Coronavirus and cancer

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Aldesleukin (IL-2, Proleukin or interleukin 2)

Aldesleukin is an immunotherpay drug. It is also known as interleukin 2 (IL-2) or by its brand name Proleukin.

It is a treatment for kidney cancer that has spread to another part of the body (advanced kidney cancer). It is also used in clinical trials for other types of cancer. 

How it works

Aldesleukin is a man made protein. It is very similar to a protein produced by the body called interleukin-2 (IL-2). Interleukin-2 is part of the immune system. It triggers certain white blood cells in the body called lymphocytes, which fight diseases and infections. 

Aldesleukin works in a number of ways. It:

  • works directly on cancer cells by interfering with how the cells grow and multiply
  • stimulates the immune system by encouraging the growth of killer T cells and other cells that attack cancer cells
  • encourages cancer cells to send out chemicals that attract immune system cells

How you have it

You usually have adesleukin as an injection just under the skin. You can also have it as a drip into your bloodstream (intravenous). 

Injection just under the skin

You usually have injections under the skin (subcutaneous injection) into the stomach, thigh or top of your arm.

You might have stinging or a dull ache for a short time after this type of injection but they don't usually hurt much. The skin in the area may go red and itchy for a while.

Into your bloodstream

You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

  • central line
  • PICC line
  • portacath

You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.

When you have it

You have aldesleukin as cycles of treatment. This means that you have the drug and then a rest to allow your body to recover.

You usually have a daily injection under the skin for 5 days then 2 days rest. You have it like this for 4 weeks and then have a week without treatment. Then this 5 week cycle is repeated. The number of cycles of treatment you need depends on how well your cancer responds.

You might have aldesleukin as a continuous drip into a vein for 5 days. This means you will need to stay in hospital. The team caring for you can keep a close eye on how you are coping with it. 

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

We haven't listed all the side effects. It's very unlikely that you will have all of these side effects, but you might have some of them at the same time.

How often and how severe the side effects are can vary from person to person. They also depend on what other treatments you're having. For example, your side effects could be worse if you're also having other drugs or radiotherapy.

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

  • you have severe side effects 
  • your side effects aren’t getting any better
  • your side effects are getting worse

Early treatment can help manage side effects better. 

Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

Common side effects

These side effects happen in more than 10 in 100 people (10%). You might have one or more of them. They include:

Increased risk of infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Breathlessness and looking pale

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Increased risk of bruising and bleeding

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).

Low levels of thyroid hormones (hypothyroidism)

The level of your thyroid hormones may drop (hypothyroidism). You may feel tired or cold, gain weight, feel sad or depressed, or your voice may deepen. You will have regular blood tests to check your thyroid hormone levels.

Less common you might have higher levels of thyroid hormones (hyperthyroidism). You may lose weight or feel hot, anxious or hyperactive.

Loss of appetite

You might lose your appetite for various reasons when you are having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.

Less common you might also loss your sense of taste. 

Confusion, anxiety or depression

You might have some mood changes while having this drug. Let your doctor or nurse know if you feel anxious or depressed.

Less common you might feel agitated and irritable. You might also have hallucinations. 

Difficulty sleeping

It can help to change a few things about how you try to sleep. Try to go to bed and get up at the same time each day and spend some time relaxing before you go to bed. Some light exercise each day may also help. 

Or you might feel very tired and drowsy.

Dizziness and headaches

Let your doctor or nurse know if you have headaches. They can give you painkillers. Don’t drive or operate machinery if you feel dizzy.

Less common you might also have fainting episodes. 

Numbness and tingling of the fingers and toes

Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Tell your doctor if you're finding it difficult to walk or complete fiddly tasks such as doing up buttons. 

Changes to how your heart works

You may get heart problems, such as angina, heart failure or a heart attack. You will have regular heart checks during and after the treatment. Tell your doctor or nurse straight away if you have any chest pain.

Your heart beat might not beat regularly or it might become faster. 

Low blood pressure

Tell your doctor or nurse if you feel light headed or dizzy. You have your blood pressure checked regularly.

Less common you might get high blood pressure.

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques can all help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treating it once it has started.

Diarrhoea

Contact your advice line if you have diarrhoea, such as if you've had 4 or more loose watery poos (stools) in 24 hours. Or if you can't drink to replace the lost fluid. Or if it carries on for more than 3 days.

Your doctor may give you anti diarrhoea medicine to take home with you after treatment. Eat less fibre, avoid raw fruits, fruit juice, cereals and vegetables, and drink plenty to replace the fluid lost.

Less common you might have constipation. Tell your healthcare team if you do. 

Sore, inflamed mouth

Mouth sores and ulcers can be painful. Keep your mouth and teeth clean; drink plenty of fluids; avoid acidic foods such as oranges, lemons and grapefruits; chew gum to keep the mouth moist and tell your doctor or nurse if you have ulcers.

You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the way your liver is working.

Skin problems

You might notice skin changes, such as dryness, itching and rashes similar to acne on your face, neck and trunk. 

Tell your doctor if you have any rashes or itching. Don't go swimming if you have a rash because the chlorine in the water can make it worse.

If your skin gets dry or itchy, using unperfumed moisturising cream may help. Check with your doctor or nurse before using any creams or lotions. Wear a high factor sun block if you’re going out in the sun.

Sweating

Let your doctor or nurse know if you are sweating much more than normal.

Tips

  • Cut out coffee, tea and nicotine.
  • Cut down on alcohol.
  • Sip cold or iced drinks.
  • Wear layers of light clothing so you can take clothes off if you overheat.
  • Have layers of bedclothes to remove as you need to.
  • Wear natural fibres such as silk or cotton instead of man made fabrics.

Muscle or joint pain

You might feel some pain from your muscles and joints. Speak to your doctor or nurse about what painkillers you can take to help with this.

Passing less urine

You might pass less urine than usual. Tell your doctor or nurse if this happens.

Less common there might be blood in your urine. Tell your doctor or nurse if the colour of your urine is red to pinkish.

Changes to the way your liver works

You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the way your liver is working.

Soreness, swelling or pain where you have the drug

The injection or infusion site where you have aldesleukin might become red, sore, painful or swollen. Tell your nurse or doctor straight away if this happens. 

High temperature (fever)

If you get a high temperature, let your health care team know straight away. Ask them if you can take paracetamol to help lower your temperature.

You might or might not have chills as well. 

Less common you might feel like you have the flu. 

Tiredness (fatigue)

You might feel very tired and as though you lack energy.

Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.

Weight gain or loss

You might gain or loss weight while having this treatment. 

Swelling 

You might have swelling while having this treatment. 

Difficulty breathing and coughing

You might develop a cough or breathing problems. This could be due to infection, such as pneumonia or inflammation of the lungs (pneumonitis). Let your doctor or nurse know straight away if you suddenly become breathless or develop a cough.

Changes to how your kidneys work

To help prevent kidney damage, it is important to drink plenty of water. You might also have fluids into your vein before, during and after treatment. You have blood tests before your treatments to check how well your kidneys are working.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (1 to 10%). You might have one or more of them. They include:

  • a serious reaction to an infection (sepsis) signs can include feeling very unwell, not passing urine, being sick, a very high or very low temperature or shivering - contact your advice line straight away if you have any of these symptoms
  • blood clots throughout your body in the small blood vessels if you have bleeding, bruising, a drop in blood pressure, shortness of breath, confusion or memory loss contact your healthcare helpline or healthcare team straight away
  • nose, throat or chest infection
  • changes to the minerals, salts and sugar in your blood such as a high levels of glucose, potassium or calcium or low levels of sodium or phosphate
  • not enough fluid in your body (dehydration)
  • nerve pain
  • problems with how you speak and talk
  • sore, red and watery eyes (conjunctivitis)
  • inflamed, congested and runny nose
  • difficulty swallowing
  • hair loss
  • hives
  • high levels of acid in the body – symptoms might include changes to your breathing, confusion, headaches, sleepiness and yellowing of the skin and whites of the eyes

Rare side effects

These side effects happen in fewer than 1 in 100 people (1%). You might have one or more of them. They include:

  • an allergic reaction that can cause a rash, shortness of breath, redness or swelling of the face and dizziness - some allergic reactions can be life-threatening alert your nurse or doctor if notice any of these symptoms
  • a low level of sugar (glucose) in the blood
  • fits (convulsions) or stiffness (paralysis)
  • inflammation of the pancreas
  • blockage of the gut and bowels
  • loss of colour to areas of the skin (vitiligo)

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know?

Other medicines, food and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Loss of fertility

It is not known whether this treatment affects fertility in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Contraception and pregnancy

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you're having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.

Treatment for other illnesses 

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisation

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)

Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help