By Dr Ananya Mandal, MD
GemCarbo chemotherapy is an anti-cancer therapy that is used to treat lung and bladder cancers. The therapy is made up of two drugs – gemcitabine and carboplatin.
GemCarbo chemotherapy is usually administered as a day care procedure or during a short stay at hospital. Before the chemotherapy, blood tests are performed to check the patient’s blood count is high enough for the treatment to be safely received.
The patient is also usually given medication to prevent nausea and sickness, although some nausea may still occur as a side effect of treatment. The anti-sickness medication is usually given by injection but can also be taken in tablet form.
Administration of therapy
The therapy may be given as an intravenous infusion into the arm using a cannula or if the site of administration is a large vein in the neck, a central venous catheter is used. The drip is usually run through a pump to ensure the medication is given over a set period of time. One drip containing gemcitabine is given first over a period of half an hour and a carboplatin drip then follows for 30 to 60 minutes.
On the first day of the regimen, both the gemcitabine and carboplatin are given. On day 8, only gemcitabine is given. The patient then rests for two weeks until day 22, when the next cycle of treatment begins. This cycle is usually repeated 4 to 6 times, with treatment lasting a total of three to four months.
After the procedure
After the chemotherapy, the patient is allowed to leave and is given anti-sickness drugs to take home with them as well as anti-diarrhea tablets if they are needed.
Chemotherapy drugs are intended to kill cancer cells but they also kill many normal cells in the process. The cytotoxic effects of these agents causes various side effects. Side effects vary form patient to patient, with some experiencing very few effects while others are severely affected.
Some examples of the common side effects include:
Increased risk of infection – The therapy suppresses the production of white blood cells (WBCs) in the bone marrow, leading to a low WBC count (neutropenia) and an increased susceptibility to infection. Resistance to infection is at its lowest 10–14 days after chemotherapy. Some patients may develop fever due to infection.
Bleeding tendencies and easy bruising – Suppression of the bone marrow leads to a low blood platelet count. Platelets aid coagulation and blood clotting processes and a low count can lead to bruising and uncontrolled bleeding, even on minor trauma. This can be corrected with platelet transfusion.
Anemia – Bone marrow suppression also leads to a lowered red blood cell count (RBC) or anemia. Blood transfusions may be needed to correct the low RBC counts.
Nausea and vomiting – These can be corrected with anti nausea and vomiting pills or injections.
Loss of appetite, diarrhea and mouth ulcers
Weakness and fatigue
Gemcitabine may affect the liver, giving abnormal liver function test results. These return to normal after chemotherapy is discontinued.
Gemcitabine may cause dry skin and skin rashes.
Some patients experience fluid retention, leading to swelling of the ankles or breathlessness.
Hair loss is a rare side effect but if it occurs, the hair usually grows back after the therapy is finished.
Mild kidney damage may occur but, again, this usually resolves after therapy is finished.
Some patients may develop drowsiness as a side effect of gemcitabine therapy.
Infertility is common after chemotherapy. Future fertility and desire for offspring must be discussed with the physician before starting treatment.
Reviewed by Sally Robertson, BSc
Last Updated: Apr 1, 2014