Cisplatin

Cisplatin

Cisplatin is one of the most widely used chemotherapeutic agents for treating solid tumours and blood cancers, despite its high toxicity. This platinum coordination complex belongs to the alkylating agent class of cytotoxic medications. The medication's power lies in its unique approach - it creates covalent bonds with DNA bases like guanine and adenine and targets cancer cells specifically.

In this article you will learn about what cisplatin is, how it works in your body, proper usage instructions, side effects and important precautions.

What is Cisplatin?

Cisplatin binds to and damages the cell's DNA, which prevents repair or copying. Cancer cells stop dividing and die because of this process. The medicine works especially well against cells that divide faster, which you typically find in growing malignant tumours.

Cisplatin Uses

The FDA has approved this powerful medication to treat advanced bladder cancer, ovarian cancer that has spread to other body parts, and testicular cancer that has metastasised. Doctors also prescribe cisplatin off-label to treat many more types of cancer. These include breast cancer, cervical cancer, lung cancer, head and neck cancers, and gastrointestinal cancers.

How and When to Use Cisplatin

Doctors give cisplatin as an intravenous infusion in a hospital or clinic setting. The medication flows through a drip over 6 to 8 hours. Patients receive treatment once every 3-4 weeks. Doctors also give extra fluids before and after cisplatin treatment to protect the kidneys.

Side Effects of Cisplatin

The most important side effects include:

• Kidney problems: Cisplatin can cause severe renal toxicity including acute renal failure
• Nerve damage: Dose-related peripheral neuropathy causing numbness, tingling or pain in hands or feet
• Severe nausea and vomiting: Often requiring anti-sickness medications
• Blood disorders: Including reduced white blood cells, red blood cells, and platelets
• Hearing loss: Affects many patients

Precautions

• Doctors monitor kidney function closely throughout treatment.
• Pregnant women should avoid cisplatin because it may harm the unborn baby.
• Women need to use effective contraception during treatment and for 14 months after the final dose.
• Men with female partners should use contraception for 11 months after treatment.
• Patients with severe kidney problems should not take cisplatin.

How Cisplatin Works

The medication enters the bloodstream and attacks cancer by binding to DNA. This creates cross-links that stop cancer cells from dividing properly. The damage triggers cell death pathways that eliminate tumour cells throughout the body.

Can I Take Cisplatin with Other Medicines?

Cisplatin interacts with many drugs. Patients must tell their medical team about all medications they take.

These medications need special caution:

• Amphotericin B
• Aminoglycosides
• Anticonvulsants like phenytoin
• Blood thinners like warfarin
• Live vaccines
• Loop diuretics
• Medications affecting hearing or nerve function
• Nephrotoxic drugs that may increase kidney damage
• NSAIDs
• Tacrolimus
• Valproic Acid

Dosage Information

Different cancer types require different dosages:

• Testicular cancer - 20 mg/m² daily for 5 days per cycle, repeated every 3 weeks.
• Advanced ovarian cancer treatment - 75-100 mg/m² once every four weeks.
• Bladder cancer treatment - 50-70 mg/m² every 3-4 weeks.

Proper hydration is vital before, during and after treatment.

Conclusion

Cisplatin revolutionised cancer treatment by boosting cancer survival rates. This platinum-based medication fights many types of cancer effectively. Cisplatin plays a crucial role in fighting advanced bladder, ovarian, testicular and other cancers. Each patient gets their own dosage based on their cancer type and how well their kidneys work.

Knowing what to expect helps patients prepare for their treatment journey. Side effects can be tough to handle, but cisplatin gives hope to many cancer patients with difficult diagnoses. After decades of use, doctors still call this medication vital - clear evidence of how well it works against some of our toughest diseases.

FAQs

1. Is cisplatin high risk?

Cisplatin ranks among the most toxic drugs with a narrow therapeutic index. The drug can damage kidneys, cause nerve problems, lead to hearing loss, and severely suppress bone marrow.

2. How long does cisplatin take to work?

The drug starts fighting cancer cells right away. You might need to wait several weeks or multiple treatment cycles to see the tumours shrink.

3. What happens if I miss a dose?

Call your medical team right away if you miss an appointment. They will adjust your schedule to keep the treatment working effectively.

4. What happens if I overdose?

A cisplatin overdose can be life-threatening. It may cause kidney and liver failure, deafness, severe bone marrow suppression, and unstoppable nausea. Doctors treat overdoses with supportive care, hydration, and sometimes plasmapheresis.

5. What not to take with cisplatin?

Stay away from aminoglycoside antibiotics, loop diuretics, amphotericin B, and medications that can harm your kidneys. Your doctor will advise against live vaccines during treatment.

6. Who cannot take cisplatin?

Cisplatin isn't safe for people who have kidney problems, hearing disorders, severe bone marrow suppression, or platinum allergies.

7. When should I take cisplatin?

Doctors give cisplatin only in clinical settings. They typically schedule treatments every 3-4 weeks.

8. How many days to take cisplatin?

Cancer type determines treatment cycles. Patients usually receive cisplatin once every 3-4 weeks. Some get it once weekly for 6 weeks, while others need it daily for 5 days every 3-4 weeks. Your oncologist will create the right schedule based on your diagnosis.

9. When to stop cisplatin?

You should stop treatment if your creatinine goes above 140 micromol/L, plasma urea exceeds 9 mmol/L, or blood counts drop too low. Your doctor might also stop treatment if hearing tests show major hearing loss.

10. Is it safe to take cisplatin daily?

Doctors don't recommend continuous daily use because toxicity builds up over time.

11. What is the best time to take cisplatin?

Research shows the specific day doesn't affect outcomes. Your healthcare team picks your schedule based on practical factors.

12. What to avoid when taking cisplatin?

Avoid:

• Nephrotoxic drugs
• Aminoglycoside antibiotics
• Loop diuretics
• Live vaccines
• Herbs like black cohosh, Garlic and ginkgo biloba

13. What is the best combination with cisplatin?

Cisplatin works best when combined with other treatments:

• Testicular cancer: vinblastine, bleomycin
• Ovarian cancer: cyclophosphamide, doxorubicin
• Head/neck cancer: paclitaxel, gemcitabine, or radiation