Etoposide is a chemotherapy drug that can be given to treat osteosarcoma, testicular and ovarian cancer as well as many other types of cancer.

Etoposide is a clear fluid. It is also available as pale pink capsules (tablets). It is usually given:

● as a drip (infusion) through a fine tube (cannula) into a vein in your arm
● as a drip through a central, PICC or hickman line
● capsules which should be swallowed whole (this is less common)

Are there any side effects?

Some people only get a few side effects while others have more. It’s hard to know how it will be for you. Most side effects are short-term and will gradually disappear once the treatment has finished.

The doctors and nurses on the ward will keep a close eye on you while you have your treatment. But it’s important to let them know if you feel unwell or have any problems.

Common side effects

• Lowered resistance to infection: Your immune system doesn’t work so well when you’re having chemo, so you might pick up more colds and infections. This begins around 7 days after treatment is started and reaches its lowest point around 10–14 days after chemo. Your blood cells then gradually go back to normal.

Keep an eye on your temperature and if it goes above 38°C (or you feel unwell) it’s important to let your doctor know. If necessary, you’ll be given antibiotics to keep any infection under control.

• Bruising and bleeding: The number of platelets in your blood can fall because of the chemo. This can cause bleeding or bruising (for example, gums, nose bleeds, heavy periods or pin prick dots on the skin). Let your doctor know if you have any problems with this. If your platelets are really low, they might suggest a platelet transfusion.
• Anaemia: The number of red cells (haemoglobin) in your blood can be low because of the chemo. This can make you feel tired and sometimes breathless. If necessary (to help with the symptoms) your doctor might suggest a blood transfusion to increase the amount of red cells in your blood.
• Hair loss usually happens 3–4 weeks after the first dose of etoposide. Very rarely it can start to fall out within a few days. You may also lose your eyelashes, eyebrows, underarm, pubic and other body hair. This can be really upsetting and tough to cope with. It’s important to remember that your hair will grow back once you’ve finished the treatment. You might want to look at our section on wigs and scarves and read some tips from other teenagers.
• Nausea and vomiting: Etoposide can make you feel sick (nausea) or actually be sick (vomit). You will be given anti-sickness drugs to try to stop any sickness. You can feel sick from a few minutes to a few hours after you have the chemo. It might last for a couple of hours but sometimes it can last for up to five days. Your doctor will prescribe anti-sickness drugs that will be given intravenously with your chemo. You’ll also have tablets to take home just in case.
• Diarrhoea: If you have diarrhoea let your doctor know as they can prescribe medicine to help. It is important to drink plenty of fluids if you have diarrhoea to stop you from becoming dehydrated.
• Sore mouth: You can get a sore mouth or mouth ulcers while on etoposide. It can help to drink plenty of fluids and clean your teeth regularly with a soft toothbrush. If your mouth is sore tell your nurse or doctor as they can give you special mouthwashes to help.
• Being off your food: You might not have much appetite and may loose weight. If this happens to you, a dietitian at the hospital can give you help and advice on what to eat and tips on how to cope.
• Taste changes: Your taste might change while you are having etoposide. Some people say they get a metallic taste in their mouth. This will return to normal when the treatment has finished. Have a look at some tips from other teenagers for how to cope with taste changes.
• Tiredness: The chemo can make you feel tired and weak, so it’s important to rest and take things easy whenever you can.
  

Less common side effects

• Skin changes – etoposide can cause a rash that can be itchy. Let your doctor know if this happens as they can prescribe something to help. It can also make your skin darken, which should return to normal a few months after the treatment has finished. 
•  Sleeplessness, headaches and confusion – this is a very rare side effect and usually only a possible problem with high-dose treatment. If you do feel any of these side effects you must let your doctor know straightaway.

Anything else I should know?

How will I feel? 

It can feel really scary reading about all these side effects. It’s important to remember that most of them can be controlled and once the treatment stops, the side effects will get better.

If you’re feeling nervous or worried, chat to your doctor and parents about things. They are there to help you. Also have a look at our forum, where you can talk to other young people who have been through a similar experience.