Fluorouracil (5FU) Speak to our specialist nurses on our free Support Line

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1 1 Fluorouracil (5FU) This fact sheet is for anyone diagnosed with pancreatic cancer who would like to find out more about Fluorouracil (5-FU) chemotherapy to treat pancreatic cancer. It provides information about how 5FU is given and the side effects. Each hospital will do things slightly differently, and treatment will vary depending on your cancer, so speak to your doctor about your own situation. You can also speak to our specialist nurses on our Support Line about any questions you have about chemotherapy. You can call them free on , or 5FU is sometimes used after surgery to remove pancreatic cancer (known as adjuvant chemotherapy), instead of gemcitabine. It may also be used in combination with radiotherapy (chemoradiotherapy) for locally advanced cancers. 5FU is one of the drugs in FOLFIRINOX, a first-line treatment for advanced pancreatic cancer. It is also combined with leucovorin (folinic acid) and oxaliplatin in FOLFOX, a second-line treatment for advanced pancreatic cancer. How is 5FU given? You will have your chemotherapy as an outpatient in the chemotherapy unit, which means you ll go in for treatment, but won t need to stay overnight. 5-FU can be given as an injection into the vein or run through a special pump. You will be able to go home with this pump on. It can be given through a fine

2 2 plastic tube (cannula) inserted into a vein in your hand each time you have treatment. More often it will be given through a tube (central line) inserted into a vein in your arm or chest, which stays in place throughout your treatment. There may also be other options available. Read more about central lines and how they are inserted at Cancer Research UK. The dose of 5-FU, how often you have it, how long for, and whether you will have other drugs, varies. This will depend on whether you re having it with other treatments, in chemoradiotherapy or as second-line treatment. Speak to your oncologist about the details of your treatment. What are the side effects? 5FU can cause side effects, although everyone is affected in different ways. It s unusual to get all the possible side effects. There are ways to manage the side effects, and you may be given medication to help with some side effects. For example, you may be prescribed antisickness medication to deal with feeling sick (nausea). If you are prescribed medication you should take it exactly as you are told. Speak to your medical team if you get any side effects that you re worried about, or that aren t being properly controlled. You should have been given a phone number to contact them on. They can help you manage the side effects. Side effects can include the following. Sore mouth or mouth ulcers clean your teeth regularly with a soft toothbrush. Your doctor or nurse will be able to give you an antibacterial mouthwash that should help. Taste changes such as a metallic taste. You might find it helps to suck boiled sweets or use herbs in your food. Loose watery stools (diarrhoea). Make sure you drink plenty of fluids, and let your doctor or nurse know as they can give you medication to help. Eye problems gritty or watery eyes (as though you are crying). This can be helped with eye drops. Risk of infection from a low level of white blood cells called neutrophils (neutropenia). You may have headaches, aching muscles, a cough or sore throat or you may feel shivery and cold. This can be serious. You should contact the hospital straight away if your temperature goes above 37.5ºC or 38ºC (depending on the advice you ve been given by your chemotherapy team) or if you suddenly feel unwell, even if your temperature is normal. Bruising or bleeding, for example, nosebleeds or bleeding gums. This is caused by a low level of platelets.

3 3 Tiredness and breathlessness from anaemia, which is caused by a low level of red blood cells. You may need a blood transfusion to help you feel better. Fatigue (extreme tiredness). Fatigue can be difficult to manage. Take it easy, and make sure you rest when you need to. You might find it helps to take some gentle exercise, such as going for a short walk when you feel able. A good well balanced diet, and sorting out any other side effects or symptoms of the cancer can also help. Changes to how the heart works though this is usually temporary. If you have any pain or tightness in your chest, have an irregular heartbeat or feel breathless, let your doctor or nurse know straight away. Less common side effects include: Feeling or being sick (nausea or vomiting) your doctor will give you anti-sickness medication. Take it as soon as you feel sick. If it doesn t work, speak to your doctor or nurse to change it. Hair thinning. Changes to the nails your nails may darken or become flaky. Skin changes your skin may feel dry and itchy or be more sensitive to the sun. Use moisturiser, cover up, and use sun cream if you are outside. Let your doctor or nurse know about any skin changes. Soreness, redness and peeling on the palms of the hands and soles of the feet. Your doctor or nurse can prescribe cream or a vitamin to help with this. If the cream doesn t work, let your chemotherapy team know straight away. It usually improves after a break from treatment. You might also find it helps to keep your hands and feet cool. A blood clot forming in a blood vessel (thrombosis). If you have pain or swelling in your arms or legs or sudden shortness of breath, let your doctor or nurse know straight away. Read more about blood clots in a vein in our blood clot FAQ on our website at: pancreaticcancer.org.uk/dvtrisk. Ask your medical team for advice on managing these or any other side effects you experience. You can also call our specialist nurses free on our Support Line.

4 4 Read more about chemotherapy for pancreatic cancer and looking after yourself during chemotherapy on website at: pancreaticcancer.org.uk You can also read more information about 5FU on the Macmillan Cancer Support website. Pancreatic Cancer UK services c cancer. Our Support Line Our Support Line is a lifeline for thousands of patients, families and friends. Our specialist nurses understand the issues you might be facing. They are there for you, giving you personalised information and support that you need, when you need it. Call us free on (Monday to Friday from 10am-4pm), or us at Our information We have the most up-to-date information on everything you need to know about pancreatic cancer on our website. We can help you every step of the way, from explaining your diagnosis and treatment options, to managing symptoms, and questions to ask at your appointments. Go to pancreaticcancer.org.uk/informationandsupport Download or order our publications, for free, at pancreaticcancer.org.uk/publications Our online community Our online community is a supportive place where everyone affected by pancreatic cancer can be there for each other. Find us now at forum.pancreaticcancer.org.uk Support groups We help set up local support groups in communities all across the UK. These groups provide the opportunity for sharing personal experiences, understanding and support. Check to see if there s a group near you at pancreaticcancer.org.uk/supportgroups

5 5 Useful organisations CancerHelp UK Cancer nurses answer questions (Mon-Fri 9am-5pm) Information for patients from Cancer Research UK Macmillan Cancer Support Support Line: (Mon-Fri 9am-8pm) Provides practical, medical and financial support for anyone affected by cancer.

6 6 This fact sheet has been produced by the Support and Information Team at Pancreatic Cancer UK. It has been reviewed by health professionals and people affected by pancreatic cancer. References to the sources of information used to write this fact sheet and a list of health professionals who reviewed it are available on our website pancreaticcancer.org.uk Pancreatic Cancer UK makes every effort to make sure that our services provide up-to-date, unbiased and accurate information about pancreatic cancer. We hope that this information will add to the medical advice you have received and help you to take part in decisions related to your treatment and care. This information should not replace information and advice from your medical team please speak to your doctor, nurse or other members of your medical team about any questions or concerns. Give us your feedback We hope you have found this information helpful. We are always keen to improve our information, so let us know if you have any comments or suggestions. us at publications@pancreaticcancer.org.uk or write to the Information Manager at the address below. Pancreatic Cancer UK 2nd floor, Camelford House Albert Embankment London SE1 7TW enquiries@pancreaticcancer.org.uk pancreaticcancer.org.uk Pancreatic Cancer UK March 2015 Review date March 2017 Pancreatic Cancer UK is a charity registered in England and Wales ( ) and in Scotland (SC046392)