Active symptom control and MVP chemotherapy

Active symptom control is described on this page. For this option you will be given a combination of three chemotherapy drugs: mitomycin (M), vinblastine (V) and cisplatin (P).

Before each chemotherapy session you will have a blood test. The treatment is usually given in the outpatient clinic, but you may need to stay in hospital overnight. The three chemotherapy drugs are given by drip through a small tube (cannula) inserted into a vein in the back of your hand or your arm.

Anti-sickness drugs will be given as tablets or through the drip before, and sometimes during, the chemotherapy. Fluids are given by drip before and after the chemotherapy, to help your kidneys to get rid of the chemotherapy drugs after the chemotherapy has acted on the cancer cells.

The whole process takes approximately eight hours and you will usually go home once the treatment has ended. You will be given anti-sickness tablets to take for the next three days.

After the chemotherapy, there is a rest period of three weeks. This completes one cycle of the chemotherapy. After the three-week rest the next chemotherapy cycle will start. In total, four cycles of chemotherapy are given, which means that the last chemotherapy treatment is given at the beginning of the ninth week.

Possible side effects

MVP chemotherapy may cause some of the following side effects:

Temporary reduction in bone marrow function

This can result in a lowering of the number of white cells (which fight infection) in your blood, making you more prone to infection. It can also result in bruising or bleeding if your platelets (cells which clot the blood) are reduced, or anaemia, if the number of your red cells is low.

This effect can begin about seven days after the treatment has been given and usually reaches its lowest point at 10-14 days after chemotherapy. Your blood count will then increase steadily and will usually have returned to normal before your next course of chemotherapy is due.

You will have a blood test before having more chemotherapy to make sure that your cells have recovered. If the number of white blood cells in your blood is very low you may be advised to wait for a week before having the next dose of chemotherapy.

Contact your doctor or the hospital straight away if:

• your temperature goes above 38ºC (100.5ºF)
• you start shivering
• you have any unexplained bruising or bleeding
• you suddenly feel unwell (even with a normal temperature).

Feeling sick (nausea) and vomiting

There are now very effective anti-sickness drugs to prevent or reduce this. If the sickness is not controlled, or continues, tell your doctor. They can prescribe other anti-sickness drugs, which may be more effective for you. Some anti-sickness drugs may cause constipation. Let your doctor or nurse know if this is a problem.

Tiredness

Many people feel extremely tired (fatigued) during chemotherapy, particularly towards the end of treatment. This is a very common side effect and it is important to try to get as much rest as you need.

CancerBACUP has a section on coping with fatigue that has helpful suggestions and advice.

Hair loss

This tends to start 2-3 weeks after the first cycle of treatment. Hair usually thins rather than being lost completely. The hair loss is temporary, and your hair will start to grow again after the treatment. CancerBACUP’s section on coping with hair loss has advice on this problem.

Taste change

You may notice that your food tastes different. Normal taste will come back after the treatment finishes.

Numbness or tingling in hands or feet

This is due to the effect of vinblastine and cisplatin on nerves. Tell your doctor if you notice these symptoms. The problem usually improves slowly a few months after treatment is over.

Aching joints and muscles

You may have these symptoms a few days after treatment. This does not usually last long and your doctor can prescribe painkillers to help.

Ringing in the ears and hearing loss

Cisplatin can cause some ringing in the ears (tinnitus). It can also cause some loss of ability to hear high-pitched sounds. Let your doctor know if this happens.

Change in kidney function

The way that your kidneys work may change slightly. Usually the effect is mild, but if the effect is severe the kidneys can be permanently damaged unless treatment is stopped.

For this reason you will be given a blood test to check how well your kidneys are working before each treatment. Plenty of fluid will be given into the vein before and after the treatment to keep your kidneys working normally.

You will be asked to measure and record what you drink and the amount of urine that you pass. If necessary, you may be given medicine to help you to pass urine.

If you are asked to drink extra fluid it is important to do this, or to let your doctor know if this is a problem – perhaps because you are feeling sick.

Changes to the lungs

Mitomycin may cause some mild inflammation of the lung tissue. Let your doctor know if you notice any cough or breathlessness.