Gemcitabine Chemotherapy for Lung Cancer: Side Effects

Gemcibine is the generic name for Gemzar, a chemotherapy produced by ELilly. According to www.gemzar.com. Gemzar is used along with cisplatin to treatment non-small cell lung cancer. The common side effect from Gemcitabine treatment for lung cancer that needs monitoring is the drop in white blood cells. The most unpleasant side effect is nausea, although it is usually mild. Report to your health care team immediately any shortness of breath that may occur while taking Gemcitabine. According to the pharmaceutical ELilly that produces gemcitabine also known as Gemzar, you may experience some of the following side effects of gemcitabine:

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

Lower Platelet Count or Low Red Cells

Blood counts will be checked weekly. Gemcitabine 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 Aranesp 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.

Hair Loss

Hair thinning or complete hair loss almost always occurs with Gemcitabine. 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.

Skin or Nail Changes

Skin rash and itching can occur. With this drug, redness and swelling can occur on the hands and feet, followed by peeling. The fingernails and toenails can become dark or brittle. Keep nails clean and dry. Notify your health care team if there is any loss of fingernails or toenails.

Fever Without Infection

Chemotherapies can sometimes induce a fever that does not seem to be caused by an infection. If you have a fever of 100.5 degrees or higher, contact your health care team.

Shortness of Breath/Dyspnea

This is a feeling of being short of breath. Report this sensation to your health care team immediately as it may be a sign of something more serious than a side effect.

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.

Mouth or Throat Irritation (Stomatitis)

Stomatitis is the inflammation of the mucous tissue lining the mouth, which is targeted by chemo because of the fast growing cells. This can occur between 5 and 10 days of the start of chemo. Practice good dental hygiene. If sores develop, tell your health care team. You may need medicine if they are painful or keep you from eating.

Nausea/Vomiting

Nausea or vomiting is caused by destruction of normal cells in the stomach lining. This can occur within hours of chemo infusion. It may last a few hours or a few days. Tell your doctor if you experience vomiting. Nausea or vomiting should be prevented or controlled with anti-emetics, but 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.

Headache

Mild to moderate headaches can occur with Gemcitabine. Remember to drink fluids while undergoing chemotherapy to help flush it from your body. Report this to your doctor so that any other causes of headache can be ruled out.

Neuropathy

Neuropathy is damage to the nerves in the hands and feet, causing numbness. Gemcitabine 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.

Liver Function

Gemcitabine 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.

Fluid Retention

This is cumulative and more common after 4 courses of chemo. Fluid retention can be reduced with preventive steroids. A corticosteroid, such as dexamethasone, also known as Decadron, is commonly used to prevent fluid retention while on this chemotherapy.

Aches and Pains

Gemcitabine is 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 doctor.

References

http://www.gemzar.com/pat/pat100_non-small_cell_lung_cancer.jsp

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a696019.html