Cyclophosphamide
Cyclophosphamide is in a class of drugs known as alkylating agents; it slows or stops
the growth of cancer cells in your body. The length of treatment depends on the types of
drugs you are taking, how well your body responds to them, and the type of cancer you
have.
Cyclophosphamide is used to treat:
- lymphomas
- multiple myeloma
- leukemias
- mycosis fungoides
- neuroblastoma
- ovarian carcinoma
- retinoblastoma
- breast cancer
- bronchogenic carcinoma
- small cell lung carcinoma
Side effects of Cyclophosphamide
Temporary reduction in the production of blood cells by the bone marrow.
This can result in anaemia, risk of bruising or bleeding and infection. This effect can
begin seven days after the treatment has been given and the number of blood cells is
usually at its lowest point at 10-14 days after the chemotherapy. Your blood count will
then increase steadily and will have usually returned to normal within 21 days.
The extent to which the number of blood cells is reduced depends on the dose of
chemotherapy you receive and which other chemotherapy drugs, if any, are given in
combination. Your doctor can advise you how likely it is that your blood cells will be
lowered by the chemotherapy. Your blood will be checked regularly to see how well your
bone marrow is working.
If your temperature goes above 38°C (100.5°F), or you have any unexplained bruising
or bleeding, or you suddenly feel unwell, even if you have a normal temperature, contact
your doctor or the hospital straight away.
Nausea (feeling sick) and vomiting. There are now very effective
anti-sickness drugs to prevent or greatly reduce nausea and vomiting. If you do feel sick
it may begin a couple of hours after the treatment is given and last for up to 24 hours
(or a few days if high dose treatment is given). If the sickness is not controlled, or
continues, tell your doctor. They can prescribe other anti-sickness drugs, which may be
more effective.
Loss of appetite. A dietician or specialist nurse at your hospital can
give advice.
Irritation of the bladder lining. It is important to drink plenty of
fluids to help prevent any irritation. If you notice any blood in your urine tell your
doctor. With high dose cyclophosphamide, fluids are given into the vein, along with a drug
called mesna, which can help to prevent bladder irritation.
Hair loss. This usually starts 3-4 weeks after the first dose of
cyclophosphamide, although it may occur earlier. Hair may be lost completely or may just
thin. You may also have thinning and loss of eyelashes, eyebrows and other body hair. This
is temporary and the hair will start to regrow once the treatment is finished.
Less common side effects of Cyclophosphamide
Your liver may be temporarily affected. Cyclophosphamide may cause
changes in the way that your liver works, which return to normal when the treatment is
finished. This is very unlikely to cause you any harm, but your doctor will monitor this
carefully. Samples of your blood will be taken from time to time to check your liver
function.
Sore mouth and taste change. Your mouth may become sore, or you
may notice small ulcers during this treatment. Drinking plenty of fluids and cleaning your
teeth regularly and gently with a soft toothbrush can help reduce the risk of this
happening. Tell your doctor if you do have any of these problems as they can prescribe
special mouthwashes and medicine to prevent or clear any mouth infection.
You may notice that your food tastes different. Normal taste will come back after the
treatment finishes.
Diarrhoea. This can usually be easily controlled with medicine but
tell your doctor if it is severe or persistent. It is important to drink plenty of fluids
if you do have diarrhoea.
Changes in nails. Your nails may become darker, or ridged. These
changes grow out over a few months once the treatment has finished.
Skin changes. Your skin may darken, due to excess production of
pigment, but this is rare.
Changes to the lungs. Cyclophosphamide may cause some changes to lung
tissue. Tell your doctor if you notice any cough or breathlessness.
Second cancer. With long-term use of this drug there is a very small
risk of developing a second cancer after many years.
Changes in the way your heart works. This is very uncommon with usual
doses but may occasionally occur with high dose treatment. The muscle of the heart may be
affected, usually temporarily. Tests to see how well your heart is working may be carried
out before the drug is given, and occasionally before each treatment. |