This page tells you about the chemotherapy drug bleomycin and its possible side effects. There are sections about
Bleomycin is used to treat many types of cancer, including
- Testicular cancer
- Non Hodgkin lymphoma
- Hodgkin lymphoma
- Voice box cancer (laryngeal cancer)
- Cancers of the head and neck area
- Food pipe cancer (oesophageal cancer)
- Cancer of the cervix (neck of the womb)
- Basal cell and squamous cell skin cancers
- Melanoma skin cancer
- Vulval cancer
- Thyroid cancer
- Lung cancer
- Bladder cancer
Some cancers can make fluid build up in body cavities. Bleomycin can sometimes help to reduce the amount of fluid.
Bleomycin is a liquid made from dissolving a yellow-white powder called Bleo-kyowa. You usually have it as an injection into a muscle (intramuscular injection).
Read about injections into a muscle (IM).
Some people have it into their bloodstream (intravenously) through a drip over 20 to 30 minutes, or longer. You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have it through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in before or during your course of treatment and it stays in place as long as you need it.
You can read our information about having chemotherapy into a vein.
Bleomycin may sometimes be given as an injection directly into a tumour.
Bleomycin is often given as a course of several cycles of treatment. The treatment plan depends on which type of cancer you have. It is often used alongside other chemotherapy drugs as part of combination chemotherapy treatments.
Sometimes, bleomycin is injected through a tube into a body cavity in the chest or abdomen. This is called an intracavity injection. You usually only have this once or twice.
You have blood tests before starting treatment and regularly during your treatment. The tests check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
We've listed the side effects associated with bleomycin. You can use the links to find out more about each side effect. Where there is no link, please go to our information about cancer drug side effects or use the search box at the top of the page.
You may have a few side effects. They may be mild or more severe. A side effect may get better or worse through your course of treatment. Or more side effects may develop as the course goes on. This depends on
- How many times you've had the drug before
- Your general health
- The amount of the drug you have (the dose)
The side effects may be different if you are having bleomycin with other medicines.
Tell your doctor or nurse straight away if any of the side effects get severe.
More than 10 in every 100 people have one or more of these.
- A hypersensitivity reaction happens in up to half the people treated with bleomycin – it causes a high temperature (fever) and chills while the drug is being given. This tends to be more severe in people who have lymphoma. You may develop a high temperature the night after your treatment. If this happens, tell your doctor or nurse when you go for your next treatment
- Skin and nail reactions – you may have reddening, darkening or thickening of the skin or nails. Or you may have dry, peeling skin at the fingertips. This is most likely to begin 2 to 3 weeks after you start your treatment
- Chest infections, causing a high temperature, breathlessness and a cough
- Hair loss – hair usually thins rather than falling out completely
- Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
- Feeling or being sick but this can usually be controlled with anti sickness medicines
- Loss of appetite and weight loss
- A sore mouth or sores on the lips
- Women may stop having periods (amenorrhoea) – this may only be temporary.
- Loss of fertility – you may not be able to become pregnant or father a child after this treatment. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment
- Pain, swelling, and redness at the area of the injection (if bleomycin is given into the muscle)
- Inflammation of the lungs happens to about 1 in 10 people (10%) – tell your doctor or nurse if you develop a dry cough, chest pain, or shortness of breath (especially in cold weather). You will have lung tests before you start your course of treatment and several times during the months of your treatment. You will also have weekly chest X-rays during treatment and for up to 4 weeks afterwards
- Low blood flow in the fingers, toes and tip of the nose (Raynaud's syndrome) – these areas may look pale or feel cold
Scleroderma – an auto immune condition in which a substance called collagen is laid down in the skin and some body organs, thickening them and stopping them working so well. It can affect the skin, joints, tendons, and parts of some internal organs
Between 1 and 10 in every 100 people have the following side effects.
- An increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, a sore throat, pain passing urine, or you may feel cold and shivery. If you have a severe infection this can be life threatening. Contact your treatment centre straight away if you have any of these effects or if your temperature goes above 38°C
- Itchy skin
- Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
- Bruising more easily due to a drop in platelets – you may have nosebleeds, or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae)
- Blood clots – there is a slightly increased risk of developing a blood clot (thrombosis) when you are having bleomycin. If you’ve had a blood clot in the past tell your doctor. Let your doctor or nurse know straight away if you have a red, hot, swollen area on your leg or if you suddenly develop a cough, breathlessness or chest pain
Fewer than 1 in 100 people have these effects.
- Low blood pressure – you may feel dizzy or faint, especially when standing up or getting out of bed
- Difficulty passing urine or pain when passing urine
- Diarrhoea – drink plenty of fluids. If your diarrhoea is severe or continues for more than 3 days you could get dehydrated so let your doctor or nurse know
- Liver changes – you are unlikely to notice any symptoms. The liver function usually goes back to normal when treatment is finished
Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. They can give you advice or reassure you. Your nurse will give you a contact number to ring if you have any questions or problems. If in doubt, call them.
Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and over the counter remedies. Some drugs can react together.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Don't breastfeed during this treatment because the drug may come through in the breast milk.
You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG, yellow fever and Zostavax (shingles vaccine).
You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy. It is safe to have the flu vaccine.
It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with vaccines you take by mouth (oral vaccines), but not many people in the UK have these now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.
On this website you can read about
On the Scleroderma Society website you can read about scleroderma.
On the NHS Choices website you can read about Raynaud's syndrome.
This page does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information look at the Electronic Medicines Compendium website at www.medicines.org.uk.
If you have a side effect not mentioned here that you think may be due to this treatment you can report it to the Medicines Health and Regulatory Authority (MHRA) at yellowcard.mhra.gov.uk.
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