Paclitaxel (Taxol)

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

What is paclitaxel ?

Paclitaxel is a chemotherapy drug used to treat different types of cancer including ovarian, lung cancer, breast, head and neck cancers and bladder cancer.

 What does it look like?

It is a clear colourless fluid.

How is it given?

• It is given in the form of a drip through a cannula or central line or PICC line.

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 paclitaxel affects your white cell production from the bone marrow. This effect usually occurs about 10-14 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.
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

Paclitaxel 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 paclitaxel. Inform your doctor if you are feeling these effects.

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.

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.

Hair loss

This usually happens 2-3 weeks after your first dose of paclitaxel treatment . The hair is usually lost completely but may just thin. 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.

Joint pain

This can happen a few days after treatment begins with paclitaxel but can be easily controlled with pain killers from your doctor.

Skin changes

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

Numbness in the hands or feet

This numbness is called peripheral neuropathy and is caused as a result of damage to the nerve endings from the drug paclitaxel. This sensation of numbness or tingling may be experienced in the hands, feet, neck or throat. The cold, e.g. cold air, cold drinks, ice cubes, may trigger the symptoms of peripheral neuropathy. If this is the case you should avoid cold sensations and keep warm in cold weather. Peripheral neuropathy may not occur after the first treatment but after several treatments. It is important to report any symptoms to your doctor who can lower the dose of the drug you are receiving to control your symptoms. All numbness and tingling sensations should improve once the treatment finishes.
For more information on peripheral neuropathy, please see our factsheet.

Allergic reactions

Some patients may experience an allergic reaction to Paclitaxel. Reactions may include breathlessness, headaches; back pain, skin rash or facial. If you experience any of these effects tell your doctor or nurse immediately. To help prevent these reactions, a medication called decadron is given before and after the treatment. You will be monitored very closely for signs of allergic reaction during your treatment.

Less common side-effects

Nausea and vomiting

Paclitaxel   can make you feel sick nausea or to to be sick vomit  . It may occur a few hours after you receive your first dose of paclitaxel and can last for several days in some cases. . Your doctor will prescribe some medications to prevent this anti-emetics  .If you continue to feel sick it is important to inform your doctor.

 Less common side effects:

Changes to your heart rhythm

Paclitaxel can affect how the heart works but it depends on the dose given. The standard doses of treatment rarely affect the hearts function. If the rhythm of your heart changes it can be treated with medications and is usually temporary.

Liver problems

Paclitaxel may alter the way the liver works. Once the treatment has finished your liver function will return to normal. Your doctor will monitor your liver function very closely while you are on treatment by checking your bloods but this temporary disturbance to your liver function is very unlikely to cause you harm.

Low blood pressure

This may happen following treatment with paclitaxel. Your blood pressure will be checked regularly while you are receiving treatment however let your doctor know if you feel faint or dizzy at any time.

Abdominal pain

This can occur a few days after finishing chemotherapy. Let your doctor know if you suffer this symptom and you will be give pain killers to ease the discomfort.

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 paclitaxel treatment. You should inform your nurse or doctor if this occurs.

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 paclitaxel.

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 (53rd edition). British Medical Association and Royal Pharmaceutical Society of Great Britian, March 2007.
• 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. 2005.
• Oncology Nursing Drug Handbook. Ed.  Barton-Burke, M. and Wilkes, G 2005

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