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CISPDOCE

Cancer Type: Lung, Non-Small Cell     Intent: Palliative
Regimen Category: Evidence-Informed
Funding
New Drug Funding Program
    Docetaxel - Non-Small Cell Lung Cancer (NSCLC)
Regimen Information Sheet

CISplatin-DOCEtaxel Treatment


This document provides general information about your cancer treatment. It does not replace the advice of your health care professional. Always discuss your therapy with your health care team.

What medications are in this treatment?
  • This treatment consists of CISplatin and DOCEtaxel.
  • Refer to the medication information sheet for each drug for more information.

What is this treatment for?
  • CISplatin-DOCEtaxel is a drug combination for treating non-small cell lung cancer.

What should I do before I have this treatment?

  • Your doctor will prescribe dexamethasone tablets for you to take at home before and after each Docetaxel injection, to help prevent allergic reaction and water retention. It is very important that you take these tablets exactly as directed by your doctor so that you do not experience these side effects.

How will this treatment affect sex, pregnancy and breastfeeding?

  • This chemotherapy regimen should not be used if you are pregnant or breast-feeding; if you or your partner may become pregnant (i.e. fertile/have not gone through menopause). Effective contraception with at least 2 methods is essential during treatment and for at least 6 months after stopping the treatment.

How is this treatment given?
  • Your oncologist will determine how many treatment cycles you need depending on how you tolerate and respond to the chemotherapy.
  • Each cycle lasts 3 weeks (21 days). You will receive docetaxel and cisplatin through a vein in your arm (IV) on the first day (Day 1) of each cycle. Days 2 to 21 are rest days.
  • You will have a blood test before each treatment to check if your blood counts are high enough for you to receive the next cycle of chemotherapy.
What else do I need to know while on this treatment?
  • Cisplatin can affect the function of your kidneys and can deplete some of the essential salts in your blood (such as magnesium). In order to prevent this, extra intravenous fluid will be given to you before and after the cisplatin infusion. Sometimes, magnesium is added in the extra fluid or your doctor might prescribe an oral magnesium supplement for you to take at home for a few days after the treatment. It is important that you drink plenty of fluids (at least 8 glasses per day) during the day and empty your bladder (pass urine) frequently.
     
  • All patients will experience some or total hair loss. This generally starts 2 to 3 weeks after the first injection. Your scalp may feel tender. It’s a good idea to consider a wig or other head covering before starting treatment. Hair loss on your face (e.g. eyebrows, eyelashes) and body can also occur. Your hair will usually start to grow back once your treatment is over, but hair loss may be permanent in some cases. The colour and texture of your new hair may be different.
     
  • Using other medications can affect the levels of chemotherapy drug in your blood (lowering level of drug making chemotherapy less effective, or increasing the level of drug causing more side effects.) Make sure your doctor and pharmacist have a complete list of all medicine and supplements (including-over-the counter ones and herbal products) that you are taking. Do not start or stop taking any medicine/supplements without first checking with your doctor and pharmacist.
     
  • Rarely, treatment with this chemotherapy regimen may increase your chance of bleeding. Because of this, you should avoid using blood thinners, or drugs that also affect bleeding such as aspirin and nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil®, Motrin®) or naproxen (Aleve®). For headache, fever, or occasional aches and pains, use acetaminophen (Tylenol®) instead. If you are taking aspirin regularly for other medical problems, it is important that you do not stop taking it before you have discussed this with your doctor.
What are the side effects of this treatment?

The table below lists other common or important side effects associated with this treatment.  You may not have all of the side effects.  Other side effects may occur.  If you have any unusual or bothersome symptoms, discuss with your doctor.


Side effects and what to do When to contact doctor?
More Common Side Effects

Diarrhea

  • May happen a few days after your treatment.
  • Limit hot, spicy, & fried foods; limit foods and drinks with caffeine.  Drink plenty of fluids.
  • Phone your oncologist if diarrhea lasts longer than 24 hours. See Diarrhea pamphlet.*
Contact your health care team if no improvement or if severe

Swelling (water retention) in arms and legs; puffiness

  • Your doctor will order some medications to prevent fluid retention.
  • Elevate your feet while sitting. Avoid tight fitting clothing.
Contact your health care team if no improvement or if severe

Tiredness, weakness
Lack of Energy

  • May increase with the number of cycles given.
  • Eat well-balanced meals.
  • Some mild exercise, such as walking, may help.
  • Rest when feeling tired or weak. Don't drive a motor vehicle or operate machinery when feeling tired.
  • Your energy level will improve over time. However, it may take a few months for the tiredness to go away even after your chemotherapy is finished.
Contact your health care team if no improvement or if severe

Nail changes

  • Your nails (fingers & toes) may change colour (yellow-orange) or become brittle a few weeks after the 1st treatment.
  • This will return to normal after you have completed the chemotherapy.
Contact your health care team if no improvement or if severe

Ringing in the ears, Hearing loss, Loss of balance

  • May occur after a few treatments
  • Please contact your oncologist or nurse if you notice ringing in the ears or notice a change in your hearing.
Contact your health care team as soon as possible (office hours)

Numbness, tingling and burning sensation in hands and feet

  • May increase with the number of cycles given.
  • Be careful when handling items that are sharp, hot or cold.
  • Check with your oncologist or nurse if this is bothersome and affecting your regular daily activities.
Contact your health care team if no improvement or if severe

Sores in the mouth / lips / tongue

  • May occur a few days after treatment begins.
  • Maintain good mouth hygiene. Brush teeth often with a soft toothbrush.  Avoid hot, spicy and acidic foods. 
  • Avoid commercial mouthwashes. See Mouth Care pamphlet.*
Contact your health care team as soon as possible (office hours)

Muscle or joint pain

  • May happen a few days after treatment and may last up to 4 days. 
  • Take 1-2 Acetaminophen tablets every 4 hours if needed for pain. 
Contact your health care team if no improvement or if severe

Pale skin, weakness, breathlessness, anemic

  • May happen after a few treatments.
  • Rest often. Eat well-balanced meals. Some mild exercise may help.
  • See Anemia pamphlet.* May need medication or blood transfusion to correct low red blood cells.
Contact your health care team if no improvement or if severe

Nausea and vomiting

  • Usually worst in the first 12–24 hours but may happen anytime during the treatment course.
  • Take your medicine for nausea and vomiting as prescribed.
  • Continue drinking clear fluids. Get fresh air and rest.
  • If you vomit within 1 hour of taking your anti-nausea tablets, you may take another dose.
  • A suppository may be ordered if you can't keep your pills down.
  • Phone your oncologist if vomiting lasts more than 24 hours or nausea longer than 48 hours. See Nausea & Vomiting pamphlet.*
Contact your health care team if no improvement or if severe

Poor appetite

  • May happen soon after your treatment.
  • Eat foods that you like and try and eat regular small meals. Use meal supplements if possible.
  • It is important to maintain your weight while going through treatment.  Please let your oncologist or nurse know if you are losing weight. 
Contact your health care team if no improvement or if severe

Kidney problems , trouble urinating

  • May occur anytime after receiving chemotherapy
  • Contact your oncologist if you experience swelling of feet and legs and difficulty to urinate.
Get emergency medical help right away

Signs of infection, for example, fever, chills, cough, sore throat

  • The risk of infection is greatest between days 8 to 21.
  • Limit contact with people who are sick or have colds. Wash your hands often.
  • Phone your oncologist or go to the closest emergency room right away if you have a fever*
  • *You have a fever if your temperature taken in your mouth (oral temperature) is:
  • 38.3°C (100.9°F) or higher at any time OR
  • 38.0°C (or 100.4°F) or higher for at least one hour.
  • While you are getting chemotherapy treatments:
  • Keep a digital thermometer at home and take your temperature if you feel hot or unwell (for example, chills).
  • Avoid taking medications that treat a fever before you take your temperature (for example, Tylenol®, acetaminophen, Advil® or ibuprofen) as they may hide a fever.
  • Do not eat or drink anything hot or cold right before taking your temperature.
  • Check with your doctor before getting any vaccines, surgeries, medical procedures or visiting your dentist.
Get emergency medical help right away

Thin, reddened painful skin on hands or feet

  • May occur a few days after treatment.
  • Usually mild. Rest often, keeping off your feet. 
  • Use a moisturizing cream on your hands and feet. See Hand-Foot Syndrome pamphlet.*
  • Check with your oncologist or nurse if this is bothersome and affecting your regular daily activities.
Contact your health care team if no improvement or if severe

Side effects and what to do When to contact doctor?
Less Common Side Effects, but may be Severe

Salt imbalances

  • May start a few days after your treatment.
  • Eat well-balanced meals. Take supplements as prescribed.  
  • Contact your oncologist if you experience any muscle weakness/cramps, trembling, tingling or confusion.
Get emergency medical help right away

Lung problems
(increased cough, breathing problems, chest pain, coughing blood)

Get emergency medical help right away

For more links on how to manage your symptoms go to www.cancercare.on.ca/symptoms.

The information set out in the medication information sheets, regimen information sheets, and symptom management information(for patients) contained in the Drug Formulary (the "Formulary") is intended to be used by health professionals and patients for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or side effects of a certain drug, nor should it be used to indicate that use of a particular drug is safe, appropriate or effective for a given condition.

A patient should always consult a healthcare provider if he/she has any questions regarding the information set out in the Formulary. The information in the Formulary is not intended to act as or replace medical advice and should not be relied upon in any such regard. All uses of the Formulary are subject to clinical judgment and actual prescribing patterns may not follow the information provided in the Formulary.