Carbo MV

Carbo MV is the name of a combination of chemotherapy drugs used to treat bladder cancer. It is made up of the drugs

• Carboplatin
• Methotrexate
• Vinblastine

The links above take you to more information about the individual side effects of each drug.

You usually have Carbo MV chemotherapy as cycles of treatment. Each cycle of treatment lasts 4 weeks. Depending on your needs, you may have up to 6 cycles, taking 6 months in total.

You have Carbo MV 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 have each cycle of treatment in the following way

On the first day of the treatment cycle you have

• Carboplatin as a drip over about an hour
• Methotrexate as an injection into the vein
• Vinblastine as a drip over about 10 minutes

Two weeks later you have

• Methotrexate as an injection into the vein
• Vinblastine as a drip over about 10 minutes

Then one week later you have

• Methotrexate as an injection into the bloodstream
• Vinblastine as a drip over 10 minutes

Your next cycle of treatment then starts one week later.

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 Carbo MV are listed below. You can use the underlined links to find out more about each one. For general information, see our side effects of cancer drugs section.

More than 10 out of 100 people have one or more of the following side effects.

A temporary drop in the number of blood cells made by the bone marrow, leading to

• 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, 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 treatment centre if you have any of these effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

• Tiredness during and after treatment – most people find their energy levels are back to normal within 6 months to a year
• Feeling or being sick, which is usually well controlled with anti sickness medicines
• Numbness or tingling in fingers and toes 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
• Diarrhoea – drink plenty of fluids and tell your doctor or nurse if diarrhoea becomes severe, or continues for more than 3 days
• 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
• A sore mouth and ulcers
• Kidney changes that are mild and unlikely to cause symptoms – they will almost certainly go back to normal when treatment finishes, but you will have regular blood tests to check how well your kidneys are working
• Loss of taste or a metallic taste
• These drugs may have a harmful effect on a developing baby so 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) but this may be temporary
• Loss of fertility – we don’t know exactly how this drug affects fertility so do talk with your doctor before starting treatment if having a baby is important to you
• Sensitivity to sunlight –  don’t sit out in the sun, and do cover up or use sun block on exposed skin
• Hair thinning or complete hair loss
• Gritty eyes
• Inflammation around the drip site – if you notice any signs of redness, pain, swelling or leaking at your drip site, tell your chemotherapy nurse immediately
• Loss of appetite

Less than 10 out of 100 people have one or more of the following effects.

• Skin changes, including a rash which may be itchy, and darkening or lightening of the skin
• Liver changes that are very mild and unlikely to cause symptoms – the liver will almost certainly go back to normal when treatment finishes, but you will have regular blood tests to check how well your liver is working
• Loss of ability to hear some high pitched sounds, which usually gets better on its own
• About 1 in 100 people have ringing in their ears (tinnitus)

A very small number of people have an allergic reaction while having this chemotherapy, usually at the first or second treatment. Let your treatment team know immediately if you have any skin rashes or itching. Also let them know if you feel hot or shivery, go red in the face, feel dizzy, or have a headache, shortness of breath, anxiety, or a sudden need to pass urine.

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.

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

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 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 from your chemotherapy.

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.