This page tells you about the chemotherapy combination GemCap and its possible side effects. You can find information about
GemCap is the name of a chemotherapy treatment made up of the drugs
You can click on the links to find out about the side effects of each individual drug.
GemCap is a treatment for cancer of the pancreas. It may also be used in clinical trial for other types of cancer.
You usually have GemCap chemotherapy in cycles of treatment which last 4 weeks. You usually have 6 cycles over 6 months.
Each cycle is given in the following way. You have a weekly injection of gemcitabine for 3 weeks. You have it into your bloodstream (intravenously). You can have it by drip through a thin tube (cannula) that goes into one of your veins. 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. The tube may stay in place throughout the whole course of treatment. The gemcitabine takes about half an hour.
You also take a capecitabine tablet twice a day after food for 3 weeks. You start the tablets on the same day as you start the gemcitabine. You then have a break, with no treatment, during the fourth week. You then start the next treatment cycle.
It is very important that you take the tablets according to the instructions your doctor or pharmacist gives you. For example, whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream. You should take the right dose, not more or less. And never stop taking a cancer drug without talking to your specialist first. It is important to store capecitabine tablets in a safe place away from children. Take any unused tablets back to the pharmacy.
The side effects associated with GemCap are listed below. Use the links (underlined) to find out more about each side effect. For more information on side effects where there is no link, please see our cancer drugs side effects section or use the search box at the top of the page.
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. You will have regular blood tests to check your blood cell levels
- 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 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
- Flu like symptoms occur in 4 out of 10 people (40%), including a raised temperature, muscle aches and shivering. These effects start a few hours after the gemcitabine drip and you can take paracetamol to help
- Soreness, redness and peeling may occur on the palms of the hands and soles of the feet (palmar plantar syndrome). This may cause tingling, numbness, pain and dryness
- Women may stop having periods but 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
- Feeling or being sick is usually well controlled with anti sickness tablets and injections – if you still have sickness after taking these, tell your doctor or nurse
- Diarrhoea occurs in around half the people who have capecitabine – it can be quite severe but is usually well controlled with medicines. Drink plenty of fluids and if diarrhoea becomes severe or continues tell your doctor or nurse straight away. Make sure you follow any special advice you have been given about how to cope with diarrhoea
Between 1 and 10 in every 100 people have one or more of these effects.
- Loss of appetite
- Mouth ulcers – let your doctor or nurse know if your mouth gets very sore and it is painful to eat. You can have painkillers and mouthwashes to help
- Hair thinning
- Abdominal pain
- Constipation is generally well controlled with laxatives but if you are constipated for more than 3 days, tell your doctor or nurse
- Swelling in the face, hands and feet occurs in about 3 out of every 100 people (3%) – it usually goes away on its own, but tell your doctor if you notice any swelling
- Headaches and dizziness
- Eye problems, including increased production of tears and infections
- Higher levels of bilirubin in your blood caused by capecitabine – you will have regular blood tests to check the levels
You may have a few of the side effects mentioned on this page. 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)
- 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 information does not list all the very rare side effects of this treatment that are very unlikely to affect you. For further information about GemCap drugs 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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