It is normal to feel a little scared and nervous when we hear the word "chemotherapy". But if we are fully aware of this treatment and the medicines given for it, we can overcome that fear and face the treatment with courage. Today we are going to talk about Doxorubicin, a very powerful and very important drug that destroys cancer cells.
What exactly is Doxorubicin?
Simply put, Doxorubicin is a chemotherapy drug that helps stop the growth of cancer cells and destroy them. It's a red liquid, so some people call it the "Red Devil." But don't be afraid of that name, because it's a very important drug that fights many types of cancer.
In particular, it is used to treat cancer conditions such as leukemia, lymphoma, neuroblastoma, sarcoma, and Wilms' tumor. In addition, this drug is also used for bladder cancer, breast cancer, lung cancer, ovarian cancer, stomach cancer, and thyroid cancer.
Things you need to tell your doctor before starting treatment
This is very important. For your safety and the success of your treatment, it is essential to be completely open with your doctor. Before starting treatment, if you have any of the following conditions, tell your doctor without hiding anything .
- If you have heart disease or if anyone in your family has had it.
- If you have low white blood cells, red blood cells, or platelets due to a previous medication.
- If you have liver disease .
- If you have recently received or are currently receiving radiation therapy .
- If you have had an allergic reaction to doxorubicin or any other chemotherapy drug, any other medicine, food, or dye.
- If you are pregnant, trying to get pregnant, or breastfeeding, this is very important.
How is this medicine administered to the body?
Doxorubicin is not a medicine that you can take at home. It is given in a hospital or clinic by a doctor or nurse who has been specially trained in this. Specifically, it is given into the body slowly through an infusion into a vein, like saline.
Very important: If you feel any pain, swelling, burning , or anything unusual at or around the injection site during the injection, tell the doctor or nurse immediately . Don't hide it.
The dosage of this medicine is determined very carefully by doctors. If you suspect that you have taken too much of the medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the ETU (Emergency Treatment Unit) of the nearest hospital.
What are the things to consider when undergoing treatment?
While taking this medication, you may experience several changes in your body. It is very important to be aware of them.
Discomfort and common side effects
It is normal to feel a little uncomfortable or tired during chemotherapy. This is because the medicine affects not only cancer cells, but also healthy cells that divide rapidly. Even if you feel uncomfortable, do not stop the treatment course until your doctor tells you to. Tell your doctor about any side effects.
A lifetime limit
This is a bit special. There is a limit to the amount of Doxorubicin a person can receive over their lifetime. The doctor will decide the amount based on your health condition and keep a record of it. If you have ever taken this medicine before, you should also tell the doctor .
Change in urine color
This is something that many people are afraid of, but it is nothing to be afraid of. Your urine may turn red for a day or two after taking the medicine. This is not blood, it is the color of the medicine. This is normal. However, if your urine turns dark brown, tell your doctor about it.
Risk of infection and bleeding
Doxorubicin can reduce the number of white blood cells, red blood cells, and platelets in your blood.
- When white blood cells decrease, the body's ability to fight disease (immunity) decreases. Therefore, try to stay away from people who are sick during this time. Reduce going to crowded places. If you experience symptoms such as fever, cold, or sore throat, do not self-medicate and call your doctor immediately .
- When platelets are low, the blood's ability to clot decreases. Therefore, even a small cut can easily bruise or bleed . If your gums bleed when you brush your teeth, if you have small red spots on your skin, or if you are bleeding in an unusual way, tell your doctor .
Pregnancy and Fertility
This is a very important matter.
Both men and women should avoid fathering children while taking this medicine and for at least 6 months after stopping treatment. If you become pregnant during this time, it can be very harmful to the baby. So talk to your doctor about using safe birth control.
Also, this medicine can cause ovarian failure in some women and a decrease in sperm count in men. This may affect your ability to have children in the future. If you have any questions about this or hope to have children, talk to your doctor about this before starting treatment .
What are the possible side effects?
Like any medicine, Doxorubicin can have side effects. Not everyone gets them. But it's important to be aware of them. Let's break them down into two categories.
| Side effect | Description and what to do |
|---|---|
| Side effects that require immediate medical attention | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips or tongue. |
| Difficulty breathing | Difficulty breathing, feeling of tightness in the chest. |
| Chest pain, changes in heartbeat | Feeling like your heart is beating fast or irregularly. |
| Signs of infection | Fever, chills, cough, sore throat, pain when urinating. |
| Abnormal bleeding | Bruising, small red spots on the skin, black stools, and blood in the urine. |
| Other serious symptoms | Swelling of ankles, feet, hands, extreme fatigue, body weakness. |
| Side effects that should be reported to the doctor if they persist or are bothersome | |
| Digestive system problems | Diarrhea, nausea, vomiting. |
| Mouth sores | Painful sores inside the mouth and on the lips. |
| Hair loss | Hair, eyebrow, and eyelash loss (this is temporary and will grow back after treatment is stopped). |
| Changes in nails | Nail discoloration or damage. |
Can there be problems with other medications?
Yes. Doxorubicin is a drug that can interact with some other drugs. For example, it can cause problems with drugs such as `(6-mercaptopurine)`, `(paclitaxel)`, `(phenytoin)`, `(St. John's Wort)`, `(trastuzumab)` and `(verapamil)`.
This list is not complete. Therefore , be sure to tell your doctor about all the medications you are taking , not just the ones prescribed by your doctor, but also any vitamins, herbal remedies, traditional medicines, and supplements you are taking. Also, tell your doctor if you smoke or drink alcohol.
Take-Home Message
- Doxorubicin is a powerful, important chemotherapy drug that fights cancer. It is only given in a hospital.
- Before starting treatment, tell your doctor about your complete health history and all other medications you are taking.
- If you feel any pain or swelling at the injection site, notify the medical staff immediately.
- It's normal for your urine to turn red for a few days after taking the medication, but be aware of symptoms like fever and unusual bleeding.
- Avoid pregnancy completely during treatment and for 6 months after stopping.
- Talk openly with your doctor about any questions, fears, or concerns you may have. You are not alone, and there is a medical team to help you.
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