Docetaxel (Taxotere)

• What docetaxel is
• How you have the treatment
• Common side effects
• Occasional side effects
• Important points to remember
• Immunisations and chemotherapy

Docetaxel is one of the taxane drugs that were originally developed from the yew tree. Docetaxel is a man-made drug that was first made from the needles of the yew tree. It is also known by its brand name, Taxotere. It works by stopping the cancer cells from separating into 2 new cells, so it blocks the growth of the cancer. It is a treatment for

• breast cancer
• lung cancer
• head and neck cancer
• prostate cancer
• stomach cancer

You may also have it as part of a trial for other types of cancer such as ovary and bladder cancers.

Docetaxel is a liquid that you have through a drip (infusion) into a vein (intravenously). Each infusion takes about an hour and you have one every 1 to 3 weeks, depending on the type of cancer you are being treated for. Docetaxel can cause an allergic reaction. To try to prevent this, your doctor will give you steroid tablets to take, usually, for 3 days, starting the day before each treatment. For prostate cancer your steroid treatment usually starts 12 hours before your chemotherapy. You will then have 2 further doses at 3 hours before treatment, and one hour before treatment.

You usually have chemotherapy as a course of several cycles of treatment. The treatment plan for docetaxel depends on which cancer you are being treated for. There is more about planning chemotherapy in the main chemotherapy section of CancerHelp UK.

The side effects associated with docetaxel are listed below. You can use the links (underlined) to find out more about each side effect. Where there is no link, see the chemotherapy side effects section or click on 'search' at the top of the page.

With this drug, many people have a temporary drop in the number of blood cells made by the bone marrow, leading to the following side effects

• Increased risk of getting an infection from a drop in white blood cells - it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. 
• Tiredness and breathlessness due to a drop in red blood cells (anaemia) - you may need a blood transfusion
• Bruising more easily due to a drop in platelets - you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia).

These effects on your bone marrow can begin about 7 days after each treatment and usually go back to normal after about 21 to 28 days. Some of these side effects can be life threatening, particularly infections.  You should contact your doctor if you have any of these side effects.  Your doctor will check your blood counts regularly to see how well your bone marrow is working

Other common side effects include

• Fatigue - patients say this is the most disruptive side effect of all. It affects up to 8 out of 10 (80%) people treated. Tiredness often carries on after treatment has ended. Most people find their energy levels are back to normal from 6 months to a year after their treatment finishes.
• Fluid retention. This occurs in about half the patients treated with docetaxel. You may have swelling of the hands and feet, breathlessness and weight gain. The steroids you will be given with the drug can help to prevent this side effect.
• A rash, which may be itchy affects half the patients treated.
• Your fingernails may become discoloured but they will go back to normal a few months after the treatment ends.
• Some people also develop soreness, redness and peeling on the palms of the hands and soles of the feet (palmar - plantar syndrome). This may cause tingling, numbness, pain and dryness. Tell your doctor if this happens - you can be given vitamin B6 (pyridoxine) to help control it. It can help to keep your hands and feet cool, avoid very hot water, avoid tight fitting gloves or socks and keep your skin well moisturised.
• Hair loss - your hair normally falls out completely and this affects 8 out of 10 people (80%) treated. A cold cap may help to stop your hair falling out, but you need to talk to your doctor about whether this is advisable with your type of cancer.
• Sore mouth affects about 4 out of every 10 (40%) patients treated
• Diarrhoea affects about 4 out of every 10 (40%) patients treated
• Numbness and tingling in hands and feet, you may also have a change in how things feel when you touch them which can make doing fiddly things difficult, for example doing buttons up
• Allergic reaction during the infusion. About 1 in 4 people (25%) have an allergic reaction to docetaxel. This nearly always happens in the first 10 minutes. If you are going to have a reaction, it is most likely the first or second time you have the drug. Your chemotherapy nurse will monitor you closely for this.
• Docetaxel may have a harmful effect on a baby developing in the womb. You should not become pregnant or father a child whilst taking this drug. Discuss contraception with your doctor before you start your treatment if there is any possibility that you or your partner could become pregnant.

Some people have the following side effects

• Feeling or being sick this is usually mild and lasts for only a short time after having each treatment
• Loss of fertility - it is not known exactly what effect this drug may have on your fertility. It is important to talk to your doctor before starting treatment. Women may stop having periods (amenorrhoea). This may only be temporary.
• Aching muscles and joints
• High temperature (fever)
• Inflammation around the drip site - if you notice any signs of redness, swelling or leaking at your drip site, tell your doctor or chemotherapy nurse immediately

The side effects above may be mild or more severe. A side effect may get better or worse through your course of treatment, or more side effects may develop as the course goes on. This depends on

• How many times you've had the drug before
• Your general health
• The amount of the drug you have (the dose)
• Other drugs you are having

Some side effects are inconvenient or upsetting but not damaging to your health.

Some side effects are serious medical conditions and need treating. Where we have urged you to contact your doctor, this is because

• Your side effect may need treating
• Your drug dose may need reducing to try to prevent the side effect

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies - some drugs can react together.

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. Your chemotherapy nurse, clinic or ward nurse will have given you a contact number. You can ring if you have any questions or problems. They can give you advice or reassure you. If in doubt, call them.

You should not have immunisations with live vaccines while you are having chemotherapy or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered from your chemotherapy.

It is perfectly safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but no one in the UK is given an oral vaccine now. So there is no problem in being with any baby or child who has recently had any vaccination in the UK. If you live abroad, you might need to make sure that you aren't in contact with anyone who has had oral polio or oral typhoid vaccination recently.