Download 415 TPF - Velindre Cancer Centre

TPF 415 (inpatient)
415 (inpatient)
Information on TPF chemotherapy
This leaflet provides information on a course of
chemotherapy treatment with docetaxel (Taxotere™),
cisplatin and 5 fluorouracil. This is usually called TPF. The
leaflet will explain what this is and when and how it will be
given. It will also tell you about common side effects that
you may experience. Contact telephone numbers and
details of how to obtain further information are given at the
end of the leaflet.
This leaflet should be read alongside the ‘General
information for patients receiving chemotherapy’ leaflet.
If you haven’t received this leaflet please ask your nurse for
a copy.
What is TPF chemotherapy?
This is a course of treatment which consists of 3 drugs:
 Docetaxel (Taxotere™)
 Cisplatin
 5 Fluorouracil (5-FU)
When combined they are known as TPF.
1
TPF 415 (inpatient)
Why am I having TPF chemotherapy?
Your doctor has prescribed this chemotherapy because it
has been found to be effective in treating your type of
cancer.
How often will I have my chemotherapy?
For this treatment to be most effective it will be given at
specific time intervals. These are known as cycles. It is
usual to have a cycle of TPF every 3 weeks for up to 4
cycles. Your doctor will discuss with you the exact number
of cycles you will have.
Will I need to stay in hospital for this treatment?
To receive this treatment you will need to stay in hospital for
5 - 6 days for each cycle of chemotherapy. You will be
admitted to the chemotherapy in-patient unit at Velindre
Cancer Centre.
Will I need any tests before I have my chemotherapy?
You will need a series of blood tests before you start your
chemotherapy. One of these blood tests helps us to check
that your kidneys are working well enough to cope with the
chemotherapy.
How will my treatment be given?
Your chemotherapy is given through a drip into a vein in the
back of your hand or arm. You will remain connected to the
drip during your stay in hospital. The drip will be attached to
a portable stand with wheels so you will be able to move
around the ward area. If you need help a nurse will be
available.
2
TPF 415 (inpatient)
We will give you steroid tablets called dexamethasone. You
must start taking them the day before you are admitted to
hospital. This is important to prevent some of the side
effects of the Taxotere treatment. They should be taken
with food, after breakfast and lunch.
What are the possible side effects?
There are a number of possible side effects which can occur
with this chemotherapy. The doctors, nurses and
pharmacists can give you advice or answer any questions
you may have.
It is very important that you take the dexamethasone
steroid tablets to reduce some of the side effects
associated with Taxotere chemotherapy. You must take
the tablets for 3 days, starting the day before you are
admitted to hospital. It is very important to take them
exactly as instructed.
Hair loss
Unfortunately you will lose your hair with this chemotherapy.
Your hair will grow back when your treatment has finished.
A method known as ‘scalp cooling’ or ‘cold capping’ can be
used to prevent hair loss. If you would like more
information about scalp cooling or wigs please speak to your
nurse.
We have a leaflet that tells you more on coping with hair
loss. Please ask your nurse if you would like a copy.
3
TPF 415 (inpatient)
Sickness
Nausea and vomiting are uncommon these days as we will
give anti-sickness medicines which are usually extremely
effective. If you are sick more than once in 24 hours despite
taking regular anti-sickness medicine when you are at home
after your chemotherapy treatment, contact Velindre Cancer
Centre for advice. The telephone number is at the end of
the leaflet.
Infection
You are at an increased risk of picking up infections
because your white blood cells which help fight infections
can be reduced by this treatment.
If you develop an infection whilst your white blood cells
are low, you are at risk of sepsis, this can be life
threatening.
Contact Velindre Cancer Centre immediately if you
develop any signs of infection, for example flu like
symptoms or a temperature above 37.5°centigrade. The
telephone number is at the end of the leaflet.
Diarrhoea
You may have diarrhoea with this chemotherapy. If this
occurs it is important that you drink plenty of fluids.
Medication is available to control diarrhoea. If you have 4 or
more bowel movements in 24 hours above what is normal
for you, please contact Velindre Cancer Centre immediately.
The telephone number is at the end of the leaflet.
Tiredness and fatigue
Chemotherapy can make you feel more tired than usual. It
is important to listen to your body and rest if you need to, but
to carry out your normal activities if you feel able. Some
4
TPF 415 (inpatient)
people find it beneficial to take gentle exercise as well as
taking rest.
Sore mouth
Your mouth may become sore or you may notice small
ulcers. Please follow the advice on caring for your mouth in
the general chemotherapy leaflet. Your doctor may
prescribe mouthwashes or medication to prevent or clear
any infection.
Effect on your kidneys
Cisplatin can affect the way your kidneys work. The blood
test which you have before your chemotherapy will check
how well your kidneys are working at the start of treatment.
We will also monitor you carefully by taking regular blood
tests throughout your treatment.
We always give cisplatin with plenty of fluids in the drip to
reduce the effect on your kidneys. It is also important that
you drink plenty of fluids for at least 2 days after each
treatment. We suggest a cup or glass of fluid every hour
during the day and evening.
Fluid retention
You may experience fluid retention which can result in
swelling of your ankles and legs. Rarely this can result in
breathlessness because of fluid on the lungs. The steroid
tablets usually prevent this from occurring. If it does occur it
is usually mild, and will reverse once your treatment is
completed. Please tell your doctor or nurse if this is a
problem.
5
TPF 415 (inpatient)
Myalgia (pain in the muscles)
Some patients may experience myalgia which is muscle or
joint pain. This can sometimes be severe but usually only
lasts for a few days. If you already have painkillers at home
you may find they relieve the pain. If this does not work
please contact Velindre Cancer Centre. The telephone
number is at the end of the leaflet
Allergic type reactions
A small number of patients have an allergic type reaction to
Taxotere. The steroid tablets usually prevent this from
occurring. If it does occur it is usually while the drip is
infusing. Symptoms include feeling:




hot and flushed
itchy
light headed
generally unwell
This can be easily treated. Please tell your nurse
immediately if you experience any of these symptoms. We
will move you to one of the day units to be given the
Taxotere so we can monitor you closely for any allergic
reaction.
Other side effects
You may experience discolouration and ridging of your
finger and toenails. A few patients may temporarily lose
their nails.
Soreness to your hands and feet
Your hands and feet may become dry and flaky, or you may
experience mild pain, redness and swelling of your hands or
feet. If this occurs we recommend using a non perfumed
6
TPF 415 (inpatient)
cream or lotion regularly. Please contact Velindre Cancer
Centre if your hands or feet become painful.
This treatment may damage the nerves of your hands and
feet. You may experience numbness or changes in
sensation such as tingling or pins and needles. Although
this is rare it is important that you tell your doctor if this
happens so that we can modify your treatment before this
side effect becomes permanent.
Cisplatin may also damage the nerves responsible for
hearing, although this is rare. If this occurs you may
experience tinnitus (ringing in the ears) or very occasionally,
some loss of hearing which may be permanent.
Women sometimes find that chemotherapy treatment affects
their periods. They could become heavier, lighter or even
stop altogether.
It is important you do not become pregnant or father a child
whilst having chemotherapy treatment as chemotherapy
could damage the unborn baby.
This chemotherapy can increase your skin’s sensitivity to the
sun. It is best to avoid strong sunlight, wear a hat and use a
high factor sun block.
Sometimes cancer drugs can have very serious side effects
which rarely can be life threatening. It is important to inform
Velindre cancer centre if you are concerned about any sideeffects.
A diagnosis of cancer can increase your risk of developing a
blood clot (thrombosis), and having cancer treatment may
7
TPF 415 (inpatient)
increase this risk further. It is important to tell your doctor
immediately if you have symptoms such as pain, redness
and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can
usually be successfully treated with drugs to thin the blood.
Your doctor or nurse can give you more information.
8
TPF 415 (inpatient)
Manufacturer’s patient information leaflets
Velindre leaflets provide information about very common
and common side-effects: for more information regarding
the less common side-effects please refer to the
manufacturers patient information leaflets, obtained from
Velindre pharmacy and/or on the internet at
www.medicines.org.uk. Sometimes patients may find these
leaflets difficult to read however. Please ask if you would like
a copy from your doctor or from Velindre pharmacy
9
TPF 415 (inpatient)
Contact telephone numbers
Velindre Cancer Centre
029 2061 5888
Ask for the chemotherapy pager if you are unwell at home
and need immediate attention at any time of the day or
night. For example you should phone if you:
 Are sick more than once in 24 hours
 Have a temperature of 37.5°C or above
 Have 4 or more bowel movements in 24 above what is
normal for you
 Have severe joint or muscle pain
Pharmacy department
029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your
medicines
Tenovus freephone
0808 808 1010
cancer helpline
7 days a week 8am – 8pm for general queries on cancer
This leaflet was written by health professionals. The
information contained in this leaflet is evidence based.
It has been approved by doctors, nurses and patients. It is
reviewed and updated every 2 years.
Prepared September 2009
Reviewed July 2016
10