PC (paclitaxel and carboplatin, CarboTaxol)

Taxol (paclitaxel) and carboplatin are two drugs given in a chemotherapy treatment used to treat ovarian cancer. The links above take you to a page about the side effects of each individual drug.

You usually have chemotherapy in cycles of treatment. You have paclitaxel and carboplatin in 3 weekly cycles (every 21 days). A usual course of treatment consists of 6 to 8 cycles in total. This means it will take between 5 and 6 months to finish all your chemotherapy treatment. You have paclitaxel and carboplatin as infusions through a drip on the first day of each cycle. Then you don’t have any more chemotherapy for 20 days. This is one cycle.

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 side effect. Or it may change the severity. The side effects associated with CarboTaxol chemotherapy are listed below. You can use the links to find out more about each side effect. Or go to the cancer drugs side effects section.

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

Other common side effects include

• Fatigue (tiredness) during and after treatment – most people find their energy levels are back to normal within 6 months to a year
• About 1 in 6 people treated (16%) have immediate minor reactions to paclitaxel, such as becoming flushed or developing a rash
• Feeling or being sick – affects most people treated, but can usually be well controlled with anti sickness medicines
• Hair loss 
• Carboplatin can cause kidney damage – you will have blood tests before your treatment to check that your kidneys are able to cope with the drug
• Mouth sores and ulcers
• Diarrhoea
• Numbness and 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
• Paclitaxel can cause aching joints and muscles in up to 6 out of 10 people (60%) treated
• Low blood pressure affects more than 1 in 10 people (10%) having paclitaxel
• Liver changes that are very mild and unlikely to cause symptoms – the liver will almost certainly go back to normal when treatment ends, but you will have regular blood tests to check how well your liver is working
• 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
• Women may stop having periods (amenorrhoea) – this may only be temporary
• Paclitaxel and carboplatin 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

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

• Loss of appetite
• Loss of taste or a metallic taste in your mouth
• Carboplatin may affect your ability to hear some high pitched sounds (this usually gets better on its own) and about 1 in 100 (10%) have ringing in the ears (tinnitus)
• Slowing down of the heart rate (bradycardia)
• Abdominal pain
• Headaches
• Inflammation around the drip site – tell your doctor or chemotherapy nurse immediately if you notice any signs of redness, swelling or leaking at your drip site

Some people have an allergic reaction while having paclitaxel and carboplatin, usually at the first or second treatment – let your treatment team know immediately if you have any skin rashes, itching, feeling hot, shivering, going red in the face, feeling dizzy, headache, shortness of breath, anxiety or a sudden need to pass urine.

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

Some side effects are inconvenient or upsetting but not damaging to your health.

Some side effects are serious medical conditions and need treating. Where we have urged you to contact your doctor, this is because

• Your side effect may need treating
• Your drug dose may need reducing to try to prevent the side effect

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 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.