Modified de Gramont Regime

Contact: (0191) 2563536/2563682 - Day Unit 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.
Treatment: Your doctor has prescribed for you chemotherapy drug known as:

Fluorouracil. Folinic Acid

These drugs are administered in the form of an intravenous injection, a ‘drip’ into the line in your vein and a continuous infusion via an infusor which you take home on Day 1 and return with on Day 3 (one cycle). You will be asked to attend the unit every two weeks for treatment for 6 to 12 cycles.

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)
A small number of patients may experience some nausea as a result of this treatment but effects are usually mild. You will be given some anti-sickness tablets to take home. If you do feel very sick contact the day unit or your GP as your anti -sickness medication may need to be changed or increased.

Sore Mouth
Following treatment you may develop a sore mouth and may notice mouth ulcers. To prevent any mouth ulcers becoming infected you should use an anti-bacterial mouthwash. Ask your doctor or nurse to recommend one that is suitable.

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. This skin discoloration may fade over time.

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.

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 dizzy, out of breath or unusually tired 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 nosebleeds, bruising or bleeding gums.

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 through a plastic needle inserted directly into a vein, this needle is known as a cannula. It is therefore very important that good venous access is found (a good vein in which to put the cannula) 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
Many people feel tired and have low energy levels whilst undergoing chemotherapy. There is very little you can do to avoid this but research has shown that patients who suffer fatigue need to take gentle exercise and rest often. This feeling of fatigue is quite normal and energy levels will begin to improve once treatment is completed.
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:

 
Mon-Thurs 8.00am - 6.00pm Day Unit ward 36 tel. 0191 2563536/2563682
Friday 8.00am - 4.30pm
Outside these hours Wards 37/38 tel. 0191 2563537/2563538

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 in formation booklet free of charge. The telephone number is Freephone 0808 800 1234.