Cisplatin (pronounced sis-pla-tin) is a chemotherapy drug that is given as a treatment for some types of cancer. It is most commonly used to treat testicular, bladder, lung, gullet (oesophagus), stomach and ovarian cancers. This information describes cisplatin, how it is given and some of its possible side effects. It should ideally be read with our general information about chemotherapy and about your type of cancer, which give further information and advice.

If you have any further questions you can ask your doctor or nurse at the hospital where you are having your treatment, or speak to one of our cancer support service nurses.

Cisplatin is a colourless fluid.

Cisplatin is given as a drip (infusion) through a fine tube inserted into the vein (cannula). It may also be given through a central line, which is inserted under the skin into a vein near the collarbone, or into a PICC line which is inserted into a vein in the crook of the arm.

Each person's reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described here will not affect everyone who is given cisplatin, and may be different if you are having more than one chemotherapy drug.

We have outlined the most common and less common side effects, so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you notice any effects which you think may be due to the drug but which are not listed in this information, please discuss these with your doctor or chemotherapy nurse.

Feeling sick (nausea) and vomiting If these side effects do occur they may begin a few hours after the treatment is given and last for up to a few days. Your doctor can now prescribe very effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting. If the sickness is not controlled, or continues, tell your doctor, who can prescribe other anti-sickness drugs which may be more effective.

Your kidneys may be affected Usually this does not cause any symptoms, and the effect on the kidneys is mild, but if the effect is severe the kidneys can be permanently damaged unless the treatment is stopped. For this reason your kidneys will be checked by a blood test before each treatment.

Fluid will be given into the vein before and after the treatment to keep your kidneys working normally. You may be asked to measure and record what you drink and the amount of urine that you pass. If you do not pass the same amount, or more, urine than you usually do it is important to tell your nurse or doctor.

If necessary, you may be given medicine to help you to pass urine. You may be asked to drink extra fluid, before and after treatment, and it is important to do this. Let your doctor know if this is a problem, for example, if you are feeling sick.

Numbness or tingling in hands or feet This is due to the effect of cisplatin on nerves and is known as peripheral neuropathy. You may notice that you have difficulty doing up buttons or similar fiddly tasks. Tell your doctor if you notice any numbness or tingling in your hands or feet. The side effect usually disappears slowly a few months after the treatment ends.

Changes in hearing You may have ringing in the ears (tinnitus) and you may lose the ability to hear some high-pitched sounds. Again, this effect usually decreases when the treatment ends, although in a small number of cases it may be permanent. Tell your doctor if you notice any loss of hearing or tinnitus.

Temporary taste alterations A dietitian or specialist nurse at your hospital can give advice about ways of coping with this side effect.

Lowered resistance to infection Cisplatin can reduce the production of white blood cells by the bone marrow, making you more prone to infection. This effect can begin seven days after treatment has been given, and your resistance to infection usually reaches its lowest point 10–14 days after chemotherapy. Your blood cells will then increase steadily, and will usually have returned to normal levels within 21–28 days.

Contact your doctor or the hospital straightaway if:

• Your temperature goes above 38ºC (100.5ºF)
• You suddenly feel unwell (even with a normal temperature).

You will have a blood test before having more chemotherapy, to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (the blood count) is still low.

Bruising or bleeding Cisplatin can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, and bleeding gums.

Anaemia (low number of red blood cells) While having treatment with cisplatin you may become anaemic. This may make you feel tired and breathless. Let your doctor or nurse know if you develop these symptoms.

Loss of appetite The dietitian or specialist nurse can give you tips on boosting your appetite, coping with eating difficulties and maintaining weight.

Diarrhoea This can usually be easily controlled with medicine but let your doctor know if it is severe or if it continues. It is important to drink plenty of fluids if you have diarrhoea.

Allergic reaction Signs of an allergic reaction include skin rashes and itching, a high temperature, shivering, redness or darkening of the face, dizziness, headaches, breathlessness, anxiety and a need to pass urine. You will be monitored for any signs of an allergic reaction during the treatment. Tell your doctor or nurse if you have any of these.

Other medicines Some other medicines can be harmful to take when you are having chemotherapy. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.

Fertility Your ability to become pregnant or father a child may be affected by taking this drug. It is important to discuss your fertility with your doctor before starting your treatment.

Contraception It is not advisable to become pregnant or father a child while taking cisplatin, as the developing foetus may be harmed. It is necessary to use effective contraception while taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor.

This section is based upon our Cisplatin factsheet which has been compiled using information from a number of reliable sources, including:

• Martindale: The Complete Drug Reference (35th edition). Eds. Sweetman et al. Pharmaceutical Press, 2006.
• British National Formulary (52nd edition). British Medical Association and Royal Pharmaceutical Society of Great Britain, September 2006.
• The Chemotherapy Source Book (3rd edition). Ed. Perry et al, 2001.

For further references, please see general bibliography.