Lokich

Contact: (0191) 2563536 or 2563682 - Chemotherapy Day Unit on Ward 36

This information sheet is offered as a guide to you and your family. Your treatment will be fully explained by your doctor or nurse, who will be happy to answer any questions.
Your treatment: Your doctor has prescribed a course of chemotherapy for you known as the Lokich regimen. Treatment involves giving a continuous infusion of hemotherapy, which is carried with you for 12 to 24 weeks. The drug in the infusion is known as:

Fluorouracil
Fluorouracil (5FU) is administered continuously via a central venous catheter or long line. Your doctor or nurse will give you separate information about the type of long line needed. The drug is administered via a pump, a small plastic bottle, which will be attached to the end of your long line. You will be supplied with a holder in which your pump can be carried whilst you are undergoing treatment. You will be asked to attend the unit every week for renewal of your ‘pump’.

As each patient is an individual your experience will be different to other patients receiving chemotherapy. Common side effects that you MAY experience during treatment are:

Nausea and vomiting (sickness)
The severity of any nausea and vomiting will vary from person to person. You will be given some anti-sickness tablets to take home. If you continue to feel sick, contact the day unit or your GP as your anti-sickness medication may need to be changed or increased.

Bone Marrow Suppression
Your bone marrow is where your blood cells are made (these are the red cells, white cells, and platelets) to replace those naturally worn out by the body. Chemotherapy interferes with this process and the number of the cells in your blood can become lower than normal. This means following your treatment you could become.

Prone to infection: White cells fight infection a low white count can make you prone to infection. You may develop a sore throat, cough, high temperature, shivering or other
symptoms, which may be due to infection.

If you develop a high temperature, shivering or any symptoms, which may be due to an infection, immediately contact your GP or NCCT. A raised temperature is:

Above 38C (100.4F) at any time or
Above 37.5C (99.5F) at any two readings, taken an hour or more apart.

Anaemia: Red cells carry oxygen around your body a shortage of these cells is called anaemia. You may feel unusually tired, feel dizzy or out of breath and you may look pale.

Prone to bleeding: Platelets help to clot your blood and slow down bleeding. A low platelet count may make you prone to bleeding, this usually takes the form of nose- bleeds, bruising or bleeding gums.

You will have a routine blood test prior to each treatment to monitor the effects of the chemotherapy. Please contact your GP or the unit if you experience any of these symptoms.

Sore Mouth
Chemotherapy can cause your mouth to become sore and you may notice mouth ulcers. To prevent the mouth ulcers from becoming infected you should use an anti-bacterial mouthwash. Ask your doctor or nurse to recommend one that is suitable. Please let your doctor or nurse know if you do develop mouth ulcers with treatment as your dosage may be changed to prevent this reoccurring.

Diarrhoea
Occasionally this treatment can cause irritation of the bowel lining. If you do experience diarrhoea please inform your nurse or doctor so appropriate treatment can be given.

Changes in Nails and Skin
Your nails may discolour or develop ridges. These changes may or may not grow out. You may also experience darkening of your veins in the area where the drug was given.

Hand - Foot Syndrome
Your skin may become quite dry when having treatment over a prolonged period of time. Skin on hands and feet can become red and tender. Occasionally blistering and numbness can occur. Please mention any of these symptoms to your doctor or nurse.

Extravasation
The drugs you are about to receive are known as “ cytotoxic “ or “chemotherapy” drugs. Very few of these drugs may be given by mouth and most need to be administered directly into the blood stream. It is therefore very important that good venous access is found so that chemotherapy may be given directly into a vein. It should not cause pain on administration and often the only sensation you may experience is a “coldness “ running up your arm. If the drip had displaced itself from the vein an “extravasation” could occur where chemotherapy is administered outside the vein, causing damage to the surrounding tissues. This happens very rarely. Indications are pain around the cannula site, redness or swelling. Your nurse will of course be looking for any signs of extravasation throughout the time your chemotherapy is in progress but it is essential that you inform your nurse if problems arise. Very occasionally patients may notice pain and discomfort around the area only after their chemotherapy has been completed. This also must be reported immediately so that appropriate treatment may be prescribed.

Fatigue
One of the more common side effects of chemotherapy is a feeling of tiredness and fatigue. You may find having low energy levels tedious and frustrating but there is little you can do to alleviate this feeling as treatment continues. Accept it as a temporary side effect: give yourself time to rest and accept any offers of help from family and friends with routine housework or chores.

Central Line Complications
There has been a great deal of research on catheter placement and care over the last few years. One of the complications can be a clot forming around some part of the catheter. The incidence of this quite low in a small thin lines like PICC, s but higher in slightly larger lines. As an added protection your doctor may feel you should take a small dose of Warfarin whilst the line remains in position. This will be discussed with you after the procedure. Other complicationswith central lines can be due to infection and the line will be flushed and dressed weekly. More information, both verbal and written about your central line, its insertion and continued care will be discussed separately in more detail by your doctor and nurse.

Please remember side effects are usually temporary. If you experience any of them, discuss them with your doctor or nurse.

If you have any questions or concerns regarding your treatment please contact:

Chemotherapy Day Unit on Ward 36
Mon - Thurs. 8.00am - 6.00pm, Fri. 8.00am - 4.30pm
0191-2563536 or 0191-2563682
After hours Wards 37/38 tel. 0191-2563537/8
Or switchboard 0191-2336161 and ask for the doctor on call.

N.B. If you require further information regarding the drugs you receive British Association of Cancer United Patients and their Families and Friends (BACUP) produce an information booklet free of charge. The telephone number is Freephone 0800 800 1234