Side Effect

Management

Infusion-related reaction 

• This sometimes occurs during the first few doses.
• This is usually mild or moderate, but rarely can be more severe.

• Inform the nurse immediately if you experience any of the following during the infusion:
  • Flu-like symptoms such as fever, chills dizziness, headache and/or feeling warm or flushed
  • Red, warm, and itchy bumps on the skin
  • Swelling of the lips, tongue, or throat
  • Breathlessness, wheezing, cough or sudden difficulty breathing
  • Back pain or chest pain
• If you do have a reaction, this is usually treated by slowing or stopping the drip until the reaction is over. Future infusions may also be given at a slower rate.

Decrease in white blood cell count. 

This may increase your chances of getting an infection.

• To reduce your risk of infection:
  • Maintain good hand hygiene. Wash your hands before handling food and after using the toilet.
  • Avoid crowds and do not go near people who are sick. Wear a mask if necessary.
  • Eat freshly cooked and well-cooked food. Avoid raw meats, vegetables and eggs, or half-cooked or uncooked food.
• Proceed to the A&E department immediately if you have any signs of infection such as fever of 38ºC and above, chills, bad sore throat, pain when you pass urine or have mouth sores or wounds that do not heal.
  • Avoid taking Paracetamol to relieve fever as this may mask your fever and delay treatment of the infection.

Decrease in platelet count. Low platelet levels can increase your chance of bleeding. 

• To reduce risk of bleeding: 
  • Be careful when using sharp objects such as scissors or knives.
  • Brush your teeth gently with a soft bristle toothbrush to prevent gum bleeding.
  • Try not to bruise, cut or knock yourself. Apply direct pressure to any cuts or wounds to help stop bleeding.
• Proceed to the A&E department immediately if you have:
  • Bruising without a cause or bruises that get larger in size
  • Black, sticky stools
  • Blood in the urine
  • Coughing out blood or vomit that looks like coffee grounds
  • Bleeding which does not stop

Decrease in the number of red blood cells (anaemia)

As your red blood cells help to carry oxygen to the different parts of your body, this may cause you to feel tired more easily.

• Proceed to the A&E department immediately if you have:
  • Unusual giddiness or light-headedness that does not go away
  • Severe shortness of breath or rapid breathing
  • A fast heartbeat while resting

Nerve problems

You may experience numbness or tingling sensation in the hands or feet.

This side effect usually affects the fingertips and toes / soles of feet after a few cycles of chemotherapy.

This may be temporary and may improve after you have finished treatment. 

• Take extra care when walking or getting up if the numbness affects your feet, and when handling hot or sharp objects.
• Inform your doctor if this symptom troubles you or affects your daily activities such as buttoning up shirts or picking up objects.

Skin rash

• This is usually mild and may be itchy.
• Avoid hot showers. Use cool or lukewarm water to bathe.
• Apply a moisturizer to areas with dry skin.
• Avoid staying out under the sun. Use sunscreen with Sun Protection Factor (SPF) and covered clothing when you are out in the sun.
• Proceed to the A&E Department immediately if the rashes are painful, blistering, or affect a large area of the body. These may be symptoms of rare but severe skin conditions  called Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN).

Hair loss

• This is a temporary side effect and may be more obvious by the second week of treatment. 
• You may lose all the hair on your head and may even lose your eyebrows, eyelashes or body hair.
• Your hair will grow back once chemotherapy is completed.

• Consider cutting your hair short before chemotherapy, using wigs or using head coverings like hats or scarves. 
• Use a mild shampoo (such as baby shampoo) to wash your hair and scalp. 

Tumour lysis syndrome (TLS) may occur as Brentuximab Vedotin may cause fast breakdown of the cancer cells.

• Keep well hydrated by drinking 6 to 8 glasses of water each day, starting 2 days before treatment initiation and dosage increase.
• Your doctor may also give you medicine to help prevent tumour lysis syndrome.
• Proceed to the A&E department immediately if you experience any unusually fast heartbeat, muscle weakness or cramps or pain, dark and cloudy urine, unusual tiredness or seizures.

Pancreas problems, which may lead to symptoms such as

• Nausea or vomiting with loss of appetite
• Severe abdominal pain

• Proceed to the A&E department immediately.

Liver problems

• Proceed to the A&E department immediately if you experience any:
  • Dark or tea-coloured urine
  • Pale or light-coloured stools
  • Yellowing of skin or eyes
  • Nausea, vomiting with loss of appetite
  • Severe abdominal pain

Lung problems 

• Proceed to the A&E department immediately if you have any new or worsening symptoms of lung problems such as shortness of breath, cough or chest pain.

Problems with normal brain function

These could be symptoms of a rare but serious infection of the brain called Progressive Multifocal Leukoencephalopathy and may occur within three months of stopping treatment. 

• Proceed to the A&E department immediately if you have symptoms such as:
  • Changes in your mood or usual behaviour
  • Feeling confused or having difficulty thinking 
  • Memory loss
  • Changes in your vision, speech, or walking
  • Decreased strength or weakness on one side of the body

Symptoms of drug allergy including one or more of the following:

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

• If you experience any of these symptoms, you see your healthcare professional immediately.

Exercise

Light exercise is recommended as it helps to improve mobility, balance, and even emotional well-being. Avoid strenuous exercise, and rest when you are feeling tired.

Adequate hydration

Maintain adequate hydration with 2 to 3 litres of fluids per day unless you have been informed by your doctor to restrict fluids. This will decrease your chances of getting constipation and prevent dehydration.

Medical and dental treatment

If you need to go to the hospital for any reason other than cancer, always inform the doctors and nurses that you are receiving anti-cancer treatment.

Talk to your cancer doctor if you think you need dental treatment. Always inform your dentist that you are receiving anti-cancer treatment.

Seek support if you feel overwhelmed

It is normal to feel fearful or worried about your condition. 

Do not be afraid to talk about your concerns with your healthcare team or loved ones. 

There may be resources and support available to help you.