Cancer specialists often use doxorubicin to treat their patients. It belongs to the class of chemotherapy agents called antitumor antibiotics, and it works by binding with the cancer cells' DNA so that it prevents both DNA and RNA synthesis. Doxorubicin is also known by the brand name Adriamycin®, and may be prescribed as part of a regimen involving other chemotherapy agents.
Types of Cancer Treated With Doxorubicin
Doxorubicin is perhaps most commonly prescribed to treat breast cancer, but oncologists use it to fight many other cancers as well. Ovarian and prostate cancers are among those frequently dosed with doxorubicin, as are small cell lung cancers and squamous cell cancers of the head and neck. Blood-related cancers such as leukemia and multiple myeloma, as well as both Hodgkin's disease and non-Hodgkin's lymphoma respond well to doxorubicin. The drug can also be used as chemotherapy for stomach and thyroid cancers, in addition to fighting a form of kidney cancer known as Wilms tumor.
Doctors and nurses administer doxorubicin intravenously, in either a hospital or outpatient infusion clinic. Depending on the condition of the patient's arm veins, and the estimated length of chemotherapy, a more permanent, central intravenous device, such as a port-a-cath or picc line may be implanted. This is especially likely to be done because doxorubicin is a vesicant, which means it will be very damaging to tissues surrounding a patient's vein if it leaks outside the veins.
Side Effects of Doxorubicin
Like all the chemotherapy agents in the "rubicin" family--so named because they are red in color--doxorubicin's most important side effect is its tendency to damage heart tissues. Most doctors treating patients with doxorubicin first order an echocardiogram of some kind to get a baseline record of heart function. Then, the total dosage of the medication is limited to 550mg per meter squared (an amount based on body surface area). If the doxorubicin is to be used in combination with radiation or another chemotherapy drug called cycloposphamide, the total dose limit is reduced to 450mg per meter squared. Once dosage with doxorubicin exceeds the 300mg per meter squared level, some oncologists will give patients a drug called dexrazoxane, which serves as an antidote to cardiotoxicity. This cannot be given at the beginning of doxorubicin treatment, because it may interfere with its cancer-fighting ability. Any symptoms of chest pain or shortness of breath while undergoing doxorubicin treatment should be reported immediately to your doctor.
Doxorubicin has other side effects as well. It can cause nausea and hair loss, and suppresses the reproduction of blood cells, dangerously lowering the body's ability to fight infection. Doxorubicin also makes patients more susceptible to yeast infections of the digestive tract, especially oral thrush. One of its most interesting side effects, though harmless, is that it turns a patient's urine red because of its own red color.
References:
Polovich, Martha, Julie M. Whitford, and MiKaela Olsen, eds. Chemotherapy and Biotherapy Guidelines and Recommendations for Practice. Pittsburgh, PA: Oncology Nursing Society, 2009.
Wilson, Billie, Margaret T. Shannon, and Kelly M. Shields, Prentice Hall Nurse's Drug Guide 2009, Upper Saddle River, NJ: Prentice Hall, 2008.
Elizabeth Thomas - Elizabeth was born and raised in Mt. Clemens, Michigan, though she now lives in a suburb of Austin, Texas. She holds a bachelor's and ...
