Cisplatin and Carboplatin Chemotherapy Treatments for Lung Cancer

Cisplatin and carboplatin share certain side effects. Like most chemotherapies, they cause nausea, low white cell counts, and stress to the kidneys. The platins also often cause neuropathy, which is damage to the nerves in the hands and feet.

Key Differences between Cisplatin and Carboplatin?

Key differences between these chemotherapies is that cisplatin is more likely to damage hearing, cause ringing in the ears, and damage nerves in the hands and feet, while carboplatin is more likely to drop the white cell count dramatically.

Side Effects of Cisplatin and Carboplatin

Report any side effects to your health care team. You may experience some of the following side effects while you are being treated with either cisplatin or carboplatin.

Low White Blood Cell Count

Your blood counts will be checked weekly through a lab test that does a complete blood count, called a CBC. You cannot tell when your white cell counts are low. Having low white cell counts is called neutropenia.

Carboplatin will affect the bone marrow's ability to produce the white cells (or neutrophils) that fight infection. The time of lowest white cell counts is between 10 and 14 days after the chemotherapy treatment, with spontaneous recovery expected by 21 days. If the bone marrow is slow to recover, there are two injectable medicines called NeulastaÒ and NeupogenÒ that can help speed the recovery of white cells.

Lower Red Blood Cell or Platelet Count

Blood counts will be checked weekly. These drugs can lower the number of red cells, which transport oxygen to cells. Red cells contain hemoglobin, a red, iron-rich protein that carries oxygen from the lungs to all of the body's muscles and organs. When the red cell count falls below normal, it is called anemia, which can be felt as fatigue, a racing heart (which is pumping harder to get oxygen to your body) and shortness of breath.

There is an injectable drug called AranespÒ that can help. Another part of the blood to be affected may be the platelets, which help the blood to clot. Low platelet counts, called thrombocytopenia, put a person at risk for bruising and bleeding. The gums may bleed more and a nosebleed may occur. Ask your doctor or nurse what precautions they want you to take, such as avoiding flossing or using an electric razor. You should also avoid taking medicines or herbs that thin the blood, such as aspirin or gingko biloba.

Nausea/Vomiting

Nausea or vomiting is caused by destruction of normal cells in the stomach lining. This can occur within hours of the chemo infusion and may last a few hours or a few days. Tell your doctor if you experience vomiting as it can prevented or controlled with anti-emetics. If you still experience nausea, work with your doctor to find the medication that works. Try to eat smaller meals, avoid foods with strong smells and avoid becoming too tired as fatigue makes nausea worse.

Stress on the Kidneys

Cisplatin and carboplatin may stress the kidneys. Your health care team will monitor your kidney function during your chemotherapy and adjust your treatment accordingly.

Neuropathy

Neuropathy is damage to the nerves in the hands and feet, causing numbness. Cisplatin and carboplatin are toxic to nerves and can affect hands and feet. There may be a tingling feeling, numbness or an aching feeling. Patients also may have difficulty with buttons or feeling their feet as they walk. The abnormal sensations are also called paresthesias. Report this to your health care team.

Other side effects that you may experience

Hair Thinning or Loss

Hair thinning or complete hair loss almost always occurs with Cisplatin and carboplatin.This usually involves the loss of eyebrows, eyelashes and pubic hair, as well as scalp hair. Hair on the legs usually thins, but does grow.

Diarrhea

The effect of chemotherapy on the lining of the intestines can cause diarrhea. It can occur any time during treatment. Report these symptoms to your health care team for assessment and suggestions on treatment. There are over-the-counter remedies, such as KaopectateÒ, as well as prescription medications.

Constipation

Some chemotherapies slow the bowel process. Also, anti-nausea medications can be constipating. Report this to your health care team. Ask about using a stool softener. Gradually increase foods with fiber in them, such as whole grains, brown rice, nuts, and popcorn.

Stress on the Liver

Cisplatin and carboplatin may cause changes in liver function, which is unlikely to cause harm. If changes to your liver function happen because of the drug, the liver should return to normal a few weeks after the last chemotherapy treatment. Your doctor will measure your liver function using blood tests during your treatment.

Aches or Pains

Cisplatin and carboplatin are likely to cause muscle aches or bone pain for a few days after each treatment. This can be relieved with over-the-counter or prescription medication. A patient also may experience headaches. Report these side effects to your health care team and ask about remedies. Get lots of rest and drink plenty of fluids.

Cisplatin is more likely to cause these side effects:

Damage to Hearing or Ringing in Ears

The nerves to the ears can be damaged by the platin chemotherapies, especially cisplatin. This damage is sometimes permanent and is a very serious side effect. An audiologist can provide testing to measure hearing before this chemo is given, and after, to measure any loss. Tinnitus is a feeling of buzzing, roaring or ringing in the ears which can be mildly irritating or disabling. The platins are said to be ototoxic, or toxic to the ears. Report this side effect to your health care team right away.

Neuropathy

Neuropathy is damage to the nerves in the hands and feet, causing numbness. This drug is toxic to nerves and can affect hands and feet. There may be a tingling feeling, numbness or an aching feeling. Patients also may have difficulty with buttons or feeling their feet as they walk. The abnormal sensations are also called paresthesias. Report this to your health care team.

References

www.nlm.nih.gov/medlineplus/druginfo/meds/a684036.html

www.nlm.nih.gov/medlineplus/druginfo/meds/a695017.html