Mitomycin
Mitomycin is a type of 
drug. You might have it as a treatment for a number of different types of cancer.
You pronounce mitomycin as mito-my-sin.
How does mitomycin work?
Mitomycin works by interfering with the development of the in the cell's . This stops the cell from dividing into 2 new cells and kills it. So mitomycin destroys quickly dividing cells, such as cancer cells.
How do you have mitomycin?
You have mitomycin into the bloodstream (intravenous).
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
For bladder cancer you have mitomycin directly into your bladder. You have it through a tube called a catheter. This is called intravesical chemotherapy.
How often do you have mitomycin?
You usually have chemotherapy as a course of several .
The treatment plan for mitomycin 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.
What are the side effects of mitomycin?
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.
When to contact your team
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. 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.
Side effects of mitomycin given into the bloodstream (intravenous)
Common side effects
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 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 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 petechiae).
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, try 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 treat it once it has started.
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:
- 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.
- 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 (less than 1%). You might have one or more of them. They include:
- mouth sores and ulcers
- diarrhoea
- loss of appetite
- hair loss
- high temperature (fever)
Side effects of mitomycin into the bladder
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:
- 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)
Other side effects
There isn't enough information to work out how often these side effects might happen. 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 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, your partner or both 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 you need to know?
Other medicines, food and drink
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.
Pregnancy and contraception
This treatment may harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you're having treatment and for at least 6 months afterwards.
Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner falls pregnant while having treatment.
Fertility
You may not be able to become pregnant or get someone pregnant 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.
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. For example, 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 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 recovers from treatment.
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. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.
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.
