Post-chemo drugs after Cisplatin/ Vinorelbine

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Good morning

My dad had his first chemo yesterday - he is on 4 cycles (3 weekly) Cisplatin and Vinorelbine for stage 3b lung CA. Yesterday was his first Cisplatin. We return next week for the top-up Vinorelbine and then not back again until cycle 2 starts w/c 12th Feb. I thought it was worth also mentioning that Dad is having concurrent radiotherapy for 6 weeks starting cycle 2 of chemo.

Yesterday Dad was given 5 litres of IV fluid with the Cisplatin. We ended up staying a bit longer on the unit because he hadn't passed enough urine. He was given 40mg furosemide to take when we got home and he was up most of the night emptying his bladder.

I wanted to ask a couple of questions:

1. Dad said that the chemo made him feel quite hungry and he was also quite elated in mood (I wonder if he was a bit hysterical because he was so tired) - is this normal?

When we returned home he had some diarrhoea which seems to have settled down now.

2. He was given some post meds - Dexamethasone 1 tablet, twice a day for 3 days; Levofloxacin 500mg OD and Filgrastim injections starting on day 2 of treatment - with the treatment that my dad has been given, is this normal protocol to be given these medications?

I also wanted to ask about the use of aspirin daily to avoid blood clots as I have read that Cisplatin can cause blood clots, heart attacks etc - would there be any reason not to take one of these daily to counteract any of these side effects?

3. Dad had some lose bowel movements when he returned home - is this a normal side effect of the chemo and are we able to use OTC loperamide to counterbalance these?

I look forward to hearing your reply

Adele

Paula - Macmillan over 1 year ago

Hi Adele

Thanks for getting in touch today.

My name is Paula and I am one of the Cancer Information Nurse Specialists on the Macmillan Support Line.

I can see you have joined the cancer forums. I hope your finding it helpful to share your experiences with us.

Thank you for sharing dad’s story on the lung cancer forum and I can understand your concerns about his concurrent treatment. I will respond to your questions in the same order as you have presented them. Hopefully, this will give you a better understanding of dad’s current care.

Your dad’s increased appetite and elated mood maybe down to the Dexamethasone (steroids) which is normally prescribed pre and post chemotherapy. The steroids are given to help reduce inflammation, prevent an allergic reaction to the chemotherapy and helps to reduce sickness which can be caused by cancer treatment itself.

The take home drugs dad has been given highlighted in point two is standard drugs prescribed for his treatment. Chemotherapy attacks fast growing cancer cells and can also affect healthy cells such your white blood cells. If the neutrophils become low, this can put dad at risk of an infection. The Levofloxacin is prescribed prophylactic to prevent an infection and the Filgrastim helps to increase the white cell count.

Cancer treatment can affect your digestive systems and can upset the bowels. It can cause both diarrhoea and constipation. Loperamide can help but dad should only take it as prescribed. If you have any problems with continuing diarrhoea, We suggest speaking to his team about this troubling side-effect.

With regards the aspirin, dad should only take this if it’s prescribed. His team will be able to advise on his risk.

I know it’s difficult not to worry about dad but, if you feel it will help to talk through your concerns, you may find it helpful to talk to one of our nurses on the support line. Sometimes giving us a call can help. It’s a free phone number on 0808 808 0000 and we are here 7 days a week, 8am-8pm or email us.

I hope this information has been helpful, please don’t hesitate to get back in touch.

Ref: PW/SB

Paula-Cancer Information Nurse Specialist

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Post-chemo drugs after Cisplatin/ Vinorelbine