Mitomycin C

Mitomycin C is a chemotherapy drug. It works by sticking the cancer cell’s DNA (the cell’s genetic code) together so that it can't come apart again. The cell cannot divide so the cancer cannot grow. Mitomycin C is a treatment for

• Bladder cancer
• Rectal cancer
• Sometimes pancreatic, lung and breast cancers

Mitomycin C is a purple liquid. You have it into your bloodstream (intravenously). You can 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.

You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for mitomycin C depends on which cancer you have. You can find out more about how doctors plan chemotherapy in the chemotherapy section of CancerHelp UK.

The side effects of mitomycin C are listed below. You can use the links to find out more about each side effect or click on search at the top of the page. If there is no link you can find more information in the cancer drugs side effects section. 

If you have mitomycin C into your bladder, it causes very few side effects. The bladder can feel inflamed and sore after the treatment – as though you have cystitis. You may feel that you need to pass urine more often than usual. You should wash your hands thoroughly after passing urine when you've had this treatment. If the urine touches your skin, the mitomycin C may cause a rash.

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 doctor if you have any of these effects. The effects on the bone marrow can be severe and long lasting with mitomycin C into the bloodstream. They may begin about 3 weeks after treatment and last until 8 weeks after treatment ends. Your blood will be checked regularly to see how well your bone marrow is working.

Other common side effects of mitomycin C into the bloodstream include

• Fatigue during and after treatment – most people find their energy levels are back to normal from 6 months to a year after their treatment ends
• Loss of appetite
• Mitomycin C may harm a developing baby – it is not advisable to become pregnant or father a child whilst taking this drug, so you should discuss contraception with your doctor before having the treatment if there is any chance you or your partner could become pregnant

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

• Inflammation around the drip site – if you notice any signs of redness, swelling or leaking at your drip site, tell your chemotherapy nurse immediately
• Feeling or being sick may happen a few hours after each treatment and last for about 3 days – it is generally well controlled with anti sickness injections and tablets so if you are still feeling or being sick tell your doctor or nurse
• Sore mouth and mouth ulcers
• Coughing or breathlessness – tell your doctor if you have this
• Temporary effect on the liver – your doctor will check your liver with blood tests
• Your kidneys may be affected and will be checked with blood tests before each treatment
• A skin rash, which may be itchy
• Your nails may become darker
• Diarrhoea – drink plenty of fluids and tell your doctor if it is severe or lasts more than a couple of days as you could get dehydrated
• Hair thinning
• Loss of fertility – you may not be able to get pregnant or father a child after treatment with this drug, so it is important to talk to your doctor about your fertility before starting treatment if having a baby is important to you
• Women may stop having periods (amenorrhoea) but this may only be temporary

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 have given 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.