OVACOME FACTSHEET 3 PACLITAXEL CHEMOTHERAPY

Paclitaxel, otherwise known as Taxol, is a type of chemotherapy that is used to treat some types of cancer. This fact sheet describes paclitaxel, 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 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
Paclitaxel is administered via a "drip" into a vein through a small and very thin plastic tube called a cannula. It is usually given over three to four hours every three weeks as an out-patient. Before each dose of paclitaxel you need to take some "pre-med" tablets of dexamethasone to prevent an allergic reaction to the chemotherapy. The pre-med is taken 12 hours and six hours before the start of the paclitaxel drip. This often means you will need to wake up in the night before treatment to take the pre-med tablets!

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. This usually begins about a week after paclitaxel is given and may take another week or two to recover. If it has not recovered fully before you are due your next infusion, the paclitaxel will be delayed for a week or so. 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.
• Aching or pain in joints and muscles may occur two or three days after paclitaxel is given but usually resolves quite quickly. Pain-killers can be used as necessary.
• Complete hair loss. Unfortunately, paclitaxel causes complete hair loss which usually includes eyebrows, eyelashes and body hair. This starts to occur about two weeks after the first treatment and may be very 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 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.
• Numbness and tingling in hands and feet may occur due to the effect of paclitaxel on nerves. Sometimes hands and feet can also feel weak and "heavy" and it may be difficult to hold things or walk upstairs. You may not be able to detect extremes of temperature if your hands and feet are numb. Therefore, take extra care when, for example, you are taking food out of the oven or getting into a hot bath. It is important to inform your doctor if you experience these problems. Numbness and tingling usually decrease over a few months after the treatment has finished, but some effects may persist for a long time.
• Allergic reaction. Occasionally, people may have allergic reaction to paclitaxel on the first dose or subsequent doses. If you ever feel hot, shivery, dizzy, short of breath – or if you develop an itchy rash while you are having paclitaxel – let a nurse or doctor know immediately.
• Nausea. You may experience nausea that develops a few hours after the paclitaxel is administered. It can last for about five days. This is usually mild. Anti-sickness tablets will be given to you to reduce or prevent this. Nausea is often initiated by the smell of cooking. It may help to eat cold foods or prepared meals that only require heating for the few days that you feel nauseous. Ginger has anti-nausea properties and some people find that sipping ginger beer can help. But please let your doctor know if you have persistent nausea as there are other tablets available that can be tried. It is very rare for people to be sick with paclitaxel.
• Temporary taste changes can occur. Sharp and spicy foods, such as lemon flavours, pickles and curries, often taste better than more bland foods. Also, fruit and herbal teas may be far more palatable than regular tea or coffee. If necessary, the hospital dietitian will be able to offer more advice.

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© 1999 OVACOME a voluntary organisation which relies on donations. Registered Charity Number 1058026. DISCLAIMER: The information gathered for this site is from many sources and is provided for guidance only. Ovacome has made every effort to ensure that it is accurate but can make no undertakings as to its accuracy of completeness. All medical information should be used in conjunction with advice from medical professionals.