Taxol is a drug that can be administered either as a single agent or in combination with carboplatin.
The route of administration is intravenous and the administration schedule is one day every 3 weeks or a weekly dosage (once a week). The clinician chooses the administration schedule based on the patient’s general condition and any comorbidities. There are no significant differences between the two schedules of administration in terms of efficacy, but only of tolerability (weekly administration is associated with fewer side effects than the thrice per week one).
Potential side effects of Taxol
- Temporary reduction of bone marrow function. Paclitaxel can cause anemia, a tendency to develop bruising, or bleeding and infections. Reduced bone marrow function may occur approximately seven days after drug administration, usually reaching minimum values 10-14 days after chemotherapy. The blood cell count starts to rise constantly and normalizes within 21 days.
The oncologist will be able to tell you the chances that your blood cell count will decrease following chemotherapy. You will undergo periodic blood tests to check bone marrow function.
If the temperature rises above 38° C or if you develop bruising or bleeding without an apparent reason, or if you suddenly do not feel well even if the temperature is normal, immediately contact the oncologist or hospital.
- Pain or ulcers of the oral cavity. Usually within the first 7-8 days. If you experience a painful sensation in your mouth or notice small ulcers, inform the oncologist, who can advise you on the most appropriate remedies for your case. Possible toothache may also occur.
- Diarrhea. It develops in very rare cases. It can be easily controlled with medication but inform the oncologist if it is severe or persistent. In case of diarrhea, you have to drink a lot to replenish lost fluids.
- Hair loss. It usually develops 2-3 weeks after the first dose of paclitaxel is given, but it can also occur earlier. You might notice that even the eyelashes, eyebrows and other body hair thin out and fall. In any case, it is a temporary phenomenon: the hair will grow back once the treatment is complete. Sometimes hair loss could be preceded by pain in the scalp.
- Joint or muscle pain. Localized shoulder and positional pain may occur few days after drug administration. They usually don’t last long. The oncologist will certainly be able to prescribe analgesics or anti-inflammatory drugs that relieve pain.
- Skin manifestations. Paclitaxel can cause a skin rash, similar to acne, which can itch. The oncologist will be able to prescribe the appropriate medications to alleviate the discomfort.
- Numbness or tingling in the hands and feet. It is determined by the action of paclitaxel on the nerves. You may notice that you have difficulty buttoning your clothes or writing correctly. If you experience a numbness or tingling sensation in your hands or feet, inform the oncologist. The situation gradually improves within a few months after the end of the treatment.
- Headache. Some patients report headaches during paclitaxel therapy. Sometimes you may have difficulty concentrating or amnesia. Inform the oncologist if a headache develops during therapy.
- Allergic reaction. Signs of an allergic reaction include rash and itching, rising temperature, chills, flushing, dizziness, headache, shortness of breath, anxiety and more frequent urination. The oncologist will keep you under surveillance during treatment to identify any signs of an allergic reaction. Inform the oncologist and/or nurse if you notice any signs of an allergic reaction. Before you are treated with paclitaxel you will be given medications by mouth to prevent the allergic reaction. In this case it is important that you follow the instructions given by the oncologist and/or nurse.
- Nausea and vomiting. Anti-emetics are very effective drugs that can prevent or significantly reduce nausea and vomiting. If nausea occurs anyway despite taking these medications, it will occur within a few hours after treatment and last for a few days. If the nausea is not controllable or persists, inform the oncologist, who will not hesitate to prescribe another more effective antiemetic.
Less frequent side effects
- Lowering of blood pressure. Your blood pressure will be kept under control for the duration of the treatment. Inform the oncologist if you feel weak or dizzy.
- Heart rate changes. Paclitaxel sometimes slows the heart rate (bradycardia), a phenomenon that usually has no consequences.
- Liver function may be temporarily reduced. Paclitaxel can alter liver function, which will still normalize at the end of treatment. This will hardly give you problems, but the oncologist will keep you under strict surveillance. You will be periodically subjected to blood sampling to check liver function.
- Abdominal pain. It may occur a few days after the end of chemotherapy and may be persistent. In this case the oncologist will prescribe analgesics to reduce discomfort.
- Temporary alteration of taste. The dietitian or a specialized nurse will be able to give you the most appropriate advice for your case.
If you experience pain in the area around the puncture site or around the vein during administration, immediately inform the oncologist or nurse, who will slow down the infusion to reduce discomfort.
Some medicines may interfere when you are on chemotherapy. For this reason, consult the oncologist before taking other drugs.
Fertility. The drug can affect the ability to conceive. It is important that you deal with fertility problems with the oncologist before treatment begins.
Contraception. It is not advisable to start a pregnancy or conceive a child if you are being treated with paclitaxel, as the drug could compromise fetal development. Again, discuss this openly with your oncologist.