Cisplatin Chemotherapy - All You Need To Know

Introduction

Cisplatin was invented to inhibit the growth of Escherichia coli. But, it is used nowadays in treating cancers like testicular, breast, cervical, and ovarian because of its anti-neoplastic and cytotoxic effects on cancer cells. The treatment of Cisplatin is effective but can cause resistance in some patients. This topic describes Cisplatin chemotherapy.

What Is Cisplatin?

Cisplatin is an organometallic platinum compound with two adjacent chlorine and amine atoms. First, it was used to inhibit the growth of E.coli because of its antibacterial effects. And later, its anti-neoplastic effects were suspected on tumor cells. Therefore, it is used nowadays as a first-line treatment for patients with tumors or malignancies.

What Is the Indication of Cisplatin Chemotherapy?

Cisplatin chemotherapy is indicated for the treatment of cancers. Some of the cancers that are treated by Cisplatin chemotherapy are

• Bladder cancers.

• Ovarian cancers.

• Testicular cancer.

• Head and neck cancers.

• Esophageal cancer.

• Small or non-small cell lung cancer.

• Breast cancer.

• Cervical cancer.

• Stomach cancer.

• Prostate cancer.

• Hodgkin's and non-Hodgkin's lymphomas.

• Neuroblastoma.

• Sarcomas.

• Multiple myeloma.

• Melanoma.

• Mesothelioma.

How Is Cisplatin Given to the Patient?

Cisplatin is given into the vein intravenously as an infusion. There are no pills for Cisplatin. Usually, before it, an anti-emetic drug is given to the patient. Then, it is delivered into the vein through:

• Cannula - The cannula is a short, thin tube inserted in the arm or hand.

• Central Line - It is a fine tube that is inserted into the skin of the chest into the vein near it.

• PICC (Peripheral Inserted Central Catheter) - A PICC line is a fine tube that is put into the vein in the arm or chest. So, Cisplatin is delivered as a drip attached to the cannula, PICC line, or central line. Along with Cisplatin, extra fluid is also given to the patient before and after the Cisplatin. A drug like Mannitol is also given to prevent kidney damage.

What Are the Side Effects of Cisplatin Chemotherapy?

Some of the common side effects faced by the patients are:

• Nausea and Vomiting - Nausea is a common side effect faced by patients and can last for one week. Sometimes to control nausea, the patient is given anti-nausea medication.

• Low Blood Cell Counts - The white, red cells and platelets can decrease temporarily. All this can cause the risk of infection, anemia, and bleeding.

• Kidney Toxicity - Kidneys are also affected but can reverse back to normal in 10 to 20 days.

• Ototoxicity - It usually causes difficulty in hearing and ringing sounds in the ears.

• Blood Test - Blood testing can reveal anomalies such as calcium, potassium, and magnesium deficiency.

Some of the less common side effects are:

• Peripheral Neuropathy - It is a severe side effect of decreased sensation and paresthesia. Sensory loss, numbness, tingling, and difficulty walking can last until the therapy is continued. And all these become more severe with continued treatment.

• Loss of Appetite - The patient does not feel like eating, and it causes a loss of appetite.

• Taste Change - The patient can have a metallic taste.

• Liver Function Test - The blood test presenting the liver function test shows increased levels.

• Hair Loss - The patient will be suffering from hair loss.

What Are the Symptoms That Require Immediate Medical Attention?

Symptoms that require immediate medical attention are:

• Fever (104 degrees F) or chills.

• Nausea.

• Vomiting.

• Diarrhea.

• Urine output in 12 hours is near zero.

• Blood in the urine.

• Pain or burning sensation while urinating.

• Bruising.

• Unusual bleeding.

• Black or tarry stools.

• Blood in stools.

• Fatigue.

• Swelling, redness, and pain in the leg or arms.

• Yellowing of skin.

• Mouth sores or ulcers.

What Are the Precautions Taken Before Starting Cisplatin Chemotherapy?

Precautions taken before Cisplatin chemotherapy are:

• Before starting Cisplatin, inform the doctor about the other medications the patient takes. Avoid taking Aspirin along with Cisplatin.

• Avoid using Cisplatin if the patient is allergic to it or a platinum-containing drug.

• The patient should consult the doctor before taking any vaccination or immunization if the patient is on chemotherapy.

• The patient's fertility can get affected after the use of Cisplatin. Therefore, the doctor and the patient should talk about ways to preserve fertility.

• The patient should inform the doctor about the pregnancy, as the treatment can affect the baby in the womb of the mother.

• Avoid breastfeeding the baby while the patient is being treated.

• The patient is advised to use contraceptives during the treatment and avoid having a baby while Cisplatin chemotherapy is going on.

How Does Cisplatin Work in a Cancer Patient?

Cisplatin kills cancer cells by stopping the ability of the cell to divide. Usually, the drug works by damaging the RNA (ribonucleic acid) or DNA (deoxyribonucleic acid) which copies the cell. These cancerous cells do not have any limit and control over cell division because they have lost the ability of contact inhibition (the ability of the normal cell to divide no longer in contact with each other). If these cancerous cells are not dividing, they eventually die. And all this kills the cells, causes the tumor to shrink, and induces cell suicide by apoptosis (programmed cell death).

The chemotherapy drugs affect the cell when they are resting or dividing. The chemotherapic drugs that are effective during the resting are cell-cycle non-specific chemotherapy. For example, Cisplatin is effective in the resting phase of the cell. Chemotherapy has no idea whether it is damaging normal or cancerous cells, but because normal cells are reversible to the effect, cancerous ones die. So, there are side effects to the cells, like red blood or white blood. Even the cells in the mouth are also affected.

Conclusion

Cisplatin chemotherapy is used to treat cancer by killing cancerous cells. The drug Cisplatin causes cell suicide of the cancerous cells. Chemotherapy treats ovarian, breast, cervical, mouth, and esophageal cancers. It is also used to treat lymphomas, sarcomas, or melanomas. It is delivered to the patient by inserting it into the vein intravenously. The cannula or central line can deliver it. It has many side effects, like metallic taste, nausea and vomiting, ototoxicity, and abnormal blood tests. Before starting Cisplatin chemotherapy, a few precautions are taken, like avoiding breastfeeding and pregnancy while getting treated.