Patient comments


Jargon buster


Fludarabine / Cyclophosphamide

Introduction Show [+]Hide [-]

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 for you a regime (treatment) known as Fludarabine/Cyclophosphamide. This treatment is given in 21-day cycles (a maximum of six). The number of days prescribed will be discussed with you by the doctor and nurse. This treatment can only be prescribed by your hospital doctor.

These drugs come in tablet form and should be swallowed whole before or after food. The dosage and time you should take the drugs will be printed on the boxes. This will be checked with you by a nurse after collection from pharmacy. If you miss a dose or take too many please ring the unit.

You will be given a personal chemotherapy book in which your blood counts, drugs and dosages are written. A full blood count is taken prior to each treatment to ensure your blood count has recovered enough to offer you the next course.

Common side effectsShow [+]Hide [-]

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. An anti-sickness injection will be administered prior to your chemotherapy. You will also be given some antisickness tablets to take home. If you continue to feel sick, contact the day unit 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. Very hot spicy foods should be avoided. To help prevent oral infections brush your teeth regularly (at least twice a day) and drink plenty of fluids. 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. Occasionally during treatment you may experience a strange taste sometimes described as a metallic or bitter. A strong flavoured sweet or mint may help disguise this.

• 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. A normal temperature is between 36°C and 37°C. A raised temperature is:

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

• Anaemic: 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 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 Ward 6b or Ward 8 if you experience any of these symptoms.

• Hair loss
Hair loss is unusual with this treatment. However if you do experience hair loss please remember that this is a temporary side effect and your hair will grow back when your treatment is completed. Your nurse will arrange for you to be provided with a wig if required. A scalp cooling service to prevent or reduce hair loss is available in this trust but is located at the Northern Centre for Cancer Treatment (NCCT) .If you wish to have further details please ask your nurse or doctor.
If you do experience hair loss then it will re-grow once the treatment has stopped. If needed you will be supplied with a wig free of charge. An information sheet is available re managing hair loss.

• Sex, pregnancy and family planning
If you are having chemotherapy it doesn’t mean that you shouldn’t have sex, but you may not feel like it. If there is a chance of pregnancy, you must use effective contraception while on chemotherapy. If you suspect that you or your partner may be pregnant please tell your doctor immediately. Chemotherapy may affect your ability to have children in the future – please discuss this with your doctor or chemotherapy nurse before treatment.

• 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.

• Cystitis
Cyclophosphamide may cause a burning sensation or irritation on passing urine because the drug irritates the bladder wall. To prevent cystitis drink a large glass of water both before and after treatment with this drug. Also, try to pass urine as soon as the urge is felt.

• Diarrhoea
Diarrhoea may be experienced however this can be controlled with medication. Please inform the doctor if it is persistent or severe. It is important to increase your intake of fluid if you have diarrhoea to prevent dehydration.

• Nail ridging
The chemotherapy can cause your fingernails to develop ridges. This is temporary and the ridging will grow out.

• Skin colouring
Sometimes as a result of the chemotherapy, your skin may appear darker in colour or lightly tanned, especially around the joints. This is known as hyperpigmentation. The skin will return to normal when treatment is finished.

After your TreatmentShow [+]Hide [-]

Please note that alcohol is best avoided for 48 hours after completing each course of treatment.

Contact numbers

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

  • Ward 6b Monday to Friday, 8.00am to 5.00pm - tel: 0191 282 4388
  • Ward 8 Available at all times - tel: 0191 282 5008

Further information

For further information regarding the drugs you receive, contact Macmillan Cancer Support.

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