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Cancer – Platinum Therapy

Sanjay Juneja, MD Sanjay Juneja, MD February 8, 2021
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Transcript

"So one of the most common chemotherapy agents that we've used for decades are platinum drugs. And we've been using them across several different tumor types. Outside of oxaliplatin, which we use in colon cancer, platinum drugs we're talking about right now are carboplatin and cisplatin. And it's very possible that this is going to be part of your regimen. Cisplatin compared to carboplatin by oncologists are thought of as a little rougher. And in that sense, we mean the symptoms are a little bit more, as far as the nausea and the fatigue and decreased appetite. The problem is studies have shown in certain settings that cisplatin is superior to carboplatin and can not be substituted in other settings that can, so that's a conversation you want to have with your oncologist. In general, these two platinum drugs that are cousins to each other, have these side effects. They do cause nausea and fatigue, like most chemo drugs do.

They can cause kidney problems. Cisplatin way more than carboplatin, but they can also kind of mess with the magnesium and the potassium and some of your electrolytes. So you may need some repletion for them. And because they cause kidney problems, you really want to hydrate both before and after. They can also cause what's called odotoxicity. And that basically means ringing in the ears. These side effects aren't common, at least the ringing in the years, but it's something to be aware of if it does happen, you need to let your oncologist know because they may need to dose reduce or even stop the therapy.

They also can cause what's called neuropathy, which is numbness or tingling in your hands and feet. If it comes and goes, that's usually something that your oncologist is okay with, but if you're having trouble buttoning the buttons on your shirt or turning the pages of a book, then that's something you want to tell your oncologist about. It can also sometimes cause problems with like your sodium and basically the access of how the endocrine things work, which is why your oncologist will be getting lab work. And finally they drop your counts. Carboplatin drops your counts even more than cisplatin. So even if the symptoms are a little harder with cis, with carbo, you can see the counts get pretty low. And by that, I mean the neutrophils that help you fight infection as well as the platelets and red blood cells that come from the bone marrow."

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