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PC (paclitaxel and carboplatin, CarboTaxol)

PC is the name of a chemotherapy combination that includes:

  • Paclitaxel (taxol) - P
  • Carboplatin - C

It is often called CarboTaxol. PC is a treatment for several cancers including ovarian, cervical and non small cell lung cancer.

How it works

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

How you have PC

You have PC as a drip into your blood stream.

Into your bloodstream

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

If you don't have a central line

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 PC

You have paclitaxel and carboplatin as fluids into a vein (drips). You have paclitaxel over 3 hours and carboplatin between 30 minutes and 1 hour. The whole treatment can take up to 4 hours. 

You have treatment once every 3 weeks. Each 3 week period is called a cycle of treatment.  

You might have 6 to 8 cycles, over 5 to 6 months.

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

Each of these effects happens in more than 1 in 10 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. 

Breathless and looking pale

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

Bruising, bleeding gums and nosebleeds

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).

Tiredness and weakness (fatigue) during and after treatment

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.

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 exactly as prescribed since it is easier to prevent sickness rather than treat it once it has started.

Aching muscles and joints

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.

Mild allergic reaction

You might have a mild allergic reaction during or shortly after treatment. You might have itching, rash or red face. 

You will usually be given medication just before treatment to prevent or reduce risk of an allergic reaction.

Hair loss

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. 

You might be offered scalp cooling to help reduce hair loss.

Kidney damage

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.

Sore mouth or mouth ulcers

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.

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.

Numbness and tingling in hands and feet

Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Talk to the team looking after you when you first notice this. 

If you are unable to walk or do fiddly tasks such as doing up  buttons, it is important to let your doctor or nurse know.

Low blood pressure

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

Liver changes

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.

Tummy (abdominal) pain

Tell your treatment team if you have this. They can check the cause and give you medicine to help. 

Occasional side effects

Each of these effects happens in more than 1 in 100 people (1%). You might have one or more of them. They include:

  • loss of appetite
  • loss of taste or a metallic taste in your mouth - your taste gradually returns to normal after treatment is finished
  • loss of hearing - especially high pitched sounds. Tell your doctor if you have hearing loss
  • ringing in the ears - this is tinnitus and it often gets better after treatment has finished
  • slow heart rate - your heart rate (pulse) will be checked regularly
  • headaches - tell your doctor if you have headaches. Mild painkillers such as paracetamol can help
  • inflammation around the drip site - tell your nurse straight away if you notice any redness, swelling or leaking at your drip site
  • nail and skin changes - these are usually mild and temporary

Rare side effects

An allergic reaction happens in fewer than 1 in 100 people (1%). 

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 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.

Fertility

You may not be able to become pregnant or father a child after treatment with these drugs. 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 drugs may come through in your breast milk.

Treatment and 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.

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)
  • 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 if your immune system is severely weakened. 

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

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