1. What is carboplatin?
Carboplatin is a drug used to treat breast cancer, usually in combination with other drugs.
2. Who might be offered carboplatin?
Carboplatin can be used to treat people who have:
- Secondary (metastatic) breast cancer – breast cancer that has spread to other parts of the body
- Locally advanced breast cancer – breast cancer that has spread to the tissues and lymph nodes (glands) around the chest, neck and under the breastbone
- Triple negative primary breast cancer – breast cancer that has not spread beyond the breast or the lymph nodes under the arm
You may be offered carboplatin as part of a clinical trial.
Research is continuing to look at the benefits of carboplatin for people with triple negative breast cancer, or breast cancer that developed due to inheriting an altered BRCA gene.
3. Before starting carboplatin
Before starting your treatment, most hospitals will arrange a chemotherapy information session. At this appointment a nurse will discuss how and when you will have your chemotherapy and how side effects can be managed.
You may have blood tests and some people will have an ECG (electrocardiogram), a simple test that checks your heart rhythm. You may have tests to check your liver and kidneys.
Your height and weight will also be measured. This is used to work out the correct dose of chemotherapy for you.
You’ll be given contact numbers so you know who to phone if you have any questions or concerns.
4. How is carboplatin given?
Carboplatin is given into a vein (intravenously). This will usually be as a drip, also called an infusion, into your hand or arm.
Other intravenous methods may be used depending on factors like how easy it is for the chemotherapy team to find suitable veins, and your preferences.
If you have primary breast cancer, carboplatin may be given in combination with other anti-cancer drugs. It may be given before or after surgery.
If you have secondary breast cancer, you may have carboplatin on its own or in combination with other anti-cancer drugs.
How long does treatment take?
Each dose, or cycle, of carboplatin takes 15 minutes to an hour. It may take longer if you are having carboplatin with other drugs.
You’ll usually have one cycle of carboplatin every 21 to 28 days.
The total number of cycles will depend on your particular situation. Your specialist will discuss this with you.
5. Side effects of carboplatin
Like any treatment, carboplatin can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others. These can usually be controlled and those described here will not affect everyone.
If you’re having other chemotherapy or anti-cancer drugs with carboplatin, you may also have side effects from those drugs.
If you’re worried about any side effects, regardless of whether they’re listed here, talk to your chemotherapy nurse or treatment team.
Common side effects of carboplatin
Effects on the blood
Carboplatin can temporarily affect the number of healthy blood cells in the body.
You’ll have regular blood tests to check your blood count. If the number of blood cells is too low, your next cycle of treatment may be delayed or the dose of chemotherapy reduced.
Risk of infection
Not having enough white blood cells can increase the risk of getting an infection.
Signs of an infection
Your treatment team may give you guidelines to follow for reporting signs of an infection. But generally you should contact your hospital immediately if you experience any of the following:
- A high temperature (over 37.5°C) or low temperature (under 36°C), or whatever your treatment team has advised
- Suddenly feeling unwell, even with a normal temperature
- Symptoms of an infection, for example a sore throat, a cough, a need to pass urine frequently or feeling cold or shivery
Before starting chemotherapy, your treatment team should give you a 24-hour contact number or tell you where to get emergency care.
You may need antibiotics. Sometimes your doctor may recommend injections of drugs called growth factors. This helps the body produce more white blood cells to reduce your risk of infection.
Anaemia
Having too few red blood cells is called anaemia. If you feel particularly tired, breathless or dizzy, let your treatment team know.
Bruising and bleeding
You may bruise more easily, have nosebleeds or your gums may bleed when you brush your teeth. Tell your treatment team if you have any of these symptoms.
Nausea and vomiting
You may feel sick (nausea) or be sick (vomit), although many people will not actually be sick. You’ll be given anti-sickness medication into your vein or as tablets on the day of treatment. You’ll also be prescribed anti-sickness drugs to take home to reduce nausea or vomiting. If you still experience nausea and vomiting, talk to your chemotherapy team.
Extreme tiredness
Cancer-related fatigue is extreme tiredness or exhaustion that doesn’t go away with rest or sleep. It’s a very common side effect of treatment and may affect you physically and emotionally.
If you think you have fatigue, tell your GP or treatment team. They will fully assess you and offer advice on how to manage your energy levels.
Find out more about managing fatigue.
Effects on your concentration
You may find it hard to concentrate or think clearly, which can be very frustrating. This is often referred to as ‘chemo brain’ or ‘chemo fog’, but your treatment team may call it cognitive impairment. It usually improves over time after treatment has finished.
Effects on fertility
Carboplatin can cause temporary or permanent infertility (being unable to get pregnant). If this is important to you, talk to your specialist before starting your treatment. They may be able to refer you to a fertility specialist.
Menopausal symptoms
For women who haven’t been through the menopause, carboplatin can cause menopausal symptoms. This is because it affects their ovaries, which produce oestrogen.
Common menopausal symptoms can include:
- Hot flushes and night sweats
- Mood changes
- Joint aches and pains
- Vaginal dryness
You can talk to your breast care nurse or treatment team about ways of coping with any of these symptoms.
Less common side effects of carboplatin
Loss of appetite
You may lose your appetite while you’re having carboplatin. This may last for a few days, but if you’re concerned about how much you’re eating and drinking speak to your treatment team. They can give you advice and information, or refer you to a dietitian if needed.
Sore mouth and taste changes
You’ll be given mouthwash to try to reduce soreness of the mouth and gums and to try to stop mouth ulcers developing.
Looking after your mouth, including your teeth and gums, is very important during treatment.
It’s advisable to see your dentist for a check-up before chemotherapy begins, and to avoid dental treatment during chemotherapy if possible.
While you're having carboplatin your taste can change. Some food may taste different, for example more salty, bitter or metallic.
Numbness and tingling in hands or feet
Some people having carboplatin have numbness or tingling in their hands and feet. This is due to the effect of carboplatin on the nerves and is known as peripheral neuropathy.
In most cases it’s mild and goes away soon after treatment stops, although in some cases it can be permanent. If it’s severe, it may be necessary to reduce the dose of carboplatin or to stop it completely.
If you have numbness or tingling, tell your treatment team so they can monitor the symptoms.
Hair loss
Carboplatin may cause hair loss. This is usually temporary and for most people hair will begin to grow back a few weeks after treatment has ended.
Hearing problems
Carboplatin may cause ringing in the ears (tinnitus) or hearing loss. This is usually temporary and improves once treatment has finished. Let your doctor know if you have hearing loss or tinnitus.
Diarrhoea or constipation
You may have diarrhoea or constipation but your specialist or GP can prescribe medicine to control it. Contact your chemotherapy team if you have four or more episodes of diarrhoea within a 24-hour period.
Liver or kidney changes
Carboplatin can affect your liver and kidneys. Your team will check these are working normally before and throughout your treatment, usually with blood tests. Any effect carboplatin has is usually mild and will get better by itself.
Skin problems
Skin rashes can develop, which may itch. Your doctor can prescribe treatment to help with this.
Occasionally swelling (oedema) can occur in the feet, hands and (extremely rarely) face. The swelling usually improves once treatment stops but tell your treatment team if it happens.
Pain in the injection site
Chemotherapy drugs can sometimes leak out of the vein they are being given in. This is called extravasation and can damage the surrounding soft tissue.
Tell the nurse giving the chemotherapy immediately if you have any pain, stinging or a burning sensation around the cannula (small plastic tube) while the drug is being given.
6. Blood clots
People with breast cancer have a higher risk of blood clots. Their risk is higher because of the cancer itself and some treatments for breast cancer.
If the cancer has spread to other parts of the body (secondary breast cancer), this also increases the risk.
Having carboplatin increases the risk of blood clots like a deep vein thrombosis (DVT).
People with a DVT are at risk of developing a pulmonary embolism (PE). This is when part of the blood clot breaks away and travels to the lung.
Blood clots can be harmful but are treatable, so it’s important to report symptoms as soon as possible.
Blood clot symptoms
Contact your treatment team or go to your local A&E department straight away if you have any of the following symptoms:
- Pain, redness/discolouration of the skin, heat and swelling of the arm or leg
- Swelling, redness or tenderness where a central line is inserted to give chemotherapy, for example in the arm, chest area or up into the neck
- Shortness of breath
- Pain or tightness in the chest
- Unexplained cough or coughing up blood
Find out more about blood clots.
7. Allergic reaction
If you have an allergic reaction to carboplatin, it will probably happen during or within the first few minutes of your treatment.
It’s most likely the first or second time you have the drug. Reactions can vary from mild to severe, but severe reactions are uncommon.
You’ll be monitored closely so that any reaction can be dealt with immediately.
Symptoms of an allergic reaction include:
- Flushing
- Skin rash
- Itching
- Back pain
- Lip or tongue swelling
- Shortness of breath
- Faintness
- Fever or chills
If you have a severe reaction, treatment will be stopped immediately.
Medication can be given before future treatments to reduce the risk of further reactions.
8. Sex, contraception and pregnancy
It’s not known if chemotherapy drugs can pass through vaginal fluids (or semen). Most hospital specialists advise using a barrier method of contraception, such as a condom, for a few days after you have chemotherapy.
Having carboplatin while pregnant may be harmful to a developing baby. Some women can still become pregnant even if their periods are irregular or have stopped.
Use a non-hormonal contraception to avoid getting pregnant, such as a condom, Femidom or diaphragm.
It may also be possible to use a coil - IUD or intrauterine device. But you would need to discuss this with your specialist, as not all types may be suitable for women with breast cancer.
9. Travel and vaccinations
If you’re planning a holiday or need to travel overseas, check with your treatment team first.
You shouldn’t have any live vaccines while you’re having chemotherapy. Live vaccines include mumps, measles, rubella (German measles), polio, BCG (tuberculosis), shingles and yellow fever.
Live vaccines contain a small amount of live virus or bacteria. If you have a weakened immune system, which you may do during chemotherapy, they could be harmful.
It’s safe to have these vaccinations six months after your treatment finishes. Talk to your GP or treatment team before having any vaccinations.
If anyone you have close contact with needs to have a live vaccine, speak to your treatment team or GP. They can advise what precautions you may need to take depending on the vaccination.
Flu vaccination
Anyone at risk of a weakened immune system, and therefore more prone to infection, should have the flu vaccine. This includes people due to have, or already having, chemotherapy. The flu vaccine is not a live vaccine so doesn’t contain any active viruses.
If you’re already having chemotherapy, talk to your chemotherapy specialist or breast care nurse about the best time to have your flu jab.
10. Further support
Your chemotherapy team and breast care nurse can help with any questions you have.
If you'd like any further information and support about breast cancer, or just want to talk things through, you can speak to one of our experts by exploring our contact options below.
And on our online forum, you can find people going through treatment at the same time as you.
