Deb has been prescribed an antitumour agent called temozolomide (trade name Temodal). This drug is used for treatment of patients with newly diagnosed glioblastoma multiforme tumour in combination with radiation (concomitant phase) and subsequently as chemotherapy only (monotherapy phase).
In the concomitant phase the chemotherapy is taken every day for 42 days in combination with radiotherapy. Based on your blood counts and/or how you tolerate the medicine during the concomitant phase, the temozolomide may be delayed or discontinued. Once the radiation therapy is completed, chemotherapy is interrupted for 4 weeks to give your body a chance to recover. You then start the monotherapy phase.
In the monotherapy phase there are 6 treatment cycles and each one lasts 28 days. Temozolomide is taken once each day for the first 5 days of the cycle followed by 23 days without temozolomide. The temozolomide dose will be higher than during the concomitant phase. Based on your blood counts and/or how you tolerate the medicine during each treatment cycle, the temozolomide may be adjusted, delayed or discontinued.
For more information on the drug treatment visit the manufacturer's (Schering-Plough) website http://www.temodar.com/en_US/Temodar/pdf/TE0276.pdf
Possible side effects of temozolomide
Each person’s reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described in this information will not affect everyone who is given temozolomide, and may be different if you are having more than one chemotherapy drug.
We have outlined the most common side effects and those that are less common, so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you notice any effects which you think may be due to the drug, but which are not listed in this information, please discuss them with your doctor or chemotherapy nurse.
Lowered resistance to infection
Temozolomide can reduce the production of white blood cells by the bone marrow, making you more prone to infection. This effect can begin seven days after treatment has been given, and your resistance to infection usually reaches its lowest point 10–14 days after chemotherapy. Your blood cells will then increase steadily and will usually have returned to normal levels within 21–28 days.
Contact your doctor or the hospital straightaway if:
Bruising or bleeding
Temozolomide can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, or bleeding gums.
Anaemia (low number of red blood cells)
While having treatment with temozolomide you may become anaemic. This may make you feel tired and breathless. Let your doctor or nurse know if these symptoms are a problem.
Feeling sick (nausea) and being sick (vomiting)
If you do feel sick this may begin soon after the treatment is given and last for a day. Your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent, or greatly reduce, nausea and vomiting. If the sickness is not controlled, or continues, tell your doctor; they can prescribe other anti-sickness drugs which may be more effective. Some anti-sickness drugs can cause constipation. Let your doctor or nurse know if this is a problem.
Diarrhoea
This can usually be easily controlled with medicine, but it is important to let your doctor know if it is severe or continues. It is important to drink plenty of fluids if you have diarrhoea.
Constipation
Constipation can usually be relieved by drinking plenty of fluids, eating a high fibre diet and taking gentle exercise. Sometimes you may need to take medicines to stimulate your bowel. These can be prescribed by your doctor.
Loss of appetite and temporary taste alterations
Both of these may occur. A dietitian or specialist nurse at your hospital can give advice on boosting appetite, coping with eating difficulties and maintaining weight.
Rashes
Temozolomide can cause a rash which may be itchy. Your doctor can prescribe treatment to help reduce this.
Headache
Let your doctor know if you have headaches while having treatment with temozolomide
Tiredness and feeling weak
You may feel very tired. It is important to allow yourself plenty of time to rest.
The NICE guidance on Temozolomide can be found at http://www.nice.org.uk/guidance/index.jsp?action=article&o=32167
The European Medicines Agency (EMEA) public assessment report for Temodal can be found at http://www.emea.europa.eu/humandocs/PDFs/EPAR/Temodal/274198en1.pdf
In the concomitant phase the chemotherapy is taken every day for 42 days in combination with radiotherapy. Based on your blood counts and/or how you tolerate the medicine during the concomitant phase, the temozolomide may be delayed or discontinued. Once the radiation therapy is completed, chemotherapy is interrupted for 4 weeks to give your body a chance to recover. You then start the monotherapy phase.
In the monotherapy phase there are 6 treatment cycles and each one lasts 28 days. Temozolomide is taken once each day for the first 5 days of the cycle followed by 23 days without temozolomide. The temozolomide dose will be higher than during the concomitant phase. Based on your blood counts and/or how you tolerate the medicine during each treatment cycle, the temozolomide may be adjusted, delayed or discontinued.
For more information on the drug treatment visit the manufacturer's (Schering-Plough) website http://www.temodar.com/en_US/Temodar/pdf/TE0276.pdf
Possible side effects of temozolomide
Each person’s reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described in this information will not affect everyone who is given temozolomide, and may be different if you are having more than one chemotherapy drug.
We have outlined the most common side effects and those that are less common, so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you notice any effects which you think may be due to the drug, but which are not listed in this information, please discuss them with your doctor or chemotherapy nurse.
Lowered resistance to infection
Temozolomide can reduce the production of white blood cells by the bone marrow, making you more prone to infection. This effect can begin seven days after treatment has been given, and your resistance to infection usually reaches its lowest point 10–14 days after chemotherapy. Your blood cells will then increase steadily and will usually have returned to normal levels within 21–28 days.
Contact your doctor or the hospital straightaway if:
- your temperature goes above 38ºC (100.5ºF)
- you suddenly feel unwell (even with a normal temperature).
You will have a blood test before having more chemotherapy to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (the blood count) is still low.
Temozolomide is sometimes given at the same time as a six week course of radiotherapy. Your blood cell count will be monitored throughout the course of treatment to make sure that the number of white blood cells doesn't get too low.
Bruising or bleeding
Temozolomide can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, or bleeding gums.
Anaemia (low number of red blood cells)
While having treatment with temozolomide you may become anaemic. This may make you feel tired and breathless. Let your doctor or nurse know if these symptoms are a problem.
Feeling sick (nausea) and being sick (vomiting)
If you do feel sick this may begin soon after the treatment is given and last for a day. Your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent, or greatly reduce, nausea and vomiting. If the sickness is not controlled, or continues, tell your doctor; they can prescribe other anti-sickness drugs which may be more effective. Some anti-sickness drugs can cause constipation. Let your doctor or nurse know if this is a problem.
Diarrhoea
This can usually be easily controlled with medicine, but it is important to let your doctor know if it is severe or continues. It is important to drink plenty of fluids if you have diarrhoea.
Constipation
Constipation can usually be relieved by drinking plenty of fluids, eating a high fibre diet and taking gentle exercise. Sometimes you may need to take medicines to stimulate your bowel. These can be prescribed by your doctor.
Loss of appetite and temporary taste alterations
Both of these may occur. A dietitian or specialist nurse at your hospital can give advice on boosting appetite, coping with eating difficulties and maintaining weight.
Rashes
Temozolomide can cause a rash which may be itchy. Your doctor can prescribe treatment to help reduce this.
Headache
Let your doctor know if you have headaches while having treatment with temozolomide
Tiredness and feeling weak
You may feel very tired. It is important to allow yourself plenty of time to rest.
The NICE guidance on Temozolomide can be found at http://www.nice.org.uk/guidance/index.jsp?action=article&o=32167
The European Medicines Agency (EMEA) public assessment report for Temodal can be found at http://www.emea.europa.eu/humandocs/PDFs/EPAR/Temodal/274198en1.pdf
1 comment:
Red and yellow and pink and blue...
It's a wonder how you keep track of it all: your excel spreadsheet moment has come! Thanks for the update & love to all.
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