Doxorubicin is a drug classified as an anthracycline and used for the treatment of various types of cancers, including leukemias, lymphomas, multiple myeloma, bone cancers and mesotheliomas. It may be used to treat tumors in the ovaries and testes and cancers of the head and neck, thyroid, lung, breast, stomach, pancreas, liver, ovary, bladder, prostate and uterus. The medication is usually prescribed with other drugs aimed at interfering with the growth of cancers, leading to their death. Doxorubicin may produce many side effects; patients should discuss concerns with a physician.
Mucositis
The stomach and intestines have a mucous lining composed of epithelial cells that are constantly being reproduced. This makes the gastrointestinal mucosa a common site for inflammation, called mucositis, which is seen with doxorubicin. According to "Pharmacotherapy: A Pathophysiologic Approach," mucositis can lead to painful ulcerations, infection and inability to eat, drink or swallow. (See References 1) The most effective way to prevent this adverse reaction is good oral hygiene. Patients with a high risk of developing this toxicity, such as those with poor oral care, high-dose chemotherapy and radiation therapy involving the neck and throat area, should be evaluated by a dentist before starting the medication. These patients should also rinse their mouths frequently with baking soda and water in between courses of medication. Treatment of mucositis involves the use of pain killers and oral hygiene.
Hair Loss
Hair loss may occur in patients on doxorubicin. This side effect is temporary and not life-threatening. The amount of hair loss depends on the dose and length of therapy and can affect any area of the body. It typically occurs about one to two weeks after starting the drug and may begin to regrow once treatment is done.
Extravasation
Extravasation, which is the escape of the drug from the vein, may occur with doxorubicin. This may lead to tissue damage which results in pain, death of cells, infection and loss of mobility. "Pharmacology" explains that the most important method of prevention is good administration technique. The medication should be administered in a vein in the forearm, because if the drug leaks out, there is an adequate amount soft tissue to protect nerves, tendons and joints. If extravasation occurs, ice packs should be applied to the affected area.
Myelosuppression
Doxorubicin may cause myelosuppression, which is a decrease in the production of blood cells due to a decrease in the activity of the bone marrow. Bone marrow suppression does not occur immediately after administering the drug but occurs gradually as the blood cells begin to decrease. The patient should keep all doctor appointments, so he can monitor the levels of blood cells. Usually, reducing the dose can prevent severe myelosuppression.
Cardiac Toxicity
Doxorubicin may cause cardiac toxicity, especially in high doses. The "Drug Information Handbook" states that a cardiac evaluation is recommended before starting the medication, particularly in patients with increased risk of toxicity and in children. (See References 2) If the patient develops uneven heartbeat or chest pain, she should inform a physician immediately.
References
- "Pharmacotherapy: A Pathophysiologic Approach"; Joseph T. Dipiro, Robert L. Talbert, et al.; 2008
- "Drug Information Handbook"; Charles F. Lacy, Lora L. Armstrong, et al.; 2009
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