Oxaliplatin is a chemotherapy drug used to treat colorectal cancer and cancer of the throat (esophagus).

HOW IS OXALIPLATIN ADMINISTERED?

Oxaliplatin is given in the chemotherapy day unit or during a hospital stay. A chemotherapy nurse will give it to you.

Before the day of treatment, a nurse will take a blood sample from you to see if you are fit for chemotherapy.

You will also be able to see a doctor or nurse before having chemotherapy. They will ask you how you have been feeling. If the results of your blood test are good on the day of your treatment, the pharmacist will prepare your chemotherapy. Your nurse will give you medication for nausea and, sometimes, steroids administered intravenously. Chemotherapy drugs may be given in the following ways:

• Through a thin tube (line) inserted into a vein in the arm or hand by a nurse
• Through a tube that goes below the skin of your chest to a nearby vein (central line)
• Through a thin tube that is placed in a vein of the arm and goes up through a vein toward the chest (PICC)

Your nurse will give you oxaliplatin as a drip (perfusion) through a cannula or a line for about half an hour. This kind of drip is usually given using a perfusion pump for the sake of timing.

When the chemotherapy is administered

Some people may have side effects while they are receiving chemotherapy.

ALLERGIC REACTION

On rare occasions, oxaliplatin can cause an allergic reaction while it is being administered. The signs of a reaction may include the following: rash, itchiness, reddening, or breathlessness; swelling in the face or lips; nausea; pain in the abdomen, back, or chest; or feeling unwell. Tell your nurse immediately if you have any of these symptoms.

LARYNGEAL SPASM

Though rare, oxaliplatin can affect the area around the larynx, which can cause difficulty with swallowing and breathing. This can happen either during the treatment or in the first days after it. This side effect can be very scary, though it should only be temporary. If you have difficulty breathing, take slow, deep breaths through your nose. This will have a calming effect and will help your breathing return to normal.

This symptom can be worse when the temperature is low, which is why it is a good idea to avoid cold drinks and ice cubes during treatment and a few days thereafter. It can also help to bundle up and cover your nose and mouth in cold weather.

It is important to let your doctor know if you have this side effect. Your doctor may increase the time of your oxaliplatin infusion to 4-6 hours in future cycles, which will reduce the chance of it happening again.

PAIN ALONG THE VEIN

Oxaliplatin can cause pain where the injection was given or along the vein. If you have pain, tell your nurse or doctor immediately so they can check the place of the puncture. They may give you the medication more slowly.

YOUR CHEMOTHERAPY CYCLE

You will have chemotherapy as part of a course or cycle, consisting of several treatment sessions and lasting several months. Each cycle of oxaliplatin normally lasts for 2 weeks. You will get oxaliplatin on the first day of the cycle.

POSSIBLE SIDE EFFECTS OF OXALIPLATIN

You may experience some of the side effects mentioned here, though it is rare for a patient to have all of them. If you receive other chemotherapy drugs, you may have other side effects that are not mentioned here. Always inform your doctor of the effects you experience.

Your doctor can prescribe medication to help control some of the side effects. It is very important to take the medication exactly as your doctor says for it to have the highest chance of working well. Your nurse will advise you on managing the side effects. After treatment, the side effects start to get better.

RISK OF INFECTION

Oxaliplatin may lower the number of white blood cells in your blood. This will make you more susceptible to infection. Your nurse can tell you when you might have the lowest levels of these cells. When the number of white blood cells is low, this is called neutropenia.

Contact your hospital immediately if any of the following happens:

your temperature goes above 38 ° C

you suddenly feel unwell, even if your temperature is normal.

You have symptoms of infection, which may include sore throat, coughing, or the need to urinate frequently.

The number of white blood cells normally increases gradually, returning to normal before your next chemotherapy session. You will have a blood test before your next chemotherapy. If your white blood cells are still low, your doctor may postpone the treatment for a short period of time.

BRUISING AND BLEEDING

Oxaliplatin may lower the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any unexplained bleeding or bruising. This includes nosebleeds, bleeding gums, blood spots, or skin eruptions (rashes). Some people may require additional platelets.

ANEMIA

Oxaliplatin may lower the number of red blood cells in your blood. Red blood cells transport oxygen throughout the body. If you have a low number of red blood cells, you may be tired and short of breath. Tell your doctor or nurse if you feel like this. If you are very anemic, it's possible you will require a blood transfusion.

NUMBNESS OR TINGLING IN THE HANDS OR FEET

These symptoms are caused by the effect of oxaliplatin on the nerves. It is called peripheral neuropathy. It may also be hard for you to press buttons and it can make other tasks more uncomfortable.

For some, these symptoms can be brought upon by things that are cold, such as frozen drinks or cold air. If you notice your symptoms are related to coldness, you should stay away from cold drinks, wear gloves, socks, and a scarf to cover your nose and mouth when it is cold out. Tell your doctor if you have these symptoms. It is sometimes necessary to lower the drug dose.

Sometimes, the tingling or numbness do not happen with the first treatment but do after several treatments. This is known as the "cumulative effect" and should get better after the treatment has concluded. However, for some people the tingling and numbness can last for months or longer.

NAUSEA

This can happen on the first few days after chemotherapy. Your doctor will prescribe you antiemetic drugs to help prevent or control your nausea. It is easier to prevent nausea than it is to treat it once it has begun.

If you still have nausea or are vomiting, get in touch with the hospital as soon as possible. They can give you advice and change your medication to one that works better.

DIARRHEA

Your doctor can prescribe medicines to control diarrhea. Let them know if your diarrhea is severe or if it doesn't get better. Make sure you drink at least two liters of fluids each day if you have diarrhea.

TIREDNESS

Feeling very tired is a common side effect. Fatigue is often worst toward the end of treatment and for a few months after the treatment has finished. Try to pace yourself and rest as much as you need to. Help balance this with a bit of light exercise, such as short walks. If you feel drowsy, don't drive or operate heavy machinery.

LESS COMMON SIDE EFFECTS OF OXALIPLATIN

SORENESS OF THE MOUTH

You may have a sore mouth or mouth ulcers, which could make you more prone to getting a mouth infection. Lightly brush your teeth and/or dentures in the morning and night and after meals. Use a soft-bristle toothbrush. Your nurse might ask you to rinse your mouth out regularly or use mouthwash. It is important that you follow all the instructions you are given and that you drink a lot of fluids.

Tell your nurse or doctor if you have any mouth problems. They can prescribe you drugs to prevent or treat infections of the mouth and to treat any kind of pain.

CHANGES IN TASTE

You may get a bitter or metallic taste in your mouth or find that food tastes different. This should go away when your treatment is over. Unless you have pain or mouth ulcers, try to use herbs and spices or strong-tasting sauces to give your food more flavor. Sucking on candy can sometimes help bitter or metallic tastes go away. Your nurse can give you further advice on this.

MORE INFORMATION ABOUT OXALIPLATIN

BLOOD CLOT RISK

Cancer and chemotherapy increase the chances of a blood (thrombosis). The symptoms include pain, reddening or swelling in a leg, difficulty breathing, and pain in the chest. Get in touch with your doctor immediately if you have any of these symptoms.

OTHER DRUGS

Some medicines can interact with chemotherapy or be harmful if they are taken alongside chemotherapy. This includes medications that can be purchased in a store or pharmacy. Tell your doctor the medicines you are taking, including over-the-counter medications, complementary therapies, and herbal medicines.

ALCOHOL

Your doctor will advise you against drinking alcohol while taking oxaliplatin, as it can interact with the medication.

FERTILITY

Oxaliplatin may affect your fertility. If this worries you, you can talk to your doctor before beginning treatment.

CONTRACEPTION

Your doctor will advise you not to become pregnant during the treatment. This is because the drugs can harm developing babies. It is important to use contraception during chemotherapy and for a few months after the treatment ends.

SEX

If you have sex within the first few days after chemotherapy, it is necessary to use a condom. This is to protect your partner in case there is chemotherapy in semen or vaginal fluid.

BREASTFEEDING

Women are recommended not to breastfeed during treatment and for a few months after chemotherapy has concluded. This is in case the chemotherapy enters their breast milk.

MEDICAL AND DENTAL TREATMENT

If you have to go to the hospital for whatever reason other than cancer, always tell the doctors and nurses that you are having chemotherapy.

Talk to your cancer doctor or nurse if you think you need dental treatment. Always let your dentist know that you are having chemotherapy.