Cisplatin

Cisplatin is a type of chemotherapy.  It is a treatment for a number of different cancer types. 

You might have cisplatin on its own or with other cancer drugs or radiotherapy.

How does cisplatin work?

Cisplatin works by quickly destroying dividing cells, such as cancer cells.

How do you have cisplatin?

You have cisplatin as a drip into your bloodstream (intravenously). This is usually for 6 to 8 hours.

You have extra fluid through your drip before the cisplatin and for about 6 to 12 hours afterwards. This is to prevent kidney damage. Your nurse will also ask you to drink plenty for 24 hours after cisplatin.

You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This can be a:

• central line
• PICC line
• portacath

If you don't have a central line

You might have treatment through a thin short tube (a cannula) that goes into a vein in your arm. You have a new cannula each time you have treatment.

Risk of tissue damage

When you are having this treatment through a cannula it could damage the tissue if it leaks out of the vein. This is called extravasation. This can happen anywhere along the vein that the drug is going into. It doesn’t happen very often. Tell your nurse straight away if you notice any changes such as swelling, redness, pain, burning, or a stinging feeling

Your nurse will stop the drug treatment. And they will treat the area to relieve symptoms and reduce tissue damage. Contact your healthcare team if you develop any of these symptoms when you are at home.

How often do you have cisplatin?

You usually have cisplatin as cycles of treatment. This means that you have the drug and then a rest to allow your body to recover. 

Each cycle varies depending on what type of cancer you have. You might have cisplatin:

• once every 3 or 4 weeks 
• once a week for 6 weeks
• every day for 5 days, every 3 to 4 weeks

You might have cisplatin on its own or with other cancer treatments such as different chemotherapy drugs or radiotherapy. 

Your doctor or nurse will tell you more about this.

Tests

You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

What are the side effects of cisplatin?

Side effects can vary from person to person. They also depend on what other treatments you're having. 

When to contact your team

Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

• you have severe side effects 

• your side effects aren’t getting any better

• your side effects are getting worse

Early treatment can help manage side effects better. 

We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.

Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.

Common side effects

Each of these effects happens in more than 1 in 10 people (more than 10%). You might have one or more of them. They include:

Risk of infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or burning feeling when weeing, or generally feeling unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Breathlessness and looking pale

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Bruising, bleeding gums or nosebleeds

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechiae).

Tiredness and weakness (fatigue)

You might feel very tired and as though you lack energy.

Various things can help you to reduce tiredness and cope with it, for example exercise. Some research has shown that taking gentle exercise can give you more energy. It is important to balance exercise with resting.

Loss of appetite 

You might lose your appetite for various reasons while having cancer treatment. Sickness, taste changes or tiredness can put you off food and drinks.

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.

It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.

Diarrhoea 

Contact your advice line if you have diarrhoea. For example, in one day you have 2 or more loose bowel movements than usual. If you have a stoma , you might have more output than normal. Your doctor may give you anti diarrhoea medicine to take home with you after treatment.

Try to eat small meals and snacks regularly. It’s best to try to have a healthy balanced diet if you can. You don’t necessarily need to stop eating foods that contain fibre. But if your diet is normally very high in fibre, it might help to cut back on high fibre foods such as beans, nuts, seeds, dried fruit, bran and raw vegetables. 

Drink plenty to try and replace the fluid lost. Aim for 8 to 10 glasses per day.

Changes to your hearing

You might have some hearing loss, especially with high pitched sounds. You might also have some ringing in your ears (tinnitus). Tell your doctor or nurse if you notice any changes.

Kidney damage

To help prevent kidney damage, it is important to drink plenty of water. You might also have fluids into your vein before, during and after treatment. You have blood tests before your treatments to check how well your kidneys are working.

Changes in blood test results

You may have changes in the levels of minerals in your blood, including low levels of sodium. You have regular blood tests during treatment to check this.

You may have other changes picked up in blood tests, for example changes to how well your liver and pancreas are working. These changes are usually mild and go back to normal after treatment finishes.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

• heart problems such as a slow, fast or irregular heartbeat
• blood clots that can be life threatening; signs are pain, redness and swelling where the clot is. Feeling breathless can be a sign of a blood clot in the lung. Contact your advice line straight away if you have any of these symptoms
• sepsis - a serious reaction to an infection. Signs can include feeling very unwell, not passing urine, slurred speech or confusion, breathlessness, mottled or discoloured skin, extreme shivering or muscle pain. Call 999 or go to accident and emergency (A&E) immediately if you have any of these symptoms

Rare side effects

These side effects happen in fewer than 1 in 100 people (less than 1%). You might have one or more of them. They include:

• an allergic reaction that can cause a rash, itching or reddening of the skin, shortness of breath, swelling of the face and dizziness – some allergic reactions can be life-threatening, tell your nurse straight away if you notice any of these symptoms

• abnormal sperm production in men

• heart attack

Other side effects

There isn’t enough information to work out how often these side effects might happen. You might have one or more of them. These include:

• a blood disorder where your red blood cells get destroyed faster than they can be made (haemolytic anaemia)

• lack of fluid in the body (dehydration)

• lack of blood flow to part of the brain (a stroke) – call 999 if you have face or arm weakness, or have speech problems such as slurring your words

• muscle cramps

• hiccups

• loss of taste

• skin rash

• hair loss

• eye problems such as pain, blurred vision, colour blindness or loss of vision

• unusually cold hands and feet, and your skin may look very pale – this is due to your blood not flowing properly (Raynaud’s phenomenon)

• damage to nerves that control the organs inside your body (autonomic neuropathy)

• tell your nurse if you notice any signs of redness or irritation around the injection site

• a sudden sharp pain or electrical buzzing feeling down your neck and spine and may go into your arms and legs

• inflammation of the blood vessels in the brain - call your advice line if you have frequent headaches, tenderness to the side of your head or scalp, jaw pain or changes to your eyesight

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to Know

Other medicines, foods and drinks 

Cancer drugs can interact with medicines, herbal products, and some food and drinks. We are unable to list all the possible interactions that may happen. An example is grapefruit or grapefruit juice which can increase the side effects of certain drugs.

Tell your healthcare team about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies. Also let them know about any other medical conditions or allergies you may have.

Contraception and pregnancy 

This treatment may harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you’re having treatment and for a number of months afterwards.

Women must continue to use contraception for at least 7 months after treatment. And men should continue using contraception for at least 4 months afterwards.

Talk to your doctor or nurse about effective contraception before starting treatment. Let them know straight away if you or your partner become pregnant while having treatment.

Loss of fertility 

You may not be able to become pregnant or get someone pregnant after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.

Men might be able to store sperm before starting treatment. And women might be able to store eggs or ovarian tissue. But these services are not available in every hospital, so you would need to ask your doctor about this.    

Breastfeeding 

Don’t breastfeed during this treatment and for 4 weeks after your last dose. This is because the drug may go through into your breast milk.

Treatment for other conditions

If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.

You can have:

• other vaccines, but they might not give you as much protection as usual
• the flu vaccine (as an injection)
• the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment

Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your immune system recovers from treatment.

Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.

If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.

Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.

More information about this treatment

For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.