Cisplatin is a chemotherapy medication administered to address a variety of cancers. It functions by inhibiting the synthesis of DNA, RNA, and proteins necessary for cell growth and division. The treatment is given intravenously on a weekly schedule, a method that helps manage its effects on the body. Understanding the potential side effects allows individuals to prepare for physical responses and facilitate better communication with the healthcare team.
Immediate and Short-Term Side Effects
Within hours to days following a weekly cisplatin infusion, individuals may experience a specific set of temporary side effects. One of the most common is nausea and vomiting, which is categorized into two phases: acute nausea within the first 24 hours, and delayed nausea two to five days later. Anti-nausea medications, known as antiemetics, are administered before, during, and after each treatment to prevent or reduce these symptoms.
Another prevalent short-term effect is significant fatigue. This is described as an overwhelming tiredness not alleviated by rest that can interfere with daily activities. This feeling may intensify in the days following an infusion. Some people also report “chemo brain,” a term for difficulties with memory and concentration.
Changes in appetite and taste are also common. A loss of desire to eat can occur, and some individuals notice that foods taste different, often with a metallic quality. These changes can affect nutritional intake and should be discussed with the healthcare team.
Cumulative Side Effects
As the total amount of cisplatin in the body increases, certain side effects can develop or intensify. These effects are dose-dependent, meaning their likelihood and severity are related to the total quantity of the drug received over time. Monitoring for these cumulative impacts is a standard part of the treatment protocol.
A primary concern is the potential for kidney damage, or nephrotoxicity. Cisplatin can harm the cells in the kidney tubules, so patients receive extensive intravenous (IV) hydration before and after each infusion. Healthcare teams monitor kidney function by regularly testing blood for levels of creatinine and other indicators of renal health.
Nerve damage, known as peripheral neuropathy, is another cumulative effect. It begins with sensations of tingling, numbness, or a “pins and needles” feeling in the fingers and toes. Early reporting of any new nerve sensations is important, as a dose adjustment may be considered to prevent further damage.
The drug can also affect hearing, a condition called ototoxicity, by damaging cells within the inner ear. Symptoms start with tinnitus (ringing in the ears) or a loss of ability to hear high-frequency sounds. Hearing tests may be performed before and during treatment to detect any changes early.
Impact on Blood and Body Chemistry
Cisplatin can cause measurable changes in blood composition and body chemistry, which are monitored through regular lab tests. The medication can suppress bone marrow function, an effect known as myelosuppression. This is less pronounced with weekly low-dose schedules compared to less frequent, high-dose regimens.
This suppression can lead to a reduction in all three major types of blood cells. A drop in white blood cells (neutropenia) increases the body’s susceptibility to infection. A lower red blood cell count (anemia) can cause or worsen feelings of fatigue and weakness. A decline in platelets (thrombocytopenia) can lead to easier bruising or bleeding.
Beyond blood counts, cisplatin can disrupt the body’s balance of electrolytes. It can cause urinary loss of magnesium and potassium, leading to low levels known as hypomagnesemia and hypokalemia. These imbalances are detected through blood tests and can be managed with oral or intravenous supplements.
Proactive Management and Communication
Taking an active role in managing side effects can influence the experience of weekly cisplatin treatment. Maintaining hydration by drinking a substantial amount of fluids, particularly in the days following each infusion, is recommended to help flush the medication through the kidneys. If nausea makes drinking difficult, it is important to inform the medical team.
Adherence to the prescribed medication schedule is also important. Antiemetics, for example, are most effective when taken consistently as directed to prevent the onset of delayed nausea. The same principle applies to any supplements, such as magnesium or potassium, prescribed to correct electrolyte imbalances.
Keeping a simple log of symptoms can be a useful tool. Note the type of side effect, when it occurs, its severity, and what provides relief. This record allows for a more precise conversation with the oncology team, enabling them to make timely adjustments to the care plan.
Contact your medical team immediately for certain symptoms. These include:
- Signs of infection, such as a fever of 38°C (100.4°F) or higher, chills, or a sore throat.
- Severe nausea or vomiting that prevents you from keeping fluids down.
- The emergence or worsening of nerve-related symptoms like numbness and tingling.
- Any changes in hearing.