Chemotherapy Drugs

What Is It?
Chemotherapy is a drug treatment that uses powerful chemicals to kill fast-growing cells in your body.

Chemotherapy is most often used to treat cancer, since cancer cells grow and multiply much more quickly than most cells in the body.

Many different chemotherapy drugs are available. Chemotherapy drugs can be used alone or in combination to treat a wide variety of cancers.

Though chemotherapy is an effective way to treat many types of cancer, chemotherapy treatment also carries a risk of side effects. Some chemotherapy side effects are mild and treatable, while others can cause serious complications.            SOURCE:  MAYO Clinic
Why it's done
Chemotherapy is used to kill cancer cells in people with cancer.

There are a variety of settings in which chemotherapy may be used in people with cancer:

• To cure the cancer without other treatments. Chemotherapy can be used as the primary or sole treatment for cancer.
• After other treatments, to kill hidden cancer cells. Chemotherapy can be used after other treatments, such as surgery, to kill any cancer cells that might remain in the body. Doctors call this adjuvant therapy.
• To prepare you for other treatments. Chemotherapy can be used to shrink a tumor so that other treatments, such as radiation and surgery, are possible. Doctors call this neoadjuvant therapy.
• To ease signs and symptoms. Chemotherapy may help relieve signs and symptoms of cancer by killing some of the cancer cells. Doctors call this palliative chemotherapy.                  SOURCE:  MAYO Clinic

DRUGS that have been given to me:

1.  RITUXAN
Rituxan is not a chemotherapy drug, but it is a type of antibody therapy that can be used alone or with chemotherapy. They work in different ways to find and attack the cells where cancer starts.

RITUXAN targets and attaches to the CD20 protein found on the surface of blood cells with cancer and some healthy blood cells. Once attached to the CD20 protein, RITUXAN is thought to work in different ways including:

• By helping your own immune system destroy the cancer cells
• By destroying the cancer cells on its own

In addition, RITUXAN can also harm healthy cells in your body.

RITUXAN can be an important part of treatment for many patients with NHL and CLL.

Common side effects of Rituxan include:

• headache,
• fever,
• chills,
• stomach pain,
• nausea,
• diarrhea,
• heartburn,
• flushing,
• night sweats,
• weakness,
• muscle or joint pain,
• back pain, or
• dizziness.

2.  CYTOXAN

Generic Name: Cyclophosphamide

Other Trade Name: Neosar®

Cyclophosphamide is the generic name for the trade name drug Cytoxan or Neosar. In some cases, health care professionals may use the trade name Cytoxan or Neosar when referring to the generic drug name cyclophosphamide.

Drug Type: Cyclophosphamide is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. This medication is classified as an "alkylating agent." (For more detail, see "How Cyclophosphamide Works" section below).

What Cyclophosphamide Is Used For
Cancers treated with cyclophosphamide include: Hodgkin's and non-Hodgkin's lymphoma, Burkitt's lymphoma, chronic lymphocytic leukemia (CLL), chronic myelocytic leukemia (CML), acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), t-cell lymphoma (mycosis fungoides), multiple myeloma, neuroblastoma, retinoblastoma, breast cancer, ovarian cancer, and conditioning regimens for bone marrow transplantation

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 Cyclophosphamide Is Given
The amount of cyclophosphamide that you will receive depends on many factors, including your height and weight, your general health or other health problems, and the type of cancer or condition you have. Your doctor will determine your exact dosage and schedule.

Cyclophosphamide can be given by a number of different routes. The route that it is given depends on the dosage, the condition being treated, as well as the purpose it is being used for.
It is usually given through a vein by injection or infusion (intravenous, IV) or by mouth in tablet form, depending upon diagnosis.

Cyclophosphamide is also approved to be given by a shot into a muscle (IM), into the abdominal lining (intraperitoneal, IP), or into the lining of the lung (intrapleural).
Tablets should be given with food or after meals. Tablets should not be cut or crushed.

Side Effects:
Important things to remember about the side effects of cyclophosphamide:
Most people will not experience all of the cyclophosphamide side effects listed.

• Cyclophosphamide side effects are often predictable in terms of their onset, duration, and severity.
• Cyclophosphamide side effects will improve after therapy is complete.
• Cyclophosphamide side effects may be quite manageable. There are many options to minimize or prevent the side effects of cyclophosphamide.

The following side effects are common (occurring in greater than 30%) for patients taking cyclophosphamide:
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.

• Onset: 7 days
• Nadir: 10-14 days
• Recovery: 21 days
• Nadir: Meaning low point, nadir is the point in time between chemotherapy cycles in which you experience low blood counts.

Hair loss: Temporary - usually begins 3-6 weeks after the start of therapy. Hair will grow back after treatment is completed although the color and/or texture may be different.

Nausea and vomiting: more common with larger doses, usually beginning 6-10 hours after therapy.

Poor appetite

Discoloration of the skin or nails

The following are less common side effects (occurring in 10-29%) for patients receiving cyclophosphamide:
Loss of fertility: Your ability to conceive or father a child may be affected by cyclophosphamide. Discuss this issue with your health care provider.

Diarrhea

Mouth sores
Bladder irritation and bleeding (hemorrhagic cystitis) (see bladder problems)

Delayed Effects of Cyclophosphamide:
There is a slight risk of developing a blood cancer such as leukemia or myelodysplasia after taking cyclophosphamide. Talk to your doctor about this risk.

Note: Not all side effects are listed above. Side effects that are very rare - occurring in less than about 10 percent of patients - are not listed here. But you should always inform your health care provider if you experience any unusual symptoms.


3.  FLUDARA

Trade names: Fludara®

Chemocare.com uses generic drug names in all descriptions of drugs. Fludara is the trade name for fludarabine. In some cases, health care professionals may use the trade name fludara when referring to the generic drug name fludarabine.

Drug type: Fludarabine 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 Fludarabine Is Used For:
Treatment of chronic lymphocytic leukemia (CLL), including CLL that has not responded to or reoccurred after standard therapy.

Salvage therapy for non-Hodgkin's lymphoma and acute leukemias.

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 Fludarabine Is Given:
Fludarabine is given through a vein, intravenously, IV.

The amount of fludarabine that you will receive 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 and schedule.

Side Effects:
Important things to remember about the side effects of fludarabine:

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.

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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 fludarabine and their severity depend on how much of the drug 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 fludarabine:

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: none noted
Nadir: 10-14 days
Recovery: 14-21 days

• Fever
• Infection
• Weakness
• Cough
• Nausea and vomiting
• Poor appetite

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

• Chills
• Fatigue
• Pain
• Sweating
• Numbness and tingling of hands and feet
• Shortness of breath (see lung problems)
• Diarrhea
• Rash (see skin reactions
• Swelling
• Taste changes, metallic taste

Other side effects:
Increased risk of infection (such as herpes, fungal infection, and Pneumocystis carinii) due to suppression of the immune system. Antibiotics are often given to prevent or protect from these infections while receiving fludaribine.

Although rare at regular dosages, severe central neurotoxicity may be seen in high dose treatment. Symptoms such as weakness, agitation, confusion, seizures, and/or coma. 

 
Hemolytic anemia has rarely occurred in people receiving one or more cycles of fludarabine. Patients are monitored for this condition.

Your fertility, meaning your ability to conceive or father a child, may be affected by fludarabine. Please discuss this issue with your health care provider.

Tumor lysis syndrome may occur as a result of leukemia treatment. Tumor lysis syndrome occurs when large amounts of cancerous cells are rapidly killed by the therapy. These cells release uric acid, potassium and phosphorus into the blood stream. Tumor lysis syndrome can lead to kidney failure.

Tumor lysis syndrome usually occurs within 24 - 48 hours of therapy. Care must be taken to prevent the development of tumor lysis syndrome. Your health care provider will prescribe plenty of fluids to keep you hydrated. You may be given a drug called allopurinol that blocks uric acid production. In some cases, your health care provider may prescribe other measures to lower your white blood count before therapy. 

Let your health care provider know immediately if you are unable to urinate. Your health care provider will monitor your progress carefully during therapy. This is rarely seen and most often in the setting of high tumor cell burden.

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.

4.  TREANDA

Generic Name: Bendamustine hydrochloride
Trade Name(s): Treanda®

Treanda® is the trade name of the chemotherapy drug bendamustine . In some cases, health care professionals may use the trade name Treanda ® when referring to the generic drug name bendamustine.

Drug Type:
Treanda is an anti-cancer ("antineoplastic" or "cytotoxic") chemotherapy drug. Treanda is classified as an "alkylating agent".

What Treanda Is Used For:

• Treanda is used for treatment of chronic lymphocytic leukemia (CLL).
• Treanda is used for the treatment of patients with indolent B-cell non-Hodgkin's 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 Treanda Is Given:
As an injection into the vein (intravenous, IV).

There is no pill form of Treanda.

The amount of Treanda that you will receive 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 and schedule.

Side Effects:
Important things to remember about the side effects of Treanda:

Most people will not experience all of the Treanda side effects listed.

• Treanda side effects are often predictable in terms of their onset, duration, and severity.
• Treanda side effects are almost always reversible and will go away after therapy is complete.
• Treanda side effects may be quite manageable. There are many options to minimize or prevent the side effects of bendamustine.

The following Treanda side effects are common (occurring in greater than 30%) for patients taking Treanda:

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 lowest blood counts.

Nadir: 14 to 21 days
Recovery: 28 days
Increase in bilirubin levels

These are less common side effects (occurring in about 10-29%) for patients receiving Treanda:
Infusion reaction (chills, fever, itching, rash) may require pre-medications,
Fever
Nausea
Vomiting
fatigue
Diarrhea
Rash

Rare but serious complications of Treanda therapy.

Tumor lysis syndrome may occur as a result of leukemia treatment including treatment with bendamustine. Tumor lysis syndrome occurs when large amounts of cancerous cells are rapidly killed by the therapy. These cells release uric acid, potassium and phosphorus into the blood stream. 

Tumor lysis syndrome can lead to kidney failure. Tumor lysis syndrome usually occurs within 24 – 48 hours of therapy. Care must be taken to prevent the development of tumor lysis syndrome. Your health care provider will prescribe plenty of fluids to keep you hydrated. You may be given a drug called allopurinol that blocks uric acid production. 

In some cases, your health care provider may prescribe other measures to lower your white blood count before therapy. Let your health care provider know immediately if you are unable to urinate. Your health care provider will monitor your progress carefully during therapy.

Infertility (loss of fertility). Meaning, your ability to conceive or father a child may be affected by Treanda. Discuss this issue with your health care provider.

This list includes common and less common side effects for those taking Treanda. Treanda side effects that are very rare -- occurring in less than about 10 percent of patients -- are not all listed here. Always inform your health care provider if you experience any unusual symptoms.