Paclitaxel and carboplatin (PC, CarboTaxol)

Paclitaxel and carboplatin are the names of a chemotherapy combination. It’s also known as PC and CarboTaxol. It is a treatment for a number of different cancer types.

What is paclitaxel and carboplatin?

Paclitaxel and carboplatin are the names of a chemotherapy combination that includes:

• Paclitaxel (taxol) - P
• Carboplatin - C

It is often called CarboTaxol or PC.

It is a treatment for a number of different cancer types. You might have paclitaxel and carboplatin on its own, with other chemotherapy drugs or radiotherapy for some cancer types.

How does paclitaxel and carboplatin work?

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

How do you have paclitaxel and carboplatin?

You have both drugs into your bloodstream (intravenously).

Into your bloodstream

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.

How often do you have paclitaxel and carboplatin?

You usually have paclitaxel over 3 hours and carboplatin between 30 minutes and 1 hour. The whole treatment can take up to 4 hours. 

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

Each cycle usually lasts 3 weeks (21 days). Depending on your cancer type you might have up to 8 cycles which can take up to about 6 months.

Your doctor, nurse, or pharmacist will explain your treatment plan to you and what to expect.

A common way of having this treatment is as follows:

You then start the next cycle of treatment.

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 paclitaxel and carboplatin?

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. 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

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Increased 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, headaches, feeling cold and shivery and generally feeling unwell. You might have other symptoms depending on where the infection is, for example an infection in your wee (urine) or in your throat and lungs.

Very rarely this can cause a severe chest infection. Or an infection that can cause a sudden drop in your blood pressure, affecting parts of your body including your heart and lungs. 

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

Breathless 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 and 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).

Less commonly you may have heavy bleeding.

Tiredness and weakness (fatigue) during and after treatment

Tiredness and weakness (fatigue) can happen during and after treatment. Doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.

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.

Pain in different parts of your body 

It’s common to feel pain in different parts of your body such as your joints, muscles, and limbs.

You might also get pain in other areas of the body for example pain in your ear, mouth, throat, face and bones but this is not as common.

Tell a member of the team treating you if you have any pain. They can check the cause and give you medicine to help.

Allergic reaction

You might have a mild allergic reaction to paclitaxel during or shortly after treatment. This can cause symptoms such as itching, rash or red face. 

Rarely you can get a severe allergic reaction. Symptoms include breathlessness, swelling of your face and lips, and dizziness. Let your nurse or doctor know straight away if you have any of these symptoms or feel unwell. Your chemotherapy nurse will keep a close eye on you and give you treatment for this straight away if this happens.

You will usually be given medication just before treatment to prevent or reduce the risk of an allergic reaction.

Hair loss

You could lose all your hair. This includes your eyelashes, eyebrows, underarms, legs and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before. 

You might be offered scalp cooling to help reduce hair loss. Some people may have permanent hair loss although this is very rare.

Urine and kidney problems

You may have an infection in your wee. Symptoms include pain when having a wee, and going more often, and blood in your wee. You may also feel unwell or have a fever. Let your healthcare team know if you have any of these symptoms.

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.

Sore mouth or mouth ulcers

Mouth sores and ulcers can be painful. It helps to keep your mouth and teeth clean, drink plenty of fluids and avoid acidic foods such as lemons. Chewing gum can help to keep your mouth moist. Tell your doctor or nurse if you have ulcers.

Rarely you may also have sore lips. 

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.

Numbness and tingling in hands and feet

Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Tell your healthcare team if you're finding it difficult to walk or complete fiddly tasks such as doing up buttons. 

Changes in your blood pressure

Tell your doctor or nurse if you feel light headed or dizzy. You have your blood pressure checked regularly. Rarely you may have high blood pressure.

Liver changes

You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the way your liver is working.

Changes in the levels of minerals in your body

Your blood contains different levels of minerals, electrolytes, and proteins. This treatment can change the levels of salt (sodium), calcium, magnesium, and potassium, in your blood.

Inflammation of the digestive system

This treatment may cause inflammation of the digestive system . This can cause pain and soreness.

It might include one or all of the following:

• the throat
• the tummy (stomach)
• the back passage (rectum)

You can have painkillers to reduce the soreness. Take them half an hour before meals to make eating easier. Your nurse, doctor or dietician will explain the best foods to have if you have any of these symptoms.

Feeling very sleepy

You might feel very tired or find you are falling asleep during the day. Do not drive or operate machinery. Let your doctor know straight away. 

Fluid build up (swelling)

You may have swelling of your hands and legs and face due to a build up of fluid (oedema). 

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:

• loss of taste or a metallic taste in your mouth - your taste gradually returns to normal after treatment has finished
• hearing changes such as ringing in your ears (tinnitus) or rarely loss of hearing, these often get better after treatment has finished
• changes to your heart rhythm and rate. More rarely you might have symptoms such as feeling dizzy, faint, weak, short of breath and you might have pain in your chest. Contact your advice line or doctor straight away if you have any of these symptoms
• inflammation around the drip site - tell your nurse straight away if you notice any redness, swelling or leaking at your drip site
• nail and skin changes - these are usually mild and temporary
• nerve damage that reduces the reflex reaction between tendons and bones, this can sometimes improve after treatment
• problems with your eyesight, this gets better when you finish your treatment. In rare situations your eyes might get dry or you might lose your sight
• changes to the lung tissue that can cause a cough and breathlessness. Rarely this can be life threatening. Contact your advice line or doctor straight away if you have any of these symptoms
• difficulty having a poo (constipation)
• depression
• difficulty sleeping
• problems when you move or walk
• feeling worried or affecting the way you think about things
• fainting
• flu like symptoms, including fever, chills, headache, muscle or body aches, cough, sore throat, runny nose, and feeling tired

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:

• blood clots, in your leg or chest, you may have pain, redness or swelling in one of your lower legs, or chest pain – contact your advice line straight away if you have any of these symptoms
• risk of developing a second cancer such as acute myeloid leukaemia (AML), or more rarely myelodysplastic syndrome (MDS)
• a severe skin reaction that may start as tender red patches which leads to peeling or blistering of the skin. You might also feel feverish and your eyes may be more sensitive to light. This is serious and could be life threatening

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, food and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This treatment might 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 few 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 father a child after treatment with these drugs. 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

It is not known whether these drugs come through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.

Treatment and 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.

Immunisation

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.