Cervical cancer occurs when abnormal cells on

the cervix grow out of control. The cervix is the lower part of
the uterus that opens into the vagina. Cervical cancer can
often be successfully treated when it's found early. It is
usually found at a very early stage through a Pap test.
Cervical cancer is one of the most common cancers in
women worldwide. But in the United States and other
countries where cervicalcancer screening is routine,
this cancer is not so common.1
Most cervical cancer is caused by a virus called human
papillomavirus, or HPV. You can get HPV by having sexual
contact with someone who has it. There are many types of
the HPV virus. Not all types of HPV cause cervical cancer.
Some of them cause genital warts, but other types may not
cause any symptoms.
Most adults have been infected with HPV at some time. An
infection may go away on its own. But sometimes it can
cause genital warts or lead to cervical cancer. That's why it's
important for women to have regular Pap tests. A Pap test
can find changes in cervical cells before they turn into
cancer. If you treat these cell changes, you may prevent
cervical cancer.
Abnormal cervical cell changes rarely cause symptoms. But
you may have symptoms if those cell changes grow into
cervical cancer. Symptoms of cervical cancer may include:

Bleeding from
the vagina that is not
normal, such as bleeding
between menstrual
periods, after sex, or
after menopause.

Pain in the lower belly or

pelvis.

Pain during sex.

Vaginal discharge that

isn't normal.
As part of your regular pelvic exam, you should have a Pap
test. During a Pap test, the doctor scrapes a small sample of
cells from the surface of the cervix to look for cell changes. If
a Pap test shows abnormal cell changes, your doctor may
do other tests to look for precancerous or cancer cells on
your cervix.
Your doctor may also do a Pap test and take a sample of
tissue (biopsy) if you have symptoms of cervical cancer,
such as bleeding after sex.

Causes and risk factors for cervicalcancer have

been identified and include human papillomavirus
(HPV) infection, having many sexual
partners, smoking, taking birth control pills, and
engaging in early sexual contact.

HPV infection may cause cervical dysplasia, or

abnormal growth of cervical cells.

Regular pelvic exams and Pap testing can detect

precancerous changes in the cervix.

Precancerous changes in the cervix may be

treated with cryosurgery, cauterization, or laser
surgery.

The most common symptoms and signs of cervical

cancer are abnormal vaginal bleeding, increased
vaginal discharge, bleeding after going through
menopause, pain during sex, and pelvic pain.

Cervical cancer can be diagnosed using a Pap

smear or other procedures that sample the cervix
tissue.

Chest X-rays, CT scan, MRI, and a PET scan may

be used to determine the stage of cervical cancer.

Cancer of the cervix requires different treatment

than cancer that begins in other parts of the uterus.

Treatment options for cervical cancer

include radiation therapy, surgery, and chemotherapy.
Two vaccines, Gardasil and Cervarix, are available
to prevent HPV infection.
The prognosis of cervical cancer depends upon
the stage and type of cervical cancer and
the tumor size.

The Bartholin's (BAHR-toe-linz) glands are located

on each side of the vaginal opening. These glands
secrete fluid that helps lubricate the vagina.
Sometimes the openings of these glands become
obstructed, causing fluid to back up into the gland.
The result is relatively painless swelling called a
Bartholin's cyst. If the fluid within the cyst becomes
infected, you may develop a collection of pus
surrounded by inflamed tissue (abscess).
A Bartholin's cyst or abscess is common.
Treatment of a Bartholin's cyst depends on the
size of the cyst, how painful the cyst is and
whether the cyst is infected.
Sometimes home treatment is all you need. In
other cases, surgical drainage of the Bartholin's
cyst is necessary. If an infection occurs, antibiotics
may be helpful to treat the infected Bartholin's
cyst.

If you have a small, noninfected Bartholin's cyst, you may not

notice it. If the cyst grows, you might feel a lump or mass
near your vaginal opening. Although a cyst is usually
painless, it can be tender.
A full-blown infection of a Bartholin's cyst can occur in a
matter of days. If the cyst becomes infected, you may
experience:

A tender, painful lump near the vaginal opening

Discomfort while walking or sitting

Pain during intercourse

Fever
A Bartholin's cyst or abscess typically occurs on only one
side of the vaginal opening.
The ovaries are two small organs located on either side of the
uterus in a womans body. They make hormones,
including estrogen, which trigger menstruation. Every month,
the ovaries release a tiny egg. The egg makes its way down the
fallopian tube to potentially be fertilized. This cycle of egg
release is called ovulation.
What causes ovarian cysts?
Cysts are fluid-filled sacs that can form in the ovaries. They
are very common. They are particularly common during the
childbearing years.
There are several different types of ovarian cysts. The most
common is a functional cyst. It forms during ovulation. That
formation happens when either the egg is not released or the

sac -- follicle -- in which the egg forms does not dissolve after
the egg is released.
Other types of cysts include:

information also helps them plan exactly when each of the

drugs should be given (in which order and how often).

Polycystic ovaries. In polycystic ovary

syndrome (PCOS), the follicles in which the eggs normally
mature fail to open and cysts form.
Endometriosis. In women with endometriosis,
tissue from the lining of the uterus grows in other areas of the
body. This includes the ovaries. It can be very painful and can
affect fertility.
Cystadenomas. These cysts form out of cells on the
surface of the ovary. They are often fluid-filled.
Dermoid cysts. This type of cyst contains tissue
similar to that in other parts of the body. That
includes skin, hair, and teeth.

Alkylating agents

What causes ovarian tumors?

Tumors can form in the ovaries, just as they form in other
parts of the body. If tumors are non-cancerous, they are said
to be benign. If they are cancerous, they are called malignant.
The three types of ovarian tumors are:

Epithelial cell tumors start from the cells on the

surface of the ovaries. These are the most common type of
ovarian tumors.
Germ cell tumors start in the cells that produce the
eggs. They can either be benign or cancerous. Most are
benign.
Stromal tumors originate in the cells that produce
female hormones.
Doctors arent sure what causes ovarian cancer. They have
identified, though, several risk factors, including:

Age -- specifically women who have gone

through menopause
Smoking
Obesity
Not having children or not breastfeeding (however,
using birth control pills seems to lower the risk)
Taking fertility drugs (such as Clomid)
Hormone replacement therapy
Family or personal history of ovarian, breast,
or colorectal cancer(having the BRCA gene can increase the
risk)
Exams and Tests
Treatment Overview
PreventionHome TreatmentMedicationsSurgeryTypes of
chemotherapy drugs
Chemotherapy drugs can be divided into several groups
based on factors such as how they work, their chemical
structure, and their relationship to another drug. Some drugs
act in more than one way, and may belong to more than one
group.
Knowing how the drug works is important in predicting side
effects. This helps doctors decide which drugs are likely to
work well together. If more than one drug will be used, this

Alkylating agents directly damage DNA (the genetic material

in each cell) to keep the cell from reproducing. These drugs
work in all phases of the cell cycle and are used to treat
many different cancers, including leukemia, lymphoma,
Hodgkin disease, multiple myeloma, and sarcoma, as well
as cancers of the lung, breast, and ovary.
Because these drugs damage DNA, they can cause longterm damage to the bone marrow. In rare cases, this can
lead to acute leukemia. The risk of leukemia from alkylating
agents is dose-dependent, meaning that the risk is small
with lower doses, but goes up as the total amount of the
drug used gets higher. The risk of leukemia after getting
alkylating agents is highest about 5 to 10 years after
treatment.
Alkylating agents are divided into different classes, including:

Nitrogen mustards: such as mechlorethamine

(nitrogen mustard), chlorambucil, cyclophosphamide
(Cytoxan), ifosfamide, and melphalan
Nitrosoureas: such as streptozocin, carmustine
(BCNU), and lomustine
Alkyl sulfonates: busulfan
Triazines: dacarbazine (DTIC) and temozolomide
(Temodar)
Ethylenimines: thiotepa and altretamine
(hexamethylmelamine)

The platinum drugs (such as cisplatin, carboplatin, and

oxalaplatin) are sometimes grouped with alkylating agents
because they kill cells in a similar way. These drugs are less
likely than the alkylating agents to cause leukemia later.

Antimetabolites
Antimetabolites interfere with DNA and RNA growth by
substituting for the normal building blocks of RNA and DNA.
These agents damage cells during the S phase, when the
cells chromosomes are being copied. They are commonly
used to treat leukemias, cancers of the breast, ovary, and
the intestinal tract, as well as other types of cancer.
Examples of antimetabolites include:

5-fluorouracil (5-FU)
6-mercaptopurine (6-MP)
Capecitabine (Xeloda)
Cytarabine (Ara-C)
Floxuridine
Fludarabine
Gemcitabine (Gemzar)
Hydroxyurea
Methotrexate
Pemetrexed (Alimta)

Anti-tumor antibiotics

Mitotic inhibitors

These drugs are not like the antibiotics used to treat

infections. They work by altering the DNA inside cancer cells
to keep them from growing and multiplying.

Mitotic inhibitors are often plant alkaloids and other

compounds derived from natural products. They work by
stopping mitosis in the M phase of the cell cycle but can
damage cells in all phases by keeping enzymes from making
proteins needed for cell reproduction.
Examples of mitotic inhibitors include:

Anthracyclines
Anthracyclines are anti-tumor antibiotics that interfere with
enzymes involved in DNA replication. These drugs work in all
phases of the cell cycle. They are widely used for a variety of
cancers.
Examples of anthracyclines include:

Daunorubicin
Doxorubicin (Adriamycin)
Epirubicin
Idarubicin

A major concern when giving these drugs is that they can

permanently damage the heart if given in high doses. For
this reason, lifetime dose limits are often placed on these
drugs.
Other anti-tumor antibiotics
Anti-tumor antibiotics that are not anthracyclines include:

Actinomycin-D
Bleomycin
Mitomycin-C
Mitoxantrone (also acts as a topoisomerase II
inhibitor)

Topoisomerase inhibitors
These drugs interfere with enzymes called topoisomerases,
which help separate the strands of DNA so they can be
copied during the S phase. (Enzymes are proteins that
cause chemical reactions in living cells.) Topoisomerase
inhibitors are used to treat certain leukemias, as well as
lung, ovarian, gastrointestinal, and other cancers.
Topoisomerase inhibitors are grouped according to which
type of enzyme they affect:
Topoisomerase I inhibitors include:

Taxanes: paclitaxel (Taxol) and docetaxel

(Taxotere)
Epothilones: ixabepilone (Ixempra)
Vinca alkaloids: vinblastine (Velban), vincristine
(Oncovin), and vinorelbine (Navelbine)
Estramustine (Emcyt)

They are used to treat many different types of cancer

including breast, lung, myelomas, lymphomas, and
leukemias. These drugs may cause nerve damage, which
can limit the amount that can be given.

Corticosteroids
Corticosteroids, often simply called steroids, are natural
hormones and hormone-like drugs that are useful in the
treatment of many types of cancer, as well as other illnesses.
When these drugs are used as part of cancer treatment, they
are considered chemotherapy drugs.
Examples of corticosteroids include:

Prednisone
Methylprednisolone (Solumedrol)
Dexamethasone (Decadron).

Steroids are also commonly used to help prevent nausea

and vomiting caused by chemotherapy. They are used
before chemotherapy to help prevent severe allergic
reactions, too.
Hydrocortisone

Topotecan
Irinotecan (CPT-11).

Topoisomerase II inhibitors include:

Etoposide (VP-16)
Teniposide.
Mitoxantrone (also acts as an anti-tumor antibiotic)

Topoisomerase II inhibitors can increase the risk of a second

cancer acute myelogenous leukemia (AML) as early as 2
to 3 years after the drug is given.

Trade Names: Ala-Cort , Hydrocortone Phosphate, SoluCortef , Hydrocort Acetate , Lanacort

Other Names: Cortisone, Hydrocortisone Sodium
Succinate, Hydrocortisone Sodium Phosphate
Drug Type:
Hydrocortisone has many uses in the treatment of cancer.
Hydrocortisone is used most often as a supportive care
medication. Hydrocortisone is classified as a

glucocorticosteroid. (For more detail, see "How

Important things to remember about Hydrocortisone side

Hydrocortisone Works" section below).

What Hydrocortisone Is Used For:

effects:

As an anti-inflammatory medication.
Hydrocortisone relieves inflammation in various
parts of the body.
To treat or prevent allergic reactions.
As treatment of certain kinds of autoimmune
diseases, skin conditions, asthma and other lung
conditions.
As treatment for a variety of cancers, such as
leukemia, lymphoma, and multiple myeloma.
To treat nausea and vomiting associated with
some chemotherapy drugs.
Used to stimulate appetite in cancer patients with
severe appetite problems.
The lotion (topical) is used in treatment of allergic
skin reactions, and relieves symptoms of itching,
redness, and swelling.
Also used to replace steroids in conditions of
adrenal insufficiency (low production of needed
steroids produced by the adrenal glands).

Note: If a drug has been approved for one use, physicians

sometimes elect to use this same drug for other problems if
they believe it might be helpful.
How Hydrocortisone Is Given:

Hydrocortisone may be given to you in many

forms. In a pill form, it is available in 5 mg, 10 mg,
and 20 mg tablets. If you are on a daily dose of
Hydrocortisone, and you miss a dose, take the
dose as soon as you remember. You may be
instructed to repeat the missed dose, and continue
the medication.
Take pills with food or after meals.
Hydrocortisone may also be given by injection into
the muscle (intramuscular,IM) or into the vein
(intravenously, IV), by a healthcare provider.
Hydrocortisone eye ointment, or eye drops, is
given to treat or prevent many inflammatory eye
conditions.
You may be given Hydrocortisone as a lotion or a
cream (topical) to treat skin disorders.
The amount of Hydrocortisone you will receive
depends on many factors, including your height
and weight, your general health or other health
problems, and the reason you are receiving this
drug. Your doctor will determine your exact
dosage and schedule.

Hydrocortisone Side Effects:

Most people do not experience all of the

Hydrocortisone side effects listed.
Hydrocortisone side effects are often predictable
in terms of their onset and duration.
Hydrocortisone side effects are almost always
reversible and will go away after treatment is
complete.
There are many options to help minimize or
prevent Hydrocortisone side effects.

The following Hydrocortisone side effects are common

(occurring in greater than 30%) for patients taking
Hydrocortisone:

Increased appetite
Irritability
Difficulty sleeping (insomnia)
Swelling in your ankles and feet (fluid retention)
Nausea (take with food)
Heartburn
Muscle weakness
Impaired wound healing
Increased blood sugar levels (persons with
diabetes may need to have blood sugar levels
monitored more closely and possible adjustments
to diabetes medications)

The following are less common Hydrocortisone side effects

(occurring in 10 to 29%) for patients receiving
Hydrocortisone:

Headaches
Dizziness
Mood swings
Cataracts and bone thinning (with long-term use)

This list includes common and less common Hydrocortisone

side effects. Hydrocortisone side effects that are very rare,
occurring in less than 10% of patients, are not listed here.
However, you should always inform your health care provider
if you experience any unusual symptoms.
When To Contact Your Doctor or Health Care Provider:
Contact your health care provider immediately, day or night,
if you should experience any of the following symptoms:

Fever of 100.4 F (38 C), chills (possible signs of

infection)

If you feel an irregular or fast heart beat, shortness

of breath, or chest or jaw pain, seek emergency
help and notify your healthcare provider.
If you become suddenly confused

The following symptoms require medical attention, but are

not emergency situations. Contact your health care provider
within 24 hours of noticing any of the following:

Extreme fatigue (unable to carry on self-care

activities)
Any unusual bleeding or bruising
Black or tarry stools, or blood in your stools or
urine
Nausea (interferes with ability to eat and
unrelieved with prescribed medications)
Vomiting (vomiting more than 4-5 times in a 24hour period)
Dizziness or lightheadedness, feeling faint
Persistent headache
Severe hot flashes or mood swings
Inability to sleep (insomnia)
Severe skeletal (bone) pain
Difficult or painful urination; increased urination, or
severe thirst
Changes in vision, blurred vision, eye pain,
enlarged pupils, discharge
Any new rashes or changes in your skin
Swelling of the feet or ankles. Sudden weight gain
(greater than 3 pounds a week)
Swelling, redness and/or pain in one leg or arm
and not the other

Always inform your health care provider if you experience

any unusual symptoms.
Hydrocortisone Precautions:

Before starting Hydrocortisone treatment, make

sure you tell your doctor about any other
medications you are taking (including prescription,
over-the-counter, vitamins, herbal remedies, etc.).
Do not take aspirin, or products containing aspirin
unless your doctor specifically permits this.
Do not receive any kind of immunization or
vaccination without your doctor's approval while
taking Hydrocortisone.
If you have been on Hydrocortisone pills daily, for
a long period of time, serious side effects may
occur if you discontinue Hydrocortisone abruptly.
Do not stop taking Hydrocortisone unless directed
by your healthcare provider. Do not change the
dose of Hydrocortisone on your own.
Inform your health care professional if you are
pregnant or may be pregnant prior to starting this

treatment. Pregnancy category C (use in

pregnancy only when benefit to the mother
outweighs risk to the fetus).
For both men and women: Do not conceive a child
(get pregnant) while taking Hydrocortisone. Barrier
methods of contraception, such as condoms, are
recommended. Discuss with your doctor when you
may safely become pregnant or conceive a child
after therapy.
Do not breast feed while taking Hydrocortisone.

Dexamethasone Sodium Phosphate

(deks a METH a sone)( SO dee um)(FOSS fate)

Brand names: Decadron, Dexasone, Diodex, Hexadrol,
Maxidex
Other names: dexamethasone sodium phosphate,
dexamethasone acetate
Drug type: Dexamethasone has many uses in the treatment
of cancer. It is classified as a glucocorticosteroid. (For more
detail, see "How this drug works" section below).
What this drug is used for:

As an anti-inflammatory medication.
Dexamethasone relieves inflammation in various
parts of the body. It is used specifically to
decrease swelling (edema), associated with
tumors of the spine and brain, and to treat eye
inflammation.
To treat or prevent allergic reactions.
As treatment of certain kinds of autoimmune
diseases, skin conditions, asthma and other lung
conditions.
As treatment for a variety of cancers, such as
leukemia, lymphoma, and multiple myeloma.
To treat nausea and vomiting associated with
some chemotherapy drugs.
Used to stimulate appetite in cancer patients with
severe appetite problems.
Also used to replace steroids in conditions of
adrenal insufficiency (low production of needed
steroids produced by the adrenal glands).

Note: If a drug has been approved for one use, physicians

sometimes elect to use this same drug for other problems if
they believe it might be helpful.
How this drug is given:

This medication may be given to you in many

forms. In a pill form, it is available in a variety of

tablet sizes. If you are on a daily dose of

dexamethasone (usually less than 10 mg), and
you miss a dose, take the dose as soon as you
remember. If you are on high doses of
dexamethasone (20 mg or 40 mg per day for 4
days out of the month), and you miss your dose,
contact your healthcare provider. You may be
instructed to repeat the missed dose, and continue
the medication.
Take pills with food or after meals
This medication may also be given by infusion into
a vein (intravenously or IV)
Dexamethasone eye drops are given to treat or
prevent many eye conditions. The eye drops are
most commonly given to patients with leukemia or
lymphoma, to prevent inflammation of the eyes
(conjunctivitis), if you are receiving high dose
chemotherapy (usually Cytarabine [Ara-C]). The
eye drops are given every six hours, in both eyes,
and for at least 48 hours after the chemotherapy
has completed. Do not stop taking these eye
drops unless directed by your healthcare provider.
You may be given dexamethasone as a lotion
(topical) to treat skin disorders.
The amount of dexamethasone you will receive
depends on many factors, including your general
health or other health problems, and the reason
you are receiving this drug. Your doctor will
determine your dosage and schedule.

Side effects:
Important things to remember about the side effects of
dexamethasone:

Most people do not experience all of the side

effects listed.
Side effects are often predictable in terms of their
onset and duration.
Side effects are almost always reversible and will
go away after treatment is complete.
There are many options to help minimize or
prevent side effects.

The following side effects are common (occurring in

greater than 30%) for patients taking dexamethasone:

Increased appetite
Irritability
Difficulty sleeping (insomnia)
Swelling in your ankles and feet (fluid retention)
Heartburn
Muscle weakness
Impaired wound healing

Increased blood sugar levels. (Persons with

Diabetes may need to have blood sugar levels
monitored more closely and possible adjustments
to diabetes medications).

The following are less common side effects (occurring

in >10%) for patients receiving dexamethasone:

Headaches

Dizziness

Mood swings

Cataracts and bone thinning (with long-term use)

Trade names: Rheumatrex, TrexallTM
Other names: Amethopterin, Methotrexate Sodium, MTX
Chemocare.com uses generic names in all descriptions of
drugs. Rheumatrex and Trexall are trade names for
Methotrexate. MTX, Amethopterin, and Methotrexate Sodium
are other names for Methotrexate. In some cases, health
care professionals may use the trade names Rheumatrex
and Trexall or other names MTX, Amethopterin, and
Methotrexate Sodium when referring to the generic drug
name Methotrexate.
rug type: Methotrexate is an anti-cancer ("antineoplastic" or
"cytotoxic") chemotherapy drug. This medication is classified
as an "antimetabolite." (For more detail, see "How this drug
works" section below).
What Methotrexate is used for:

Used in the treatment of breast, head and neck,

lung, stomach, and esophagus cancers. Acute
lymphoblastic leukemia (ALL), sarcomas, nonHodgkin's lymphoma (NHL), gestational
trophoblastic cancer, and mycosis fungoides
(cutaneous T-cell lymphoma).
Note: If a drug has been approved for one use, physicians
may elect to use this same drug for other problems if they
believe it may be helpful.
How Methotrexate is given:

As an infusion into the vein (intravenous, IV).

As an injection into the muscle (intramuscular, IM).

Another method it is given is by intraventricular or

intrathecal infusion. This method is used when
drugs need to reach the cerebrospinal fluid (CSF)
the fluid that is surrounding the brain and spinal
cord, the drug is infused directly into the spinal
fluid.

There is also a pill form of methotrexate.

The amount of methotrexate and how it is given

depends on many factors, including your height
and weight, your general health or other health
problems, and the type of cancer or condition
being treated. Your doctor will determine your
dose, schedule and how it is given.
Side effects of Methotrexate:
Important things to remember about the side effects of
methotrexate:

Most people do not experience all of the side

effects listed.

Side effects are often predictable in terms of their

onset and duration.

Side effects are almost always reversible and will

go away after treatment is complete.

There are many options to help minimize or

prevent side effects.

There is no relationship between the presence or

severity of side effects and the effectiveness of the
medication.

The side effects of methotrexate and their severity

depend on how much of the drug is given. In other
words, high doses may produce more severe side
effects.

In some cases leucovorin infusion (see leucovorin)

may be given 24 hours after methotrexate to
lessen the side effects of methotrexate.
The following side effects are common (occurring in
greater than 30%) for patients taking methotrexate:

Low blood counts. Your white and red blood cells

and platelets may temporarily decrease. This can
put you at increased risk for infection, anemia
and/or bleeding.
Nadir: Meaning low point, nadir is the point in time between
chemotherapy cycles in which you experience low blood
counts.

Onset: 7 days
Nadir: 10 days
Recovery: 21 days

Mouth sores. (usually occur 3-7 days after

treatment)

Nausea and vomiting. (uncommon with low dose)

Poor appetite
These side effects are less common side effects
(occurring in about 10-29%) of patients receiving
methotrexate:

Kidney toxicity (see kidney problems) particularly

with high-doses. In severe cases can lead to
kidney failure. Care is taken to make sure patient
is well hydrated with IV fluids before infusion of
high-dose methotrexate.

Skin rash, reddening of the skin (with high doses).

Diarrhea

Hair loss

Eye irritation (conjunctivitis) (see eye problems).

Increases in blood tests measuring liver function,

often seen with high dose treatment. These return
to normal within about 10 days. (see liver
problems).

Darkening of the skin where previous radiation

treatment has been given. (radiation recall - see
skin reactions).

Loss of fertility. Meaning, your ability to conceive

or father a child may be affected by methotrexate.
Discuss this issue with your health care provider.

Side effects specific to intrathecal administration of

methotrexate (the drug is infused directly into the
cerebrospinal fluid (CSF) the fluid that is surrounding
the brain and spinal cord):

Acute chemical arachnoiditis: a syndrome that can

be seen immediately after the infusion of
methotrexate intrathecally. It is an inflammation of
the membrane surrounding the brain and spinal
column. Symptoms are: severe headache, stiff
neck, seizures, vomiting, and fever.

Central neurotoxicity: Less-common, seen with

intrathecal or very high IV dose methotrexate.
Symptoms are; difficulty with speech, paralysis of
the arms and legs, seizures, or coma. This may
develop within 6 days of treatment and resolves
within 48-72 hours.
Not all side effects are listed above. Some that are rare
(occurring in less than 10% of patients) are not listed here.
However, you should always inform your health care provider
if you experience any unusual symptoms.
Carboplatin

Trade name: Paraplatin

Drug type:
Carboplatin is an anticancer drug ("antineoplastic" or
"cytotoxic") chemotherapy drug. Carboplatin is classified as
an "alkylating agent."
What Carboplatin Is Used For:

Carboplatin is used to treat ovarian cancer.

Carboplatin is also used for other types of cancer,
including lung, head and neck, endometrial,
esophageal, bladder, breast, and cervical; central
nervous system or germ cell tumors; osteogenic
sarcoma; and as preparation for a stem cell or
bone marrow transplant.

Note: If a drug has been approved for one use, physicians

may elect to use this same drug for other problems if they
believe it may be helpful.
How Carboplatin Is Given:

Carboplatin is usually given by infusion into a vein

(intravenous, IV).
Carboplatin can also be given intra-peritoneal,
directly into the peritoneal cavity in the abdomen.
The amount of Carboplatin you receive depends
on many factors, including your height and weight,
your general health or other health problems, and

how your body responds to it. Your doctor will

determine your dose and schedule.

Carboplatin Side Effects:

Important things to remember about the side effects of
Carboplatin:

Most people do not experience all of the side

effects listed.
Side effects are often predictable in terms of their
onset and duration.
Side effects are almost always reversible and will
go away after treatment is complete.
There are many options to help minimize or
prevent side effects.
There is no relationship between the presence or
severity of side effects and the effectiveness of
Carboplatin.
The side effects of Carboplatin and their severity
depend on how much of Carboplatin is given. In
other words, high doses may produce more severe
side effects).

The following side effects are common (occurring in greater

than 30%) for patients taking Carboplatin:

Low blood counts (including red blood cells, white

blood cells and platelets)

Nadir: Meaning low point, nadir is the point in time between

chemotherapy cycles in which you experience low blood
counts.
Onset: None reported
Nadir: 21 days
Recovery: 28 days

Nausea and vomiting usually occurring within 24

hours of treatment
Taste changes
Hair loss
Weakness
Blood test abnormalities: Abnormal magnesium
level

These are less common (occurring in 10-29%) side effects

for patients receiving Carboplatin:

Burning sensation at the injection site

Abdominal pain
Diarrhea
Constipation
Mouth sores
Infection

Peripheral neuropathy: Although uncommon, a

serious side effect of decreased sensation and
paresthesia (numbness and tingling of the
extremities) may be noted. Sensory loss,
numbness and tingling, and difficulty in walking
may last for at least as long as therapy is
continued. These side effects may become
progressively more severe with continued
treatment, and your doctor may decide to
decrease your dose.
Central neurotoxicity: Infrequent but patients over
age 65 are at increased risk. Symptoms include
dizziness, confusion, visual changes, ringing in the
ears.
Nephrotoxicity (see kidney problems): More
frequent when Carboplatin is given in high doses
or to people with kidney problems.
Hearing loss (ototoxicity) - loss of high pitched
sounds.
Abnormal blood electrolyte levels (sodium,
potassium, calcium).
Abnormal blood liver enzymes (SGOT, Alkaline
phosphatase) (see liver problems).
Cardiovascular events. Although infrequent, heart
failure, blood clots and strokes have been reported
with Carboplatin use. Less than 1% were lifethreatening.
Allergic reaction may occur. It would occur during
the actual transfusion. This may include itching,
rash, shortness of breath or dizziness (especially
in patients who have received cisplatin).

Not all side effects are listed above, some that are rare
(occurring in less than 10% of patients) are not listed here.
However, you should always inform your health care provider
if you experience any unusual symptoms.
When To Contact Your Doctor or Health Care Provider:
Contact your health care provider immediately, day or night,
if you should experience any of the following symptoms:

Fever of 100.4(F (38(C) or higher, or chills

(possible signs of infection).
Difficulty breathing or shortness of breath.
Chest pain.

The following symptoms require medical attention, but are

not an emergency. Contact your health care provider within
24 hours of noticing any of the following:

Unusual bleeding or bruising

Black or tarry stools, or blood in your stools or
urine
Diarrhea (4-6 episodes in a 24-hour period)

Nausea (interferes with ability to eat and

unrelieved with prescribed medications).
Vomiting (vomiting more than 4-5 times in a 24hour period)
Severe abdominal pain
Lip or mouth sores (painful redness, swelling or
ulcers)
Extreme fatigue (unable to carry on self-care
activities)
Muscle cramps or twitching
Change in hearing
Dizziness, confusion or visual changes

Always inform your health care provider if you experience

any unusual symptoms.
Carboplatin Precautions:
Before starting Carboplatin treatment, make sure
you tell your doctor about any other medications
you are taking (including prescription, over-thecounter, vitamins, herbal remedies, etc. Do not
take aspirin, products containing aspirin unless
your doctor specifically permits this.

Carboplatin may be inadvisable if you have a

history of severe allergic reaction to cisplatin,
Carboplatin, other platinum-containing
formulations or mannitol.

Do not receive any kind of immunization or

vaccination without your doctor's approval while
taking Carboplatin.

Decreased sensation, numbness and tingling in

fingers and toes may become progressively worse
with repeated doses of Carboplatin. It is important
to report this to your doctor.

Inform your health care professional if you are

pregnant or may be pregnant prior to starting this
treatment. Pregnancy category D (Carboplatin
may be hazardous to the fetus. Women who are
pregnant or become pregnant must be advised of
the potential hazard to the fetus).

For both men and women: Do not conceive a child

(get pregnant) while taking Carboplatin. Barrier
methods of contraception, such as condoms, are
recommended. Discuss with your doctor when you
may safely become pregnant or conceive a child
after therapy.

Do not breast feed while taking Carboplatin.

How Carboplatin Works:
Cancerous tumors are characterized by cell division, which is
no longer controlled as it is in normal tissue. "Normal" cells
stop dividing when they come into contact with like cells, a
mechanism known as contact inhibition. Cancerous cells
lose this ability. Cancer cells no longer have the normal

checks and balances in place that control and limit cell

division. The process of cell division, whether normal or
cancerous cells, is through the cell cycle. The cell cycle
goes from the resting phase, through active growing phases,
and then to mitosis (division).
The ability of chemotherapy to kill cancer cells depends on
its ability to halt cell division. Usually, the drugs work by
damaging the RNA or DNA that tells the cell how to copy
itself in division. If the cells are unable to divide, they die.
The faster the cells are dividing, the more likely it is that
chemotherapy will kill the cells, causing the tumor to shrink.
They also induce cell suicide (self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are
dividing are called cell-cycle specific. Chemotherapy drugs
that affect cells when they are at rest are called cell-cycle
non-specific. The scheduling of chemotherapy is set based
on the type of cells, rate at which they divide, and the time at
which a given drug is likely to be effective. This is why
chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly
dividing. Unfortunately, chemotherapy does not know the
difference between the cancerous cells and the normal cells.
The "normal" cells will grow back and be healthy but in the
meantime, side effects occur. The "normal" cells most
commonly affected by chemotherapy are the blood cells, the
cells in the mouth, stomach and bowel, and the hair follicles;
resulting in low blood counts, mouth sores, nausea, diarrhea,
and/or hair loss. Different drugs may affect different parts of
the body.
Chemotherapy (anti-neoplastic drugs) is divided into five
classes based on how they work to kill cancer. Although
these drugs are divided into groups, there is some overlap
among some of the specific drugs. The following are the
types of chemotherapy:
Alkylating Agents
Alkylating agents are most active in the resting phase of the
cell. These drugs are cell-cycle non-specific. There are
several types of alkylating agents.

Mustard gas derivatives: Mechlorethamine,

Cyclophosphamide, Chlorambucil, Melphalan, and
Ifosfamide.

Ethylenimines: Thiotepa and

Hexamethylmelamine.

Alkylsulfonates: Busulfan.

Hydrazines and Triazines: Procarbazine,

Dacarbazine and Temozolomide.

Nitrosureas: Carmustine, Lomustine and

Streptozocin. Nitrosureas are unique because,
unlike most chemotherapy, they can cross the
blood-brain barrier. They can be useful in treating
brain tumors.

Metal salts: Carboplatin, Cisplatin, and

Oxaliplatin.