Bleomycin is a treatment for a number of types of cancer. You might have it as part of a clinical trial for some types of cancer.
How it works
Bleomycin is a type of antibiotic that is poisonous to cells. It binds to the cancer cells’ DNA so that the cells can't divide or grow. It also causes free radicals to be made inside the body. Free radicals are overactive oxygen atoms that damage DNA.
How you have bleomycin
You might have bleomycin in the following ways:
Into a muscle
You might have it as an injection into a muscle (intramuscular injection).
Into your bloodstream
Some people have bleomycin as a drip into their bloodstream (intravenously). Each treatment takes between 20 and 30 minutes, or longer.
You can have it through a thin, short tube (a cannula) put into a vein in your arm each time you have your treatment.
You can also have it through a long line either a central line, a PICC line or a portacath.
These are long, plastic tubes that give the drugs into a large vein in your chest. The tube stays in place throughout the course of treatment.
Into a tumour
Some people may have bleomycin as an injection directly into a tumour.
Into a cavity
Sometimes, bleomycin is injected through a tube into a body cavity in the chest or abdomen. This is called an intracavity injection. You usually only have this once or twice.
When you have it
Bleomycin is often given as a course of several cycles of treatment. The treatment plan depends on which type of cancer you have. It is often used alongside other chemotherapy drugs as part of combination chemotherapy treatments.
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.
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.
We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.
Common side effects
Each of these effects happens in more than 1 in 10 people (more than 10%). You might have one or more of them. They include:
Pain and swelling at the injection site
Tell your nurse straight away if you have any pain, redness, swelling or leaking around your drip site.
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.
Poor blood flow in your fingers and toes
These areas might look pale and feel cold. Tell your medical team if this is happening.
This is an autoimmune condition. Collagen is laid down in the skin and body organs, thickening them and stopping them working well. It can affect joints, tendons, and internal organs.
Mouth sores and ulcers can be painful. It helps to keep your mouth and teeth clean, drink plenty of fluids, avoid acidic foods such as oranges, lemons and grapefruits, and chew gum to keep the mouth moist. Tell your doctor or nurse if you have ulcers.
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.
Increased risk of getting a chest 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.
Nail and skin changes
Skin and nail problems include a skin rash, dry skin, itching and darker skin. Your nails may also become brittle, dry, change colour or develop ridges. This usually goes back to normal when you finish treatment.
You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.
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.
Tiredness and weakness (fatigue)
Tiredness and weakness (fatigue) can happen during and after treatment - doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.
Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
- increased risk of getting an infection
- bruising, bleeding gums or nosebleeds
- allergic reaction (whilst having treatment or soon afterwards)
- rash or redness of the skin
- blood clots
Rare side effects
Each of these effects happens in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:
- low blood pressure
- difficulty in passing urine
- changes to the way the liver works
- pain in area of cancer following bleomycin injection directly into the cancer
What else do I need to know?
Other medicines, foods 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.
Pregnancy and contraception
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 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.
Don’t breastfeed during this treatment because the drug may come through into your breast milk.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
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 one of the shingles vaccines called Zostavax.
You can have:
- other vaccines, but they might not give you as much protection as usual
- the flu vaccine (as an injection)
- the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment
Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your
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 as this is a live vaccine. 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.
This page is due for review. We will update this as soon as possible.