seem hard to bear at the time, any side effects you have are usually temporary and will disappear once your treatment is over. Some people feel better during their chemotherapy treatment as it can help to ease symptoms they ve been living with. More information and support Cancer is the toughest fight most of us will ever face. But you don t have to go through it alone. The Macmillan team is with you every step of the way, from the nurses and therapists helping you through treatment to the campaigners improving cancer care. We are Macmillan Cancer Support. To order a copy of Understanding lung cancer or one of the other booklets or fact sheets mentioned in this information, visit be.macmillan.org.uk or 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 OCTOBER 2012 Planned review in 2014 Questions about cancer? Ask Macmillan Page 5 of 5