Mitomycin

Please read this information in conjunction with our general information on chemotherapy, and with the information in relation to your specific type of cancer.

• What is mitomycin?
• What does it look like?
• How is it given?
• Side effects
• Less common side effects
• Additional information
• References

What is mitomycin?

Mitomycin is a chemotherapy drug that is given to treat many different types of cancer including stomach, oesophagus, bladder, non-small cell lung cancer and breast.

 What does it look like?

Mitomycin is a powder for injection, which must be dissolved with water. Once the water is added it becomes a purple colour.

How is it given?

• It is given as injection into a vein via a cannula.
• It is given in the form of a drip through a cannula or central line or PICC line.
• Into the bladder intravesically

Side effects

The side effects mentioned below may not affect everyone, as each patient’s reaction to chemotherapy is different. It will also depend on how many chemotherapy drugs you are receiving. If you experience any side effects that you think are related to your chemotherapy, please discuss them with your oncology doctor or chemotherapy nurse.

Infection

You will be more prone to infection as mitomycin affects your white cell production from the bone marrow. This effect usually occurs about 7 - 10 days after your chemotherapy. You will have blood tests to check your levels before every chemotherapy dose to ensure your blood levels have returned to normal. Occasionally your treatment may be delayed until your blood levels come back to normal.  If you notice any signs of infection visit your doctor for assessment.
You should contact your doctor or the Oncology Unit straight away if you if you have a sore throat,cough, pain passing urine, redness and swelling at e.g. at a catheter site. Or have a temperature of 38 degrees° C or greater.

Bruising

Mitomycin can also affect the production of platelets, which can cause bleeding or bruising. Inform your doctor if you notice any unexplained bleeding or bruising.

Anaemia

You may feel lethargic and breathless due to a reduction in your red cells caused by mitomycin.  Inform your doctor if you are feeling these effects.

Loss of appetite

You may feel lees like eating your usual diet while you are having mitomycin treatment. A dietician can advise you of build up foods and drinks to boost you calorie intake.

Fatigue

You may feel very tired. This can last for a few months after your treatment. Inform your doctor or nurse of how you are feeling.

Less common side-effects

Nausea and vomiting

Mitomycin   can make you feel sick nausea   or to to be sick vomit  . When this occurs can vary. Your doctor will prescribe some medications to prevent this anti-emetics  .If you continue to feel sick it is important to inform your doctor.

Lung changes

In rare case mitomycin may cause changes to the lung tissue. If you notice any breathlessness or unusual symptoms inform your nurse or docor immediately.

Kidney problems

Your kidneys may be affected by large doses of mitomycin. Your doctor will monitor your kidney’s closely during and before each treatment with a blood and urine test.

Hair loss

It is not usual to lose your hair when you are having mitomycin treatment. The usual effect on a persons is hair thining . You may also have loss of hair or thining of your eyebrows, eyelashes and other body parts. It is important to remember that this hair loss is just temporary and hair will regrow once treatment stops.

Skin changes

Mitomycin can cause a rash, which may be itchy. Your doctor can prescribe medicine to help. Let your doctor know if this happens.

Changes in nails

Your nails may become darker. This change grows out over a few months once treatment has finished.

Sore mouth

You may develop a sore mouth or ulcers due to your chemotherapy. You will be prescribed some mouthwashes. Inform your doctor or nurse if your mouth becomes sore or you develop ulcers. You may also experience some taste changes, which will resolve after you finish your treatment.

Diarrhoea

If Diarrhoea occurs it can be easily controlled with medicine. It is important to drink plenty of fluid if you experience diarrhoea and to inform your doctor or nurse.

Additional information

Phlebitis

You may experience a pain or swelling at the injection site (cannula) in you hand or arm while you are having your mitomycin treatment. You should inform your nurse or doctor if this occurs.

Bladder side effects

When mitomycin is given into the bladder the side effects may be different to those mentioned here. Usually the side effects listed above would be milder or may not occur at all. When mitomycin is given in this way, it can occasionally cause damage to the bladder, including ulcers and a need to pass urine more often.

Other medications

It is important to inform your doctor of any medications that you are taking, including over the counter medications or herbal drugs as they can interfere with some chemotherapy drugs.

Fertility

It is important to discuss this with your doctor as your fertility may be affected by mitomycin.

Contraception

It is important to use a reliable form of contraception while you are on treatment and for at least two years after your treatment has completed. It is not advised to get pregnant or father a child while on treatment as the drugs may affect the foetus.

References:

• British National Formulary. British Medical Association and Royal Pharmaceutical Society of Great Britian, March 2002
• The Chemotherapy Source Book (2rd edition). Ed. Perry. Lippincott Williams and Wilkins, 1997
• The Royal Marsden Hospital Handbook of Cancer Chemotherapy. Ed. Brightwood, D., Ford, H., Johnston, S., Ross, P. and Wood, M.
• Oncology Nursing Drug Handbook. Ed.  Barton-Burke, M. and Wilkes, G 2005

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