PCV

PCV is the name of a chemotherapy combination used to treat brain tumours. It is

• P = procarbazine
• C = lomustine (also called CCNU)
• V = vincristine

You can click on the links for information on the side effects of each individual drug.

You usually have chemotherapy in cycles of treatment. PCV is given in cycles lasting 6 to 8 weeks. A usual course of treatment consists of 6 of these cycles in total. So, the whole course could take up to a year. You take procarbazine each day for 2 weeks at a time. You take lomustine as a single dose once every 6 weeks. You should keep these tablets in tightly closed containers and out of reach of children. You usually have vincristine twice during each 3 week cycle. (You may have it on the 8th and 29th day of each cycle OR on the 1st and 22nd day.) You have it as a drip (infusion) through a fine tube (cannula) into a vein.

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 PCV are listed below. You can use the links (underlined) to find out more about each side effect. Or you can go to the cancer drug 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.

Procarbazine interacts with alcohol and some foods, causing sickness, headaches, difficulty breathing, sweating, faintness or drowsiness. You should not drink alcohol while you are taking procarbazine, but reactions to foods are rare. If you want to try one of these foods, you could have a little at a time until you are sure it won't upset you

• Mature cheeses (including processed cheeses)
• Yeast or meat extracts (Marmite, Oxo, Bovril)
• Salami and pepperoni
• Overripe fruit, broad bean pods
• Non alcoholic beers, lagers and wines
• Foods which have been fermented, pickled, smoked, hung or matured

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
• Feeling or being sick – this is usually well controlled with anti sickness medicines
• Loss of appetite
• Abdominal cramps and 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
• Numbness and tingling 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
• 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
• This treatment 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
• Flu like symptoms (a fever, chills, blocked nose, sweating, aches and pains) can occur, particularly when you first start your treatment.
• Children having PCV may get a high temperature (fever) starting 6 to 24 hours after the treatment and lasting for 2 to 3 days
• Effect on the muscle wall of the bowel, causing sickness, a swollen abdomen and cramps – this is common in children
• Depression, difficulty sleeping or nightmares happens in between 1 and 3 out of every 10 people (10 to 30%) treated with procarbazine

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

• Diarrhoea – drink plenty of fluid and tell your doctor or nurse if diarrhoea becomes severe, or continues for more than 3 days
• Hair loss
• Skin changes, such as darkening of the skin, or a rash, which may be itchy
• A sore mouth
• 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
• Changes in the amount of urine you make – you may produce a lot of urine, not enough, or have temporary loss of bladder control (incontinence)
• Jaw pain

Fewer than 1 in 100 people have these.

• Very rarely, fits (seizures) or unconsciousness
• An allergic reaction, with an itchy rash, flushed face and difficulty breathing – tell your doctor or nurse straight away if you have any of these symptoms.
• A cough or breathlessness
• Confusion, extreme tiredness, difficulty walking or loss of balance – tell your doctor or nurse if you have any of these symptoms
• Rarely, a second cancer may develop years after 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 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.