Topotecan chemotherapy
Topotecan, otherwise known as Hycamtin, is a new type of chemotherapy that is being used to treat some types of cancer, including ovarian cancer. This factsheet describes topotecan, how it is given and the side effects that it may cause. It is important to know that each person's reaction to chemotherapy is different. Some people experience very few side-effects, while others may experience more.
Please let your doctor or nurse know about any side effects you have, even if they have gone by the time you attend for your next hospital appointment. Treatment can often be prescribed to relieve them. You will have regular appointments with your doctor to monitor the effect of the chemotherapy and side effects.
How it is given
Topotecan is administered via an intravenous infusion or "drip" into a vein through a very small and very thin plastic tube called a cannula. Each infusion lasts about half an hour and will be given to you in the out-patient department. You will be given the tapotecan infusion on five consecutive days, every three weeks. This means you will have one week of chemotherapy, then two weeks off before coming back for your next regimen. You may receive six or more such cycles of treatment if there is evidence of benefit.
Common side effects
- Temporary reduction in bone marrow function. Bone marrow manufactures red blood cells which carry oxygen to all the body's cells so that they can work effectively. It also manufactures white blood cells which fight infection, and platelets which help to stop bleeding. Therefore, if bone marrow function is reduced it may result in anaemia (loss of red blood cells), infection, or risk of bleeding. Bone marrow suppression usually begins about a week after the topotecan is given and may take another week or two to recover. If it has not recovered fully before you are due your next treatment, this will be delayed. However, this does not often happen. It is very important to report any fever, temperature, bruising, bleeding, breathlessness or extreme tiredness as these symptoms may indicate that your blood cells are low.
- Nausea and vomiting. You will be given anti-sickness drugs to reduce/prevent this, if required. If these do not control it, please let your doctor know as there are other drugs you can try. Nausea may be pre-empted by cooking smells and it may be easier to eat cold foods or prepared meals that only require heating when you feel nauseous. Eat and drink slowly and relax after meals. Some people find that sipping ginger beer helps as ginger has anti-sickness properties.
- Mouth ulcers. Your mouth may become sore and you may develop mouth ulcers while you are having topotecan. If this happens, appropriate mouth care can be prescribed. It will also help if you drink plenty of fluids and avoid salty and rough-textured foods, such as toast. Clean your teeth with a child's toothbrush, as these are very soft and gentle. Wear dentures as little as possible and ensure that they are cleaned thoroughly.
- Diarrhoea. Topotecan can cause quite severe diarrhoea in some patients and it is very important to let your doctor know if you are having this problem so that treatment can be prescribed to reduce it. It is also important to drink plenty of fluids when you have diarrhoea. Try small, frequent meals and reduce your intake of vegetables while the diarrhoea persists.
- Complete hair loss. Unfortunately, tapotecan can cause complete hair loss or hair thinning. This starts to occur about three weeks after the first treatment and may be rapid. Chemotherapy-induced hair loss is temporary and your hair will start to grow back once the treatment has finished. The hospital will provide you with a wig if you would like one. It is important to remember that hair protects you and, without it, you will have to take certain precautionary measures. For example, in the summer your head may burn very easily and in the winter you may feel very cold if your head is uncovered. At first, powerful showers may be quite painful if sprayed directly on top of your head and nylon pillowcases may irritate.
Other side effects
After extensive early research the side effects described above have been found to be the most likely to occur. However, topotecan is a new drug that is still being monitored. If you have any unusual symptoms please let your doctor know about them, even if they do not trouble you.
