Cancer specialists who prescribe chemotherapy often choose Cisplatin for their patients. Like all chemotherapy drugs, it helps kill cancer cells, but it also has risks and side effects. Cisplatin belongs to the group of chemotherapy drugs called alkylating agents, which means it attacks cancer by breaking the DNA strands of the cells so they cannot reproduce. It is also known by the brand name Platinol®.
Types of Cancer Treated With Cisplatin
Cisplatin is used as chemotherapy for many different types of cancers, including ovarian and testicular cancer. Doctors also use it against bladder, cervical, and breast cancers, as well as prostate cancer and cancers of the head and neck. Cisplatin can act against leukemia and brain tumors, and has also been used against Wilms tumor, a cancer of the kidney. It has also been used to fight certain forms of lung cancer.
How Patients Receive Cisplatin
Patients receive their cisplatin treatments intravenously, either in a hospital setting or in an outpatient cancer clinic. Nurses can give it either through a freshly-started peripheral IV site in the patient's arm, or through a port-a-cath that has been more permanently implanted for long-term chemotherapy.
Major Side Effects of Cisplatin
Cisplatin holds a high ranking among the chemotherapy medications that cause nausea or vomiting. The nausea can begin one to six hours after receiving a treatment, and last for 24 to longer than 48 hours afterwards. Doctors commonly prescribe anti-nausea medications such as ondansetron or aprepitant before treatment to help alleviate the nausea. Dexamethasone, a steroid, may be prescribed as well – steroids improve the effectiveness of anti-nausea medications. Cisplatin can also cause diarrhea in some patients.
One of the most dangerous side effects of cisplatin, however, is its toxicity to kidneys. The patient needs to be sure and take in a great deal of fluid, either by drinking it or intravenously, to make sure cisplatin clears the kidneys quickly and in low concentrations. Doctors often have the drug administered in the morning, to make sure the patient does not go to bed without urinating all of the cisplatin out of his or her system. Doctors will not give a scheduled dose of cisplatin if the patient's pre-treatment bloodwork shows a serum creatinine level (an indicator of kidney function) higher than 1.5 mg per dl. They will often prescribe the medication amifostine, which helps protect the kidneys.
Cisplatin and the Heart
Cisplatin is not nearly as damaging to heart function as drugs like doxorubicin and its "-rubicin" relatives. It can, however, cause the body to lose magnesium, which in turn can cause a lengthening of the heart's QT wave, which can cause the heart rate to become slower or become irregular. Lab work should include magnesium levels, which should remain higher than 2 mEq per liter. There can be some ischemia associated with cisplatin, but this can be reversed after chemotherapy has been completed.
Other Side Effects of Cisplatin
Cisplatin can also cause numbness and tingling in the hands and feet, but this often goes away when chemotherapy is finished. Some degree of hearing loss may also occur, and many doctors have their patients take a hearing test before starting cisplatin, and then again after chemotherapy is completed.
Of course, like many other chemotherapy drugs, cisplatin can cause both white and red blood cell counts to become dangerously low, placing the patient at risk for deadly infections. Patients should always report any changes from their usual state of health to their doctor while undergoing chemotherapy, especially fever. In addition to pre-treatment lab work, patient report is essential to helping the doctor determine whether the chemo dose should be stopped for a period of time, or whether the whole course of treatment should be altered.
References
Polovich, Martha, Julie M. Whitford, and MiKaela Olsen, eds. Chemotherapy and Biotherapy Guidelines and Recommendations for Practice. Pittsburgh, PA: Oncology Nursing Society, 2009.
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 ...
