VAC
Administration
• Administered intravenously (IV, meaning through the veins), typically in a hospital setting or chemotherapy day unit.
• Different delivery methods, including cannulas, central lines, PICC lines, or implantable ports, are tailored to individual patient needs.
• Treatment is given on 1 day of every cycle, which is defined by 21 days.
• Imaging is usually repeated every 2-3 cycles to determine the response.
• The number of cycles of treatment will depend on your tolerance to treatment and your response.
• A multidisciplinary team, including a cancer doctor, chemotherapy nurse, and specialist pharmacist, oversees the administration.
• Before treatment, a blood sample is taken to ensure safe blood cell levels for chemotherapy.
• You may receive oral or IV drugs prior and after the infusion to prevent nausea.
• It is possible that a subcutaneous injection is required following each cycle. Given at home or at the clinic, it will help boost the immune system.
Potential Side Effects & Management
While treatment is being given:
• Allergic Reactions: Signs include feeling hot, itching, rash, dizziness, or swelling. Prompt identification and treatment are crucial.
• Extravasation: Drug leakage outside the vein is critical for sarcoma patients. It can impact surrounding tissues, warranting urgent intervention. Immediate reporting of stinging, pain, redness, or swelling around the vein is essential.
• Pain along the vein: Treatment may cause pain at the infusion site. Promptly inform your nurse or doctor for assessment. Adjustments in drug administration speed or dilution may alleviate pain.
• Facial Flushing: A temporary warm, red sensation during drug administration.
Common Side Effects:
• Infection Risk: Given sarcoma treatments’ intensity, reduced white blood cell counts heighten infection risks, necessitating vigilance and timely medical intervention. If you have a fever over 38.3°C, you should advise your medical team or go to the emergency department.
• Sore Mouth & Throat: Treatment may cause sore mouth and throat which can potentially lead to mouth ulcers and increased risk of infection. Maintain oral hygiene; contact your healthcare team for mouthwash or medicines if needed.
• Bruising and Bleeding: Reduced platelets due to treatment can lead to easy bruising, nosebleeds, or blood in urine/stool. Platelet transfusion might be necessary.
• Anemia: Reduced red blood cells due to treatment can cause anemia. If severe, blood transfusion might be necessary.
• Bladder Irritation: This treatment may cause bladder discomfort. Stay hydrated, and a drug called mesna is often given to prevent irritation. If you notice blood in your urine, please advise your medical team.
• Nausea and Hair Loss: Managing these side effects can significantly impact quality of life during treatment.
• Diarrhea: Increased bowel activity; more common if you have a stoma.
• Constipation: Inability to pass stools as often as usual. Management includes drinking a lot of fluids, increasing fiber consumption, light exercise, and in severe cases, laxatives may be prescribed.
Less Common Side Effects:
• Numbness and tingling in hands and feet: This treatment can cause numbness, tingling, or pain in the hands or feet; inform your doctor for possible dose adjustments.
• Nail Changes: Slower nail growth, breakage, ridges, or discoloration may be experienced. Moisturize nails, keep them short, wear protective gloves.
• Skin Changes: Rash, sensitivity, discoloration; moisturizing and protective measures are recommended.
• Effects on the Heart: Regular heart function tests are conducted. Report chest pain, breathlessness, or dizziness to your doctor.
• Effects on Kidneys and Liver: Blood tests monitor kidney and liver function. Maintain hydration and report any unusual symptoms.
• Fatigue: This treatment may cause fatigue or weakness, which can impact daily activities.
• Effects on the Lungs: Notify your doctor of any respiratory symptoms like coughing or breathlessness.
• Sore Eyes: discomfort and temporary vision impairment may occur; inform your doctor if redness develops (conjunctivitis).
• Muscle or Joint Pain: Post-treatment pain in muscles or joints may arise; notify your doctor for pain relief, especially if persistent.
• Effects on the Nervous System: Report any unusual symptoms like weakness, numbness, or headaches to your doctor immediately.
• Excessive and uncontrolled secretion of antidiuretic hormone (ADH): This results in low sodium levels, leading to symptoms like nausea, decreased appetite, muscle soreness, and weakness. Regular blood tests are conducted to monitor sodium levels.
Precautionary Measures for Sarcoma Patients
• Blood Clot Risk: Cancer and its treatments, including VAC, heighten the risk of blood clots; be vigilant for symptoms such as leg/arm pain, breathlessness, or chest pain. Promptly contact the hospital if experienced, and follow prescribed measures, including staying active and well-hydrated, to reduce the risk.
• Communication: Always prioritize informing your healthcare team about ongoing sarcoma treatments, ensuring coordinated care and potential adjustments.
• Vaccinations: Sarcoma patients should be aware of vaccination recommendations, especially considering treatment impacts on immune responses.
• Sex and Contraception: This treatment may impact fertility; discuss and plan contraception strategies with your oncologists.
• Breastfeeding: Avoid while having treatment.
Understanding the details of this treatment, including its administration, potential side effects, and precautionary measures, empowers patients to actively participate in their care and optimize treatment outcomes. Always communicate openly with your healthcare team for personalized guidance and support.