Cancer drugs A to Z list
CAV is the name of a chemotherapy combination. You have:
C - cyclophosphamide (pronounced sike-low-foss-fa-mide)
A - doxorubicin (docs-oh-roo-bi-sin) also known as Adriamycin
V - vincristine (vin-kris-teen)
It can be a treatment for , neuroendocrine cancer and some bladder cancers.
Read more about small cell lung cancer
These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.
Read more about how chemotherapy works
You have CAV as a drip into your bloodstream (intravenously).
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. You have a new cannula each time you have treatment.
When you are having this treatment through a cannula it could damage the tissue if it leaks out of the vein. This is called extravasation. This can happen anywhere along the vein that the drug is going into. It doesn’t happen very often. Tell your nurse straight away if you notice any changes such as swelling, redness, pain, burning, or a stinging feeling.
Your nurse will stop the drug treatment. And they will treat the area to relieve symptoms and reduce tissue damage. Contact your healthcare team if you develop any of these symptoms when you are at home.
You usually have CAV chemotherapy as . This means that after each round of treatment you have a break to allow your body to recover.
Each cycle of treatment lasts 21 days (3 weeks). Depending on your needs, you might have between 4 and 6 cycles.
You have a cycle of treatment in the following way:
You have doxorubicin and cyclophosphamide as slow injections or a drip into your bloodstream.
You have vincristine as a drip into your bloodstream.
It takes about an hour to have all 3 drugs.
You have no treatment.
You then start the next cycle of treatment.
You have blood tests before and during your treatment. They check your levels of and other substances in the blood. They also check how well your liver and kidneys are working.
Before treatment starts you may have a blood test to check for viruses such as hepatitis B, hepatitis C, and HIV. This is called a viral screen.
It’s important for your doctor to know if you have had any of these viruses. This is because this treatment can weaken your and can cause the virus to become active again (reactivation).
Doxorubicin can sometimes affect how the heart works. You might have heart tests, such as an ), , or before you start your treatment. You might continue to have these tests during and after treatment.
Side effects can vary from person to person. They also depend on what other treatments you're having.
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you 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. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.
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.
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Increased risk of getting an infection is due to a drop in . Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing, or generally feeling unwell. You might have other symptoms depending on where the infection is.
You may get an infection from bacteria, viruses, fungi, or contaminated food, water, or insect bites. Less commonly you may get an infection in your lung (pneumonia).
Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection.
You might be breathless and look pale due to a drop in . This is called anaemia.
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. This is known as petechiae.
You might get a high temperature. Or you might feel cold or start shivering (chills).
Mouth sores and ulcers can be painful. Keep your mouth and teeth clean; drink plenty of fluids; avoid acidic foods such as oranges and lemons; chew gum to keep the mouth moist and tell your doctor or nurse if you have ulcers.
You may also have soreness and inflammation in your throat and stomach lining. This can cause you to feel pain or burning when you swallow, or pain in your tummy (abdomen).
Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.
Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain . But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables.
Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.
is easier to sort out if you treat it early. Drink plenty and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your healthcare team if you think you are constipated. They can give you a if needed.
You might not feel like eating and may lose weight. Eating several small meals and snacks throughout the day can be easier to manage. You can talk to a dietitian if you are concerned about your appetite or weight loss.
Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also 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 treat it once it has started.
Contact your advice line if you have this. Depending on what is causing the pain, they might give you medicine to help.
Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Sometimes you may feel numbness, pain or tingling along your lower leg and foot. And your toes might drag when walking (drop foot). Tell your healthcare team if you're finding it difficult to walk, lift your foot, or complete fiddly tasks such as doing up buttons.
The skin on your hands and feet may become sore, red, or may peel. You may also have tingling, numbness, pain and dryness. This is called hand-foot syndrome or palmar plantar syndrome.
Moisturise your skin regularly. Your healthcare team will tell you what moisturiser to use.
You might have aches or pain in your bones and muscles. Less commonly you may have pain in your jaw. Speak to your doctor or nurse about what painkillers you can take to help with this.
You could lose all your hair. This includes your eyelashes, eyebrows, underarms, legs 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 have irregular results when you have a heart trace (ECG) or other tests on your heart.
Occasionally you may have heart problems including increased heart rate, or heart failure which can cause shortness of breath and swelling of the ankles. Rarely you might have changes in your heart rhythm, chest pain, inflammation around your heart or a heart attack.
You might have pain when you pass urine. Or you might not be able to empty your bladder fully or have a wee when you feel the need to. This can feel very uncomfortable or painful. Drink 8 to 12 cups of fluid a day to try to prevent this.
Some people have red or pink urine for a few days after having doxorubicin. This is temporary but let your healthcare team know if this happens. You may have small amounts of blood in your urine that may be found when your nurse tests your urine. Less commonly, you might see blood in your urine yourself. This is caused by inflammation of the bladder. Let your doctor know if this happens.
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.
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.
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:
pain, swelling or redness around the injection site, tell your nurse straight away if you have this side effects
slowing or stopping of the bowels which can cause severe constipation, stomach pain, feeling or being sick and bloating
skin changes include a rash, redness and darker skin
changes in the colour of your nails. You may see dark lines or coloured patches on your fingernails or toenails
eye infection (conjunctivitis) – your eyes may feel gritty, itchy, sticky from pus, watery and look red
problems with making sperm
These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:
blood clots that can be life threatening; signs include pain, swelling and redness where the clot is. Feeling breathless can be a sign of a blood clot on the lung. Contact your advice line or doctor straight away if you have any of these symptoms
an allergic reaction 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 severe and possible life threatening infection (sepsis) which can cause changes in temperature, fast heartbeat, feeling faint, rapid breathing and feeling or being sick – contact your advice line immediately
damage to your nerves, symptoms include numbness and tingling in hands and feet, muscle cramps or dizziness
being unconscious and unable to wake (a coma)
temporary or permanent loss of hearing (deafness), you may also feel dizzy and have difficulties with balance
feeling warm and reddening of the skin (flushing) - these symptoms can come and go
problems with , this is usually reversible
Very rarely, you can develop a secondary cancer such as a type of blood cancer called leukaemia, or bladder cancer.
If you have side effects that aren’t listed on this page, you can look at the individual drug pages:
We have more information about side effects and tips on how to cope with them.
Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.
Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.
You may not be able to become pregnant or get someone pregnant 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 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.
This treatment might harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you are having treatment. Women must use 2 effective methods of contraception during treatment and for 7 months afterward. Men should not get someone pregnant for at least 4 months after treatment. Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.
Don’t breastfeed during this treatment and for 1 month after your last dose. This is because the drugs may come through in your breast milk.
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
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, and yellow fever.
You can usually 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 a vaccine in relation to your cancer treatment.
You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your is weakened.
Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.
For further information about each drug and the possible side effects go to the electronic medicines compendium (emc) website. You can find patient information leaflets for each drug on this website.
You can report any side effect you have to the Medicines and Healthcare Regulatory Agency (MHRA) as part of their Yellow Card Scheme.
Last reviewed: 08 Jun 2026
Next review due: 08 Jun 2029
Lung cancer starts in the windpipe (trachea), the main airway (bronchus) or the lung tissue. Cancer that starts in the lung is called primary lung cancer.
Chemotherapy is a standard treatment for some types of cancer. It uses anti cancer drugs to destroy cancer cells.
Cancer drugs have side effects and these can vary from person to person. But there are things that you can do to help you cope.
Coping with cancer can be difficult. There is help and support available. Find out about the emotional, physical and practical effects of cancer and how to manage them.
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