Possible side effects

As with any medicines, the drugs given in the FOCUS trial can cause some unwanted side effects, although they vary from person to person. Common side effects are described here, along with some of the ways they can be reduced.

The chemotherapy drugs used in the FOCUS trial can temporarily reduce the number of normal cells in your blood. When your blood count is low you are more likely to get an infection. During chemotherapy your blood will be tested regularly and, if necessary, you may be given antibiotics to treat any infection.

Other side effects may include feelings of sickness (nausea) and being sick, hair loss and tiredness. Feelings of sickness and being sick are now much less of a problem then they used to be because of effective anti-sickness drugs. If you do have hair loss your hair will start to grow again once your treatment is over.

CancerBACUP has further information about cancer related fatigue which has helpful tips on coping with tiredness due to chemotherapy.

Some chemotherapy drugs also make your mouth sore and cause small ulcers. Regular mouthwashes are important and your nurse will show you how to do these properly. If you don’t feel like eating meals, you can supplement your diet with nutritious drinks or soups. There is a wide range of drinks available and you can buy them at most chemist shops. CancerBACUP’s information about diet and the cancer patient has some useful tips on coping with eating problems.

Which side effects am I likely to have?

The following are some of the most common side effects caused by the chemotherapy drugs given in the FOCUS trial. Each person’s reaction to chemotherapy is unique. Some people have very few side effects, while others may experience more. Your doctor or nurse will tell you more about what to expect.

5-fluorouracil and folinic acid

The side effects are usually very mild, even when given for several months. Side effects include feelings of sickness (nausea), diarrhoea and some tiredness for a few days after each treatment. After some months of treatment, you may get sore hands and feet, or some hayfever-like symptoms such as a runny nose or sore eyes. Hair loss is uncommon. A few people are extra-sensitive to 5FU and have more exaggerated side effects. If this happens, it is usually possible to continue with effective treatment using a lower dose.

Irinotecan

The side effects can vary from very mild to quite severe. On the day of treatment, you may notice sweating, feelings of sickness or diarrhoea. These symptoms can usually be stopped by having an injection of a drug to overcome these problems. Between treatments, the main side effect is diarrhoea although treatment with anti-diarrhoea tablets can usually stop this. Other side effects include tiredness, feelings of sickness and being sick and a reduction in the number of white blood cells in your blood (which may make you more likely to get an infection). Hair loss is common with irinotecan, but your hair will start to grow again when irinotecan is stopped.

5FU and folinic acid plus irinotecan

This can cause diarrhoea, sweating and feelings of sickness and being sick in some people. About half of patients on this combination treatment have noticeable thinning of their hair. As with irinotecan alone, the combination can reduce the white blood cell count, which could make you more likely to get an infection.

5FU and folinic acid plus oxaliplatin

This combination can also cause diarrhoea, feelings of sickness and being sick in some people. It can also cause tingling and temporary feelings of numbness in particular parts of the body, commonly in your hands or throat. This usually stops when treatment is stopped, but can last for more than two months in about one in every five people. Sometimes, reducing the dose of oxaliplatin can help. Oxaliplatin combination treatment may also reduce your white blood cell count, which could make you more likely to get an infection.

Coping with side effects

There are lots of things that can be done to help with the side effects of chemotherapy. If you have any problems at all, tell the trial doctor or nurse. If you are thinking of ringing the doctor about something — go ahead and do it, don’t put it off. They are there to help.

Phone the trial staff, your GP, hospital doctor or cancer nurse immediately if you become suddenly unwell between hospital visits, and especially if you develop a high temperature, shivering, or severe diarrhoea.

Although they may be hard to bear at the time, these side effects do disappear once your treatment is over.