UNDERSTANDING ADRIAMYCIN CHEMOTHERAPY

A Guide for Patients produced by the Western General Hospital, Edinburgh

Introduction
This guide has been designed to help you and your family understand more about the chemotherapy you are about to have as treatment for your cancer. If you need more information or have any further questions, please do not hesitate to ask your hospital doctor or chemotherapy nurse.

What Is Cancer?
Our bodies are made up of tiny structures called cells that cannot be seen by the naked eye. Normally these cells reproduce themselves by dividing in a regular fashion. This enables growth and repair of the body tissues. Sometimes an uncontrolled growth of cells occurs. This is what happens in cancer.

What is Chemotherapy?
Chemotherapy means treatment with medicines called cytotoxic drugs that are given to eradicate or control cancer

How Do Chemotherapy Drugs Work?
The drugs enter the bloodstream and are distributed to all parts of your body. The drugs destroy the cancer cells by interfering with their ability to grow and divide. Chemotherapy can also affect normal cells that are growing and dividing. This may cause certain side effects, but these are temporary because healthy cells grow back to normal quickly. The side effects of the drug you are going to receive will be discussed later. It is likely to take at least 4 weeks from the start of treatment for any benefit to be seen

How Are Chemotherapy Drugs Given?
The drug(s) enter your bloodstream through a cannula (a fine tube that is inserted temporarily into a vein on the back of your hand and is attached to an intravenous drip containing saline).

What Can I Do While Having This Treatment?
While you are having this chemotherapy treatment you can get on with life as normal. Provided you feel well enough, you can carry on working and doing your favourite activities and hobbies. You should discuss this with the hospital doctor or chemotherapy nurse caring for you.
You can eat and drink as normal while on this treatment and alcohol is permitted. You may find you experience taste changes; food and drinks may not taste as they did before. This will return to normal once the treatment has finished.
You may feel a little sluggish or under the weather at times. This feeling can get worse the more treatment you have, but should improve on completion of treatment.
You may be able to go on holiday if it fits in around your chemotherapy. However, your skin may be more sensitive to the sun. Discuss it with your chemotherapy nurse before arranging anything. If you are going abroad you may need to take a covering letter. You should not receive certain 'live vaccines' while on chemotherapy or for 3 months afterwards.
We advise you not to become pregnant, father a child or breast feed while you are receiving chemotherapy, as some drugs may harm the developing foetus or baby. Contraception should be used, preferably a barrier method.

What is Adriamycin?
Adriamycin is the name of the chemotherapy drug which you are going to receive. It is a red drug given by injection every three weeks into the port in drip tubing. This is called one course of chemotherapy.

The number of chemotherapy treatments (courses) varies depending on each individuals treatment plan. You will be seen regularly by your specialist at a clinic to assess this, so he/she can monitor the effect of your chemotherapy. You will need to attend the hospital to have the Adriamycin chemotherapy. You must have a blood count check before we can go ahead with the chemotherapy. This can either be done on the day by your chemotherapy nurse or by the practice nurse at your GP's surgery. It will be discussed with you by your chemotherapy nurse on your first treatment visit

Will I Have Any Side Effects?
Each persons reaction to chemotherapy is unique. Some people have very few side effects, while others may experience more. Below are some of the side effects which may be experienced

• Red Urine
  Your urine may be pink or red for up to 24 hours after you receive Adriamycin This is quite normal.
• Temporary Reduction In Bone Marrow Function.
  This effect can begin about 7 days after the treatment has been given and usually reaches the lowest point 14-21 days after chemotherapy. Your blood count will then increase steadily and will usually have returned to normal within 2 1-28 days. You may be more susceptible to infections while you are on chemotherapy, particularly if your blood count is low. Contact your GP immediately if your temperature goes above 38°C or if you feel hot and shivery (fluey), or if you become suddenly unwell, even with a normal temperature. If you cannot contact your GP Practice, phone the hospital for advice on the contact numbers below. Urgent treatment with antibiotics may be necessary.
• Hair Loss
  It is very likely that total hair loss will be experienced however, hair does regrow on completion of treatment. Your chemotherapy nurse will discuss with you about wigs.
• Sore Mouth
  We will give you mouthwashes to use when you start your treatment to try and counteract any problems. Contact your GP or Ward 1 for advice if your mouth becomes sore or ulcerated
• Fertility
  Your ability to conceive or father a child may be affected by this drug. If you are planning to have children in the future, you should discuss fertility with your hospital doctor before starting treatment.
• Other
  Less commonly, patients have reported other side effects including flushing, diarrhoea, skin rash, redness of the vein, or increased sensitivity of the skin to sunlight. Adriamycin may affect the heart function at high doses, and you will be monitored for this if necessary.
  

When you attend for your next course of treatment please let your chemotherapy nurse know if you have experienced any side effects. The doctor may wish to adjust the dose of chemotherapy to lessen your side effects.

We hope this information booklet will help you understand more about chemotherapy. If you have any further questions or do have any problems, please phone using the contact number provided.

Contact Numbers:
Ward 1 (Mon - Fri 083 0-1630) 0131 5372219
Ward 4 (Emergency advice out of hours) 0131 537 2200