This page tells you about the chemotherapy drug combination GC and its possible side effects. There is information about
GC is the name of a combination of chemotherapy drugs used to treat bladder cancer, non small cell lung cancer and some cancers of the liver or bile duct. It is also known as Gemcis or Gemcisplat. It is made up of the drugs
- Gemcitabine (Gemzar)
The links above take you to information about the individual side effects of each drug.
The side effects of a combination of drugs are usually a mixture of those of each drug. The combination may increase or decrease your chance of getting each side effect or it may change the severity. The side effects associated with GC are listed below. You can use the underlined links to find out more about each one. For general information, see our cancer drugs side effects section.
You have GC drugs into your bloodstream (intravenously). You can have them through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have them 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 just before your course of treatment starts and it stays in place as long as you need it.
You usually have GC chemotherapy as cycles of treatment. You have each cycle of treatment over 3 or 4 weeks. You will have between 4 and 6 cycles of GC treatment, taking from 3 to 6 months.
If you have the 3 weekly cycle, you have both gemcitabine and cisplatin on the first day. Then you have gemcitabine a week later. You then have no treatment for 2 weeks and the cycle starts again.
If you have the 4 weekly cycle, you have both gemcitabine and cisplatin on the first day of the cycle. You then have gemcitabine a week later followed by another dose a week later. You then have no treatment for a week until the cycle starts again.
More than 10 in every 100 people have one or more of the side effects listed below.
- 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. Your doctor will check your blood cell levels regularly
- 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, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia)
- Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
- Numbness or tingling in fingers and toes affects half the people having treatment (50%). It can cause difficulty with fiddly things such as doing up buttons. This starts within a few days or weeks and usually goes within a few months of finishing treatment
- Feeling or being sick is worse at the beginning of each cycle of treatment and may last for a few days – if it is not controlled let your doctor or nurse know. They can change your anti sickness medicines to others that may work better for you
- Constipation occurs in 1 out of 2 people (50%) – your doctor or nurse may give you laxatives to help prevent this but do tell them if you are constipated for more than 3 days
- Flu like symptoms affect 4 out of every 10 people (40%) and include a raised temperature, muscle aches (myalgia), and shivering. These effects start a few hours after the gemcitabine drip. You can take paracetamol tablets 6 to 8 hourly to help
- Swelling in the face, hands and feet occurs in about 3 out of every 10 people (30%) – this usually goes away on its own, but tell your doctor or nurse if you have it
- A skin rash, which may itch, happens in about 1 in 4 people (25%)
- Kidney changes may occur – you will have fluids through your drip before and after treatment to try to prevent damage. It helps to drink plenty of fluid. You will have regular blood tests to check how well your kidneys are working
- Women may stop having periods but this may be temporary
- Loss of fertility – you may not be able to become pregnant or father a child after treatment with this drug. 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
- Ringing in the ears (tinnitus) – this usually gets better on its own once treatment ends but for some people may be permanent. Let your doctor or nurse know if you have tinnitus
- Loss of taste or a metallic taste
- Hearing changes – let your doctor or nurse know if you notice any changes in your hearing
Between 1 and 10 in every 100 people have one or more of these.
- A sore mouth
- Hair thinning – this is usually mild and your hair will grow back once the treatment ends
- Inflammation of the lungs causing wheeziness or breathlessness affects about 1 in 12 people (8%)
- Drowsiness (somnolence) occurs in about 1 in 10 people (10%). You may become extremely sleepy after your treatment. This usually goes away on its own. Tell your doctor or nurse if you have drowsiness and don't drive or operate machinery
- Diarrhoea – drink plenty of fluids and tell your doctor or nurse if it becomes severe or continues for more than 3 days
- Some people have an allergic reaction while having GC treatment, usually at the first or second treatment – let your treatment team know straight away if you have any skin rashes, itching, feeling hot, shivering, reddening of the face, dizziness, headaches, shortness of breath, anxiety, or a sudden need to pass urine
Not everyone will get these side effects. You may have one or two or several. A side effect may get worse through your course of treatment. Or you may have more side effects as the course goes on. This depends on
- How many times you've had a drug before
- Your general health
- How much of the drug you have (the dose)
- Other drugs you are having
Coping with side effects
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
These drugs 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.
Do not breastfeed during this treatment because the drugs 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.
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 www.mhra.gov.uk.
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