Care During Chemotherapy and Beyond
Trade Name: Abraxane®
Drug type: Paclitaxel Protein-bound is an anti-cancer ("antineoplastic"
or "cytotoxic") chemotherapy drug. Paclitaxel Protein-bound is classified
as an "plant alkaloid," a "taxane" and an "antimicrotubule agent." (For more
detail, see "How Paclitaxel Protein-bound Works" section below.)
What Paclitaxel Protein-Bound Is Used For:
- Paclitaxel Protein-bound is used to treat breast cancer after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy. Prior therapy should have included an anthracycline chemotherapy unless clinically not appropriate.
- Non-small cell lung cancer
- Pancreas cancer
Note: If a drug has been approved for one use, physicians may elect to use
this same drug for other problems if they believe it may be helpful.
How Paclitaxel Protein-Bound Is Given:
- The amount of Paclitaxel Protein-bound that you will receive depends on many factors,
including your height and weight, your general health or other health problems,
and the type of cancer or condition you have. Your doctor will determine your
exact dosage and schedule.
Important things to remember about the side effects of Paclitaxel Protein-bound:
- You will not get all of the side effects mentioned below.
- Side effects are often predictable in terms of their onset, duration, and severity.
- Side effects are almost always reversible and will go away after therapy is complete.
- Side effects are quite manageable. There are many options to minimize or prevent
The following side effects are common (occurring in greater than 30%) for patients
taking Paclitaxel Protein-bound:
The following are less common side effects for patients receiving Paclitaxel Protein-bound:
This list includes common and less common side effects for those taking Paclitaxel
Protein-bound. Side effects that are very rare -- occurring in less than about
10 percent of patients -- are not listed here. But you should always inform
your health care provider if you experience any unusual symptoms.
When to contact your doctor or health care provider:
Contact your health care provider immediately, day or night, if you should
experience any of the following symptoms:
- Fever of 100.4° F (38° C) or higher, chills (possible signs of infection)
The following symptoms require medical attention, but are not an emergency.
Contact your health care provider within 24 hours of noticing any of the
- If you notice any redness or pain at the site of injection.
- Nausea (interferes with ability to eat and unrelieved with prescribed medication).
- Vomiting (vomiting more than 4-5 times in a 24 hour period).
- Diarrhea (4-6 episodes in a 24-hour period).
- Unusual bleeding or bruising
- Black or tarry stools, or blood in your stools.
- Extreme fatigue (unable to carry on self-care activities).
- Mouth sores (painful redness, swelling or ulcers).
- Numbness and tingling of the hands and feet.
- Signs of infection such as redness or swelling, pain on swallowing, coughing up
mucous, or painful urination
Always inform your health care provider if you experience any unusual symptoms.
- Before starting Paclitaxel Protein-bound treatment, make sure you tell your doctor
about any other medications you are taking (including prescription, over-the-counter,
vitamins, herbal remedies, etc.). Do not take aspirin, products containing
aspirin unless your doctor specifically permits this.
- Do not receive any kind of immunization or vaccination without your doctor's approval
while taking Paclitaxel Protein-bound.
- Inform your health care professional if you are pregnant or may be pregnant prior
to starting this treatment. Pregnancy category D (Paclitaxel Protein-bound
may be hazardous to the fetus). Women who are pregnant or become pregnant
must be advised of the potential hazard to the fetus.
- For both men and women: Use contraceptives, and do not conceive a child (get pregnant)
while taking Paclitaxel Protein-bound. Barrier methods of contraception, such as
condoms, are recommended.
- Do not breast feed while taking Paclitaxel Protein-bound.
- Paclitaxel Protein-bound, or the medications that you take with Paclitaxel Protein-bound
may cause you to feel dizzy or drowsy. Do not operate any heavy machinery
until you know how you respond to Paclitaxel Protein-bound.
- If you notice any redness or pain at the injection site, place a warm compress,
and notify your healthcare provider.
- Drink at least two to three quarts of fluid every 24 hours, unless you are instructed
- You may be at risk of infection so try to avoid crowds or people with colds, and
report fever or any other signs of infection immediately to your health care provider.
- Wash your hands often.
- To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times
a day with 1/2 to 1 teaspoon of baking soda and/or 1/2 to 1 teaspoon of salt mixed
with 8 ounces of water.
- Use an electric razor and a soft toothbrush to minimize bleeding.
- Avoid contact sports or activities that could cause injury.
- To reduce nausea, take anti-nausea medications as prescribed by your doctor, and
eat small, frequent meals.
- Acetaminophen or ibuprophen may help relieve discomfort from fever, headache and/or
generalized aches and pains. However, be sure to talk with your doctor before
- Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
- In general, drinking alcoholic beverages should be kept to a minimum or avoided
completely. You should discuss this with your doctor.
- Get plenty of rest.
- Maintain good nutrition
- If you experience symptoms or side effects, be sure to discuss them with your health
care team. They can prescribe medications and/or offer other suggestions that
are effective in managing such problems.
Monitoring and Testing:
You will be checked regularly by your doctor while you are taking Paclitaxel Protein-bound,
to monitor side effects and check your response to therapy. Periodic blood
work will be obtained to monitor your complete blood count (CBC) as well as the
function of other organs (such as your kidneys and liver) will also be ordered by
How Paclitaxel Protein-Bound Works:
Cancerous tumors are characterized by cell division, which is no longer controlled
as it is in normal tissue. "Normal" cells stop dividing when they come
into contact with like cells, a mechanism known as contact inhibition. Cancerous
cells lose this ability. Cancer cellsno longer have the normal checks and balances
in place that control and limit cell division. The process of cell division,
whether normal or cancerous cells, is through the cell cycle. The cell cycle
goes from the resting phase, through active growing phases, and then to mitosis
The ability of chemotherapy to kill cancer cells depends on its ability to halt
cell division. Usually, the drugs work by damaging the RNA or DNA that tells
the cell how to copy itself in division. If the cells are unable to divide,
they die. The faster the cells are dividing, the more likely it is that chemotherapy
will kill the cells, causing the tumor to shrink. They also induce cell suicide
(self-death or apoptosis).
Chemotherapy drugs that affect cells only when they are dividing are called cell-cycle
specific. Chemotherapy drugs that affect cells when they are at rest are called
cell-cycle non-specific. The scheduling of chemotherapy is set based on the
type of cells, rate at which they divide, and the time at which a given drug is
likely to be effective. This is why chemotherapy is typically given in cycles.
Chemotherapy is most effective at killing cells that are rapidly dividing.
Unfortunately, chemotherapy does not know the difference between the cancerous cells
and the normal cells. The "normal" cells will grow back and be healthy but in the
meantime, side effects occur. The "normal" cells most commonly affected by
chemotherapy are the blood cells, the cells in the mouth, stomach and bowel, and
the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea,
and/or hair loss. Different drugs may affect different parts of the body.
Paclitaxel belongs to a class of chemotherapy drugs called plant alkaloids.
Plant alkaloids are made from plants. The vinca alkaloids are made from the
periwinkle plant (catharanthus rosea). The taxanes are made from the bark of the
Pacific Yew tree (taxus). The vinca alkaloids and taxanes are also known as
antimicrotubule agents. The podophyllotoxins are derived from the May apple plant.
Camptothecan analogs are derived from the Asian "Happy Tree" (Camptotheca acuminata).
Podophyllotoxins and camptothecan analogs are also known as topoisomerase inhibitors.
The plant alkaloids are cell-cycle specific. This means they attack the cells
during various phases of division.
- Vinca alkaloids: Vincristine, Vinblastine and Vinorelbine.
- Taxanes: Paclitaxel and Docetaxel.
- Podophyllotoxins: Etoposide and Tenisopide.
- Camptothecan analogs: Irinotecan and Topotecan.
Antimicrotubule agents (such as Paclitaxel), inhibit the microtubule structures
within the cell. Microtubules are part of the cell's apparatus for dividing
and replicating itself. Inhibition of these structures ultimately results
in cell death.
Note: We strongly encourage you to talk with your health
care professional about your specific medical condition and treatments. The information
contained in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
Chemocare.com is designed to provide the latest information about chemotherapy to patients and their families, caregivers and friends. For information about the 4th Angel Mentoring Program visit www.4thangel.org