Carboplatin: Indications, Administration, Side Effects and Tips for its Use

It is a chemotherapy drug used to treat breast cancer.

Indications

Carboplatin can be used to treat people with:

  • Secondary breast cancer: Breast cancer that has spread from the breast to another part of the body.
  • Locally advanced breast cancer (also known as regional recurrence) : Breast cancer that has spread to the tissues and lymph nodes (glands) around the chest, neck, and below the breastbone.
  • Primary breast cancer: Cancer that has not spread beyond the breast or the lymph nodes under the arm. It can be given after surgery (known as adjuvant chemotherapy) in combination with other anticancer drugs.

Carboplatin may be offered as part of a clinical trial. Research is studying the benefits of using carboplatin in specific types of breast cancer, such as triple negative breast cancer or breast cancer that has developed due to the inheritance of an altered gene.

Management

Carboplatin is given by drip into a vein (intravenously) in the hand or arm, although there are other ways to give it, depending on factors such as how easy it is for the chemotherapy staff to find the right veins and their preferences.

Carboplatin is usually given once every three weeks. This pattern is known as ‘cycle’ or ‘course’. How often you receive carboplatin and the total number of cycles will depend on your particular situation. Your specialist will discuss this with you.

When carboplatin is given on its own, it takes between 30 and 90 minutes, but the total time can be longer when given with other medications.

Before starting your treatment, many hospitals organize a chemotherapy information session. At this appointment, a nurse will discuss how and when your chemotherapy will be given and how side effects can be managed.

You will also be given contact numbers so you know when and who to call if you have any questions or concerns.

Side effects

Common side effects of carboplatin

Everyone reacts differently to drugs, and some people have more side effects than others.

The side effects described here will not affect everyone, and in general, most can be controlled. If you are being given other chemotherapy or anticancer drugs with carboplatin, you may have side effects from those drugs as well.

If you are concerned about side effects, whether they are listed here or not, tell your chemotherapy nurse or cancer specialist ( oncologist ).

Effects on blood

Carboplatin can temporarily affect the number of healthy blood cells in the body.

You will have regular blood tests to monitor your blood count. If the number of blood cells is too low, the next course of treatment may be delayed or the chemotherapy dose may be reduced.

Not having enough white blood cells can increase your risk of getting an infection.

Contact your hospital immediately if:

  • You have a high temperature (more than 37.5 ° C) or low temperature (less than 36 ° C), or whatever your chemotherapy team has advised.
  • Suddenly you feel bad, even with a normal temperature.
  • You have any symptoms of infection, for example a sore throat, cough, need to urinate frequently, or feeling cold and / or constipated.

Having too few red blood cells is called anemia. If you feel particularly tired, out of breath, or dizzy, tell your specialist team. A blood transfusion may be necessary during your treatment if the number of red blood cells drops significantly.

Nausea and vomiting

You may experience nausea and vomiting, although many people will not actually get sick.

An anti-disease drug will be given into your vein before chemotherapy is given, and anti-disease medication will be prescribed for you to take home to reduce nausea or prevent it from happening.

Tiredness (fatigue)

It is common to feel extremely tired during your treatment. For some people, fatigue can last for several weeks or even months after treatment has ended, but their energy levels should gradually return.

Effects on your concentration (“chemo brain” or cognitive impairment)

Your ability to focus or think clearly can also be affected, which can be very frustrating. This is often referred to as “chemo brain” or “chemo-fog,” but your team of specialists may call it cognitive impairment. It usually improves over time after treatment is finished.

Effects on fertility

Carboplatin causes changes in the ovaries, which can lead to infertility in women who have not been through menopause. How likely you are to become infertile may also depend on whether you have had chemotherapy in the past and your age.

If you are concerned about your fertility, it is important to speak with your team of specialists before beginning treatment to discuss options for preserving fertility.

Symptoms of menopause

Sometimes carboplatin can cause women who have not been through menopause to experience menopausal symptoms. This is because it affects your ovaries, which make estrogen.

Common symptoms can include:

  • Hot flashes and night sweats.
  • Humor changes.
  • Joint pains
  • Vaginal dryness

Less common side effects of carboplatin

Changes in your appetite

Your appetite may change while taking carboplatin. This may take a few days, but if you are concerned about how much you are eating and drinking, speak with your team of specialists.

Pain in the mouth and changes in taste

You will be given a mouthwash to try to reduce pain in your mouth and gums and to try to stop the development of mouth ulcers. Good oral hygiene is very important during treatment.

It is advisable to see your dentist for a dental checkup before chemotherapy begins and to avoid dental treatment during chemotherapy.

While you are taking carboplatin, your taste may change, and some foods may taste different (for example, more salty, bitter, or metallic). This usually returns to normal once the treatment is finished.

Numbness and tingling in the hands or feet (peripheral neuropathy)

Some people using carboplatin have numbness or tingling in their hands and feet. This is due to the effect of carboplatin on the nerves and is known as peripheral neuropathy.

In most cases it is mild and disappears shortly after treatment ends, although in some cases it may be permanent. If severe, the dose of carboplatin may need to be lowered or stopped altogether.

If you have numbness or tingling, tell your specialist team so they can control your symptoms.

Hair loss (alopecia)

Carboplatin causes hair loss. Some people have thinning hair, but most people will lose all of their hair, including eyebrows, eyelashes, and body hair.

Hair loss is usually temporary and for most people their hair will start to grow a few weeks after treatment is over.

Diarrhea or constipation

You may have diarrhea or constipation, but your specialist or GP can prescribe medications to control this. Contact your specialized chemotherapy team if you have four or more episodes of diarrhea within a 24-hour period.

Liver or kidney changes

Because carboplatin can affect your liver and kidneys, your team will check if they are working normally (usually with blood tests) before starting treatment and throughout treatment. Any effect carboplatin has is usually mild and will get better on its own.

Skin problems

Skin rashes, which can be itchy, can develop. Your doctor can prescribe a treatment to help with this.

Pain at the injection site (extravasation)

If chemotherapy drugs leak out of the vein being given (called extravasation), they can damage the surrounding soft tissue.

Tell the nurse to administer chemotherapy right away if you have any pain, stinging, or burning sensation around the cannula (small plastic tube) while the medicine is being given.

Allergic reaction

If you have an allergic reaction to carboplatin, it will likely occur within the first few minutes of your treatment and will probably be the first or second time you have taken the medication. Reactions can range from mild to severe, but severe reactions are rare.

You will be closely monitored so that any reactions can be dealt with immediately.

Symptoms of an allergic reaction include:

  • Redness
  • Acne.
  • Itch.
  • Back pain.
  • Difficulty breathing.
  • Soft spot.
  • High temperature or chills.

If you have a severe reaction, treatment will be stopped immediately.

If you have a reaction, medications may be given before future treatments to reduce the risk of new reactions.

Sex and contraception

You are advised not to get pregnant while receiving treatment because carboplatin can have a harmful effect on a developing baby.

If you have not been through menopause, talk with your team about the best method of birth control for you.

You can still have sex during treatment. Because it is not known whether chemotherapy drugs can pass into vaginal fluids (or semen), most hospital specialists recommend using barrier methods of contraception, such as condoms, for a few days after chemotherapy is given.

Vaccines

You should not have any live vaccines while you are receiving chemotherapy. Live vaccines include measles, rubella (German measles), polio, tuberculosis, shingles, and yellow fever.

Live vaccines contain a small amount of live virus or bacteria. If you have a weakened immune system, what you can do during chemotherapy could be harmful.

It is safe to have these vaccines six months after your chemotherapy ends. Talk to your GP or specialist before getting vaccinated.

If someone you live with needs a live vaccine, talk to your specialist or GP. They can tell you about the precautions to take depending on the vaccination.

Flu shot

Anyone at risk of having a weakened immune system, and therefore more prone to infection, should get a flu shot. This includes people who already have or have already received chemotherapy.

The flu vaccine is not a live vaccine, so it does not contain any active viruses. If you are already receiving chemotherapy, talk to your chemotherapy specialist or breast care nurse about the best time to get your flu shot.

Blood clots

People with breast cancer are at increased risk for blood clots. Your risk is higher because of the cancer itself and some breast cancer treatments. If the cancer has spread to other parts of the body (secondary breast cancer), this also increases the risk.

Using carboplatin increases the risk of blood clots, such as a deep vein thrombosis (DVT). People with DVT are at risk of developing a pulmonary embolism. This is when part of the blood clot breaks off and travels to the lung.

Blood clots can be harmful, but they are treatable, so it is important to report symptoms as soon as possible.

If you experience any of the following symptoms, contact your GP or specialist team immediately:

  • Pain, redness / discoloration, warmth, and swelling of the calf, leg, or thigh.
  • Swelling, redness, or tenderness when a central line is inserted to give chemotherapy, for example in the arm, chest area, or up to the neck.
  • Difficulty breathing.
  • Chest tightness.
  • Unexplained cough (you may cough up blood).

Self-care tips while using carboplatin

  • Drink at least two to three quarts of liquid every 24 hours, unless otherwise instructed.
  • You may be at risk for infection, so try to avoid crowds or people with colds, and report fever or other signs of infection to your healthcare provider immediately.
  • Wash your hands often.
  • To help treat / prevent mouth sores, use a soft toothbrush and rinse three times a day with 1/2 to 1 teaspoon of baking soda and / or 1/2 to 1 teaspoon of salt mixed with 8 ounces of Water.
  • Use an electric razor and a soft toothbrush to minimize bleeding.
  • Avoid contact sports or activities that could cause injury.
  • To reduce nausea, take anti-nausea medications as prescribed by your doctor and eat small, frequent meals.
  • Avoid sun exposure. Wear SPF 15 (or higher) sunscreen and protective clothing.
  • In general, alcoholic beverages should be drunk in small amounts or avoided altogether.
  • Get plenty of rest.
  • Maintain good nutrition.
  • If you experience symptoms or side effects, be sure to discuss them with your healthcare team. They can prescribe medications or other suggestions that are effective in managing such problems.