Trabectedin is a chemotherapy drug used to treat advanced soft tissue sarcoma. It can also be used to treat some cases of ovarian cancer. In this information, we focus on its use to treat soft tissue sarcomas.
HOW IS TRABECTEDIN ADMINISTERED?
You will be given trabectedin in the chemotherapy unit. A chemotherapy nurse will give it to you.
Before the day of treatment, a nurse will take a blood sample from you to see if you are fit for chemotherapy.
You will also be able to see a doctor or nurse before having chemotherapy. They will ask you how you have been feeling. If the results of your blood test are good on the day of your treatment, the pharmacist will prepare your chemotherapy.
Your nurse will give you a steroid intravenously 30 minutes before you are to receive trabectedin; steroids are given to help control nausea and prevent allergic reactions.
YOUR TREATMENT COURSE
Trabectedin infusion takes about 24 hours. The drug can be placed inside a small portable pump. This is joined to the central line and can be taken home with your while the drug is being infused. Infusion is repeated every three weeks; this is known as one drug cycle. You may sometimes have to remain in the hospital overnight.
WHEN THE CHEMOTHERAPY IS GIVEN - ALLERGIC REACTIONS
Some people may have an allergic reaction while receiving the chemotherapy. Your nurse will see if there are signs of this, and if you have a reaction they will treat it quickly. Let them know if you develop a rash, itchiness, fever, shortness of breath, dizziness, headache, or any other symptom.
POSSIBLE SIDE EFFECTS OF TRABECTEDIN
You may experience some of the side effects mentioned here, though it is rare for a patient to have all of them. If you receive other chemotherapy drugs, you may have other side effects that are not mentioned here. Always inform your doctor of the effects you experience.
Your doctor can prescribe medication to help control some of the side effects. It is very important to take the medication exactly as your doctor says for it to have the highest chance of working well. Your nurse will advise you on managing the side effects. After treatment, the side effects start to get better.
RISK OF INFECTION
Trabectedin may lower the number of white blood cells in your blood. This will make you more susceptible to infection. Your nurse can tell you when you might have the lowest levels of these cells. When the number of white blood cells is low, this is called neutropenia.
Contact your hospital immediately if any of the following happens:
- your temperature goes above 38 ° C
- you suddenly feel unwell, even if your temperature is normal.
- You have symptoms of infection, which may include sore throat, coughing, or the need to urinate frequently.
The number of white blood cells normally increases gradually, returning to normal before your next chemotherapy session. You will have a blood test before your next chemotherapy. If your white blood cells are still low, your doctor may postpone the treatment for a short period of time.
BRUISING AND BLEEDING
Trabectedin may lower the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any unexplained bleeding or bruising. This includes nosebleeds, bleeding gums, blood spots, or skin eruptions (rashes). Some people may require additional platelets.
Trabectedin may lower the number of red blood cells in your blood. Red blood cells transport oxygen throughout the body. If you have a low number of red blood cells, you may be tired and short of breath. Tell your doctor or nurse if you feel like this. If you are very anemic, it's possible you will require a blood transfusion.
This can happen on the first few days after chemotherapy. Your doctor will prescribe you antiemetic drugs to help prevent or control your nausea. It is easier to prevent nausea than it is to treat it once it has begun.
If you still have nausea or are vomiting, get in touch with the hospital as soon as possible. They can give you advice and change your medication to one that works better.
Feeling very tired is a common side effect. Fatigue is often worst toward the end of treatment and for a few months after the treatment has finished. Try to pace yourself and rest as much as you need to. Help balance this with a bit of light exercise, such as short walks. If you feel drowsy, don't drive or operate heavy machinery.
Trabectedin can cause constipation and abdominal pain. Drinking at least two liters of fluids each day will help if this is the case. Try to eat more high-fiber foods such as fruit, vegetables, and whole-grain bread and get some light exercise.
If you have not had a bowel movement in two days, contact your hospital for advice. Your doctor can prescribe laxatives to help with this.
LOSS OF APPETITE
You may lose your appetite during the treatment. Try to eat in small quantities and have frequent meals. Don't worry if you don't eat much for a day or two. If your appetite doesn't get any better after a few days, tell your nurse or dietitian. They can give you nutritional supplements or good-tasting meal-replacement drinks.
Your doctor can prescribe medicines to control diarrhea. Let them know if your diarrhea is severe or if it doesn't get better. Make sure you drink at least two liters of fluids each day if you have diarrhea.
SORENESS OF THE MOUTH
You may have a sore mouth or mouth ulcers, which could make you more prone to getting a mouth infection. Lightly brush your teeth and/or dentures in the morning and night and after meals. Use a soft-bristle toothbrush. Your nurse might ask you to rinse your mouth out regularly or use mouthwash. It is important that you follow all the instructions you are given and that you drink a lot of fluids.
Tell your nurse or doctor if you have any mouth problems. They can prescribe you drugs to prevent or treat infections of the mouth and to treat any kind of pain.
Tell your doctor or nurse if you have headaches. They can prescribe mild painkillers to help.
CHANGES IN THE LIVER
Trabectedin can cause changes in the way your liver works, although this will return to normal once your treatment is over. It is very unlikely you will notice any problems, though your doctor will take periodic blood samples to check whether your liver is working properly. If you see that the whites of your eyes or your skin turns yellow, tell your doctor or nurse immediately.
Trabectedin can affect the functioning of your kidneys. These changes are normally mild and return to normal after the treatment. You will have blood tests done to see how your kidneys are working. Your nurse will ask you to drink lots of fluids.
PAIN AND REDNESS IN THE PALMS OF THE HANDS AND SOLES OF THE FEET
This is known as palmar-plantar syndrome or hand-foot syndrome. This gets better when the treatment ends. Your doctor or nurse can prescribe creams to improve the symptoms. It may help to keep your hands and feet cool and avoid wearing tight-fitting socks, shoes, and gloves.
LESS COMMON SIDE EFFECTS OF TRABECTEDIN
Your hair may thin out, though it is unlikely you will lose all of the hair on your head. Hair loss normally starts after your first or second cycle of chemotherapy. It is almost always temporary, and the hair will continue to grow after you finish your treatment. Your nurse can give you advice on how to cope with losing your hair.
Trabectedin can cause changes in the lungs. Always let your doctor know if you have wheezing, coughing, fever, or if you are out of breath. If necessary, tests can be done to check your lungs.
MUSCLE PAIN AND WEAKNESS
You may have pain in your joints or muscles for a few days after chemotherapy. Tell your doctor if this happens so they can prescribe you some painkillers. Let them know if your pain doesn't go away. Try to get lots of rest. Taking warm baths on a regular basis can help.
MORE INFORMATION ABOUT TRABECTEDIN
BLOOD CLOT RISK
Cancer and chemotherapy increase the chances of a blood (thrombosis). The symptoms include pain, reddening or swelling in a leg, difficulty breathing, and pain in the chest. Get in touch with your doctor immediately if you have any of these symptoms.
Some medicines can interact with chemotherapy or be harmful if they are taken alongside chemotherapy. This includes medications that can be purchased in a store or pharmacy. Tell your doctor the medicines you are taking, including over-the-counter medications, complementary therapies, and herbal medicines.
You should refrain from having alcohol while taking trabectedin.
Trabectedin may affect your fertility. If this worries you, you can talk to your doctor before beginning treatment.
Your doctor will advise you not to become pregnant during the treatment. This is because the drugs can harm developing babies. It is important to use contraception during chemotherapy and for a few months after the treatment ends.
If you have sex within the first few days after chemotherapy, it is necessary to use a condom. This is to protect your partner in case there is chemotherapy in semen or vaginal fluid.
Women are recommended not to breastfeed during treatment and for a few months after chemotherapy has concluded. This is in case the chemotherapy enters their breast milk.
MEDICAL AND DENTAL TREATMENT
If you have to go to the hospital for whatever reason other than cancer, always tell the doctors and nurses that you are having chemotherapy.
Talk to your cancer doctor or nurse if you think you need dental treatment. Always let your dentist know that you are having chemotherapy.