Bleomycin

Bleomycin is used to treat many types of cancer, including testicular cancer, non Hodgkin’s lymphoma, Hodgkin’s lymphoma and cancers of the head and neck area. Bleomycin is a type of antibiotic that is poisonous to cells. It binds to the cancer cells’ DNA so that the cells can't divide or grow. It also causes free radicals to be made inside the body. Free radicals are hyperactive oxygen atoms that damage DNA.

You usually have bleomycin through a drip into a vein over 20 to 30 minutes, or longer. You may 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 just before your course of treatment starts and it stays in place as long as you need it.

Or you may have bleomycin as an injection into a muscle (IM). Or very rarely by injection under the skin (subcutaneously).

You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for bleomycin depends on which type of cancer you have. It is often used alongside other chemotherapy drugs as part of combination chemotherapy treatments. You can find out more about the way chemotherapy treatment is planned in our planning chemotherapy section.

The side effects associated with bleomycin are listed below. You can use the underlined links to find out more about each side effect. Where there is no link please look at our cancer drug side effects section or click on the search box at the top of the page.

More than 10 in every 100 people have one or more of these.

• Tiredness and weakness (fatigue) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
• A hypersensitivity reaction happens in up to half the people treated with bleomycin, causing fever and chills during the infusion – it tends to be more severe in people who have lymphoma. You may develop a high temperature the night after your treatment. Tell your doctor or nurse when you go for your next treatment.
• Skin reactions – you may have reddening, darkening or thickening of the skin or nails or dry, peeling skin at the fingertips. This is most likely to begin 2 to 3 weeks after you start your treatment
• Hair loss – hair usually thins rather than falling out completely
• Loss of appetite
• Sore mouth or sores on the lips
• Bleomycin may have a harmful effect on a developing baby – do talk to your doctor or nurse about contraception before having treatment if there is any chance that you or your partner could become pregnant
• Women may stop having periods (amenorrhoea) – this may only be temporary.
• Loss of fertility – you may not be able to get pregnant or father a child after treatment with this drug. It is important to talk to your doctor before starting treatment if having a baby is important to you

With this drug, some people have a temporary drop in the number of blood cells made by the bone marrow, leading to the following side effects. Between 1 and 10 in every 100 people have one or more of these.

• 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, sore throat, pain passing urine or feel cold and shivery 
• 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)

Some of these side effects can be life threatening, particularly infections. You should contact your hospital if you have any of these side effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other occasional side effects include

• Feeling sick but this is usually mild
• 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). This is more common in people over 70 years old. You will have lung tests before you start your course of treatment and several times during the months of your treatment.

Not everyone will get these side effects. You may have 1 or 2 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

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. Your nurse will give you a contact number. You can ring them if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.

You should not have immunisations with live vaccines while you are having this treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but not many people in the UK have oral vaccines 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.