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Mitomycin C

Mitomycin C is a type of chemotherapy drug. You might have it as a treatment for a number of different types of cancer. 

How mitomycin C works

Mitomycin C works by interfering with the development of the genetic material in a cell, the DNA. This stops it from dividing into 2 new cells and kills it. So it destroys quickly dividing cells, such as cancer cells.

How you have mitomycin C

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

If you don’t have a cannula you 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

Bladder cancer

For bladder cancer you have mitomycin C directly into your bladder. You have it through a tube called a catheter. This is called intravesical chemotherapy.

When you have mitomycin C

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 may have it with other chemotherapy drugs and with radiotherapy.

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.

The side effects of mitomycin C given into the bloodstream (IV mitomycin) are listed below.

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. 

Bruising, bleeding gums or nose bleeds

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 petechia).

Breathlessness

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

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.

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:

  • lung changes - which can cause shortness of breath, a dry cough or difficulty breathing
  • skin problems including a rash, dry skin, blisters and itching
  • soreness, redness and peeling on the palms and soles of your feet – this is called hand-foot syndrome or palmar plantar syndrome
  • changes in how your kidneys work - you'll have regular blood tests to check this
  • inflammation around the injection site

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
  • mouth sores and ulcers
  • diarrhoea
  • loss of appetite
  • hair loss
  • high temperature (fever)
  • a blood disorder called haemolytic anaemia
  • changes to the way your heart works
  • change to the way your liver works

Side effects of mitomycin C into the bladder

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:

  • skin problems including a rash, dry skin, blisters and itching
  • soreness, redness and peeling on the palms and soles of your feet – this is called hand-foot syndrome or palmar plantar syndrome
  • problems passing urine including pain, increased frequency during the day and night, and feeling unwell – this is due to bladder inflammation called cystitis
  • blood in your urine (haematuria)

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:

  • changes to your bladder wall including tissue damage or hardening
  • your bladder holding less urine than it did before
  • a hole in the bladder wall
Tell your team straight away if you have any of the following effects; severe abdominal (tummy) pain, problems passing urine or can't pass it or blood in your urine.

After the treatment

If the urine touches your skin, the mitomycin C may cause a rash. For a couple of days after having this treatment you should wash your hands thoroughly with warm, soapy water. For the first 6 hours after treatment, you should also be washing your body parts too. 

For 24 hours after treatment, you should not have sexual intercourse. For a week after each treatment, you and your partner should wear a condom.

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.

Pregnancy and contraception

This treatment may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Fertility

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 may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Breastfeeding

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.

Immunisations

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)
  • 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 oral polio or the typhoid vaccine.

This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could make you ill. So avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.

You should also avoid close contact with children who have had the flu vaccine nasal spray. You should do so for 2 weeks following their vaccination if you have a severely weakened immune system.

Information and help