Cisplatin, also known as CDDP, is a powerful chemotherapy medication used in cancer treatment. It is a platinum-based agent, meaning its molecular structure incorporates a platinum atom. Cisplatin has significantly impacted oncology, becoming a foundational component in regimens designed to combat various types of malignancies. Its efficacy stems from its ability to interfere with cancer cell processes, ultimately halting their uncontrolled growth.
How Cisplatin Works
Cisplatin functions as an alkylating agent, a type of chemotherapy that directly interferes with the DNA of cancer cells. Once administered, cisplatin enters the cancer cell and becomes highly reactive. This activated form then binds to the purine bases, primarily guanine, on the DNA strands. The binding process creates what are known as DNA adducts, which deform the DNA double helix, preventing the strands from uncoiling and separating. This disruption blocks essential cellular processes like DNA replication and RNA transcription, which are necessary for cell division and survival. The extensive DNA damage triggered by cisplatin ultimately overwhelms cellular repair mechanisms, leading to programmed cell death, or apoptosis, in the cancer cells.
Cancers Treated with Cisplatin
Cisplatin is a versatile chemotherapy agent used to treat a broad spectrum of solid tumors. It is a standard component of treatment protocols for testicular cancer, where cisplatin-based regimens have achieved high cure rates. The drug is also widely used for advanced ovarian cancer, often in combination with other chemotherapy drugs after surgery or radiation.
Cisplatin also plays a role in managing bladder cancer, particularly in advanced stages. It is prescribed for head and neck cancers, lung cancer, and cervical cancer. The effectiveness of cisplatin across these diverse cancers is attributed to its broad-spectrum activity and its frequent use in combination therapies, where it works synergistically with other drugs to enhance tumor cell destruction.
What to Expect During Cisplatin Treatment
Cisplatin is typically administered intravenously, given directly into a vein through a drip. The infusion duration can vary, often lasting for 6 to 8 hours. Prior to and following the cisplatin infusion, patients receive a substantial amount of intravenous fluids, commonly normal saline, to help protect the kidneys from damage. This pre- and post-hydration can extend the total duration of a treatment session.
Cisplatin treatment is usually given in cycles, meaning patients receive the drug for a period, followed by a rest period to allow the body to recover. The frequency of these cycles can differ based on the specific cancer being treated, with common schedules including once every 3 to 4 weeks, or sometimes once a week. Patients also receive pre-medication, such as anti-sickness drugs, to help prevent or control common side effects like nausea and vomiting, which can be severe with cisplatin.
Managing Cisplatin Side Effects
Cisplatin can cause a range of side effects. Nausea and vomiting are particularly common and potentially severe, often persisting for several days. Antiemetic medications are routinely prescribed before and after treatment to minimize discomfort.
Kidney damage, known as nephrotoxicity, is a significant concern as cisplatin accumulates in the kidneys, disrupting their function. To mitigate this, aggressive hydration with intravenous fluids is standard practice, and regular monitoring of kidney function through blood tests is performed.
Nerve damage, or neuropathy, can manifest as numbness, tingling, or pain in the hands and feet. These symptoms may appear weeks after the last dose and can worsen with repeated treatments, and may not fully resolve. Hearing loss (ototoxicity) and ringing in the ears (tinnitus) are also possible, particularly with higher doses or prolonged use.
Cisplatin can suppress bone marrow function, leading to a decrease in blood cell counts. This can result in:
Anemia (low red blood cells, causing fatigue)
Increased risk of infections (due to low white blood cells)
Higher chance of bruising or bleeding (due to low platelets)
Blood tests are regularly conducted to monitor these counts. Hair loss is another potential side effect, although it is often temporary.