This page tells you about the chemotherapy drug combination PCV. There are sections about
PCV is the name of a chemotherapy combination used to treat brain tumours. It is made up of the drugs
- P – Procarbazine
- C – Lomustine (also called CCNU)
- V – Vincristine
You usually have PCV chemotherapy as cycles of treatment. Each cycle lasts 6 weeks. A usual course of treatment consists of 6 of these cycles. So, the whole course could take about 9 months.
On the 1st day of the treatment cycle you have vincristine as a drip (infusion). You may have it through a fine tube (cannula) into a vein or through a tube into a vein in your chest. You can read our information about having chemotherapy into a vein.
As well as the vincristine drip you have lomustine as capsules. You also take procarbazine as capsules and you continue to take these once a day for 10 days. It is very important that you take the capsules 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 must take the right dose of the capsules, not more or less. When you finish the procarbazine you have a rest with no treatment for about a month. You then start the treatment again.
The side effects associated with PCV are listed below. You can use the links (underlined) to find out more about each side effect. Or you can go to the cancer drug 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 petechiae)
- Tiredness (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 – this is usually well controlled with anti sickness medicines
- Loss of appetite
- Abdominal cramps and constipation – 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
- Numbness and tingling of the fingers and toes affects between 1 and 2 out of every 10 people (10 to 20%). 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
- Flu like symptoms (a fever, chills, blocked nose, sweating, aches and pains) can occur, particularly when you first start your treatment.
- Children having PCV may get a high temperature (fever) starting 6 to 24 hours after the treatment and lasting for 2 to 3 days
- Effect on the muscle wall of the bowel, causing sickness, a swollen abdomen and cramps – this is common in children
- Depression, difficulty sleeping or nightmares may happen in between 1 and 3 out of every 10 people (10 to 30%)
- 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
Between 1 and 10 in every 100 people have one or more of these effects.
- Diarrhoea – drink plenty of fluids and tell your doctor or nurse if diarrhoea becomes severe or continues for more than 3 days
- Hair loss
- Skin changes, such as darkening of the skin, or a rash, which may be itchy
- A sore mouth
- Inflammation around the drip site – tell your chemotherapy nurse straight away if you notice any signs of redness, swelling or leaking at your drip site
- Changes in the amount of urine you make – you may produce a lot of urine, not enough, or have temporary loss of bladder control (incontinence)
- Jaw pain
Fewer than 1 in 100 people have these.
- Fits (seizures) or loss of consciousness
- An allergic reaction, with an itchy rash, flushed face and difficulty breathing – tell your doctor or nurse straight away if you have this
- A cough or breathlessness
- Confusion, extreme tiredness, difficulty walking or loss of balance – tell your doctor or nurse if you have any of these symptoms
- A small increase in the risk of developing a second cancer some years after treatment ends
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.
Alcohol and foods
Procarbazine interacts with alcohol and some foods, causing sickness, headaches, difficulty breathing, sweating, faintness or drowsiness. You should not drink alcohol while you are taking procarbazine, but reactions to foods are rare. If you want to try one of these foods, you could have a little at a time until you are sure it won't upset you
- Mature cheeses (including processed cheeses)
- Yeast or meat extracts such as Marmite, Oxo or Bovril
- Salami and pepperoni
- Overripe fruit, broad bean pods
- Non alcoholic beers, lagers and wines
- Foods which have been fermented, pickled, smoked, hung or matured
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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