MIC

MIC is the name of a chemotherapy treatment used to treat non small cell lung cancer and sometimes oesophageal cancer. MIC is made up of the drugs

• M = mitomycin C
• I = ifosfamide
• C = cisplatin

Click on these links to find out about the side effects of each individual drug.

You usually have chemotherapy as cycles of treatment. You have MIC in 3 week cycles. A usual course of treatment consists of 4 to 6 cycles. You have all 3 drugs as injections into a vein or through a drip (infusion) on the first day of each cycle.

You can have the drugs 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.

The side effects of a combination of drugs are usually a mixture of the side effects of each drug. You may get some or all of the side effects. The combination of drugs may increase or decrease your chance of getting each effect, or it may change the severity of the side effect.

We've listed the side effects associated with MIC below. Use the links (underlined) to find out more about each effect. For more information about side effects where there is no link, please see the 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.

Temporary drop in the number of blood cells made by the bone marrow, causing

• 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 side effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

• Fatigue during and after treatment – most people find that their energy levels are back to normal from 6 months to a year after their treatment finishes
• Feeling or being sick can be severe with MIC – it may begin a few hours after treatment and last for a few days but can usually be controlled with anti sickness drugs
• Loss of appetite
• Irritation or damage to your kidneys – drink plenty of water to flush the drugs out of your system. You will be given fluids through your drip before and after your treatment. You have a drug called mesna with ifosfamide, to protect your bladder and kidneys
• Hair loss
• Loss of fertility – we don’t know exactly how these drugs affect fertility so do talk with your doctor before starting treatment if having a baby is important to you
• MIC may have a harmful effect on a developing baby – do talk to your doctor about contraception before having treatment if there is any chance that you or your partner could become pregnant
• You may not be able to hear some high pitched sounds – this usually gets better on its own

Between 1 and 10 in every 100 people have one or more of these.

• Skin changes – your skin may darken temporarily or you may have an itchy rash
• Brittle, chipped and ridged nails
• Diarrhoea – drink plenty of fluids and tell your doctor if this is severe or lasts more than a couple of days
• A sore mouth and mouth ulcers
• Coughing or breathlessness due to lung inflammation – tell your doctor if you have this
• 1 person in 8 has confusion, sleepiness, extreme lack of energy or hallucinations from ifosfamide – tell your doctor immediately if you have any of these
• Numbness or tingling in fingers and toes affects between 1 and 2 out of every 10 people (10 to 20%) and 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
• Ringing in the ears (tinnitus), which nearly always gets better on its own
• Loss of taste or a metallic taste in your mouth
• Allergic reactions while having cisplatin – tell your nurse if you have a skin rash, itching, dizziness, headache, shortness of breath, anxiety, feel hot and shivery, go red in the face, or need to pass urine suddenly
• Inflammation around the drip site – if you notice any signs of redness, swelling or leaking at your drip site, tell your chemotherapy nurse immediately
• There is a small risk that you may get a second cancer some years after MIC treatment

The side effects above 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

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse, clinic or ward nurse will give you a contact number. You can ring 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 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.