Thiotepa

Thiotepa (pronounced thigh-o-tee-pa) is a chemotherapy drug that is given as a treatment for some types of cancer. This information describes thiotepa, how it is given and some of its possible side effects. It should ideally be read with our general information about chemotherapy

and about your type of cancer.

If you have any further questions you can ask your doctor or nurse at the hospital where you are having your treatment, or speak to one of our cancer support service nurses.

• What thiotepa looks like
• How it is given
• Possible side effects
• Less common side effects
• Additional information

What thiotepa looks like

Thiotepa is a colourless fluid after being dissolved from powder.

How it is given

Thiotepa may be given:

• by injection into a muscle (intramuscularly)
• as a drip (infusion) through a fine tube (cannula) inserted into the vein. It may be given through a central line, which is inserted under the skin into a vein near the collarbone, or into a PICC line, which is inserted into a vein in the crook of the arm.
• as an injection into the vein (intravenously) through a cannula
• directly into the bladder (intravesically)
• by injection into the muscle (intramuscularly)
• by injection into the fluid around the spinal cord through a lumbar puncture (intrathecally) or an Ommaya reservoir (a flat plastic bubble which has been inserted into an area beneath the scalp). Only specially trained doctors and nurses can give drugs in this way and the procedure has to be carried out in a special area, so you may be given this treatment by different staff and in a different hospital from the rest of your chemotherapy.

Possible side effects

Each person's reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described in this information will not affect everyone who is given thiotepa, and may be different if you are having more than one chemotherapy drug.

We have outlined the most common and less common side effects, so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you notice any effects which you think may be due to the drug, but which are not listed in this information, please discuss them with your doctor or chemotherapy nurse.

Lowered resistance to infection Thiotepa can reduce the production of white blood cells by the bone marrow, making you more prone to infection. This effect can begin seven days after treatment has been given and your resistance to infection usually reaches its lowest point any time up to 30 days after the chemotherapy. Your blood cells will then gradually return to normal over 21–28 days.

Contact your doctor or the hospital straightaway if:

• Your temperature goes above 38ºC (100.5ºF)
• You suddenly feel unwell (even with a normal temperature).

You will have a blood test before having more chemotherapy, to make sure that your cells have recovered. Occasionally it may be necessary to delay your treatment if the number of blood cells (the blood count) is still low.

Bruising or bleeding Thiotepa can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, and bleeding gums.

Anaemia (low number of red blood cells) While having treatment with thiotepa you may become anaemic. This may make you feel tired and breathless. Let your doctor or nurse know if these are a problem.

Nausea (feeling sick) and vomiting If you do feel sick it may begin several hours after the treatment is given and may continue while you are having your treatment. Your doctor can now prescribe very effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting. If the sickness is not controlled or continues, tell your doctor, who can prescribe other anti-sickness drugs that may be more effective.

Tiredness and feeling weak You may feel very tired. It is important to allow yourself plenty of time to rest.

Less common side effects

Skin changes Your skin may darken due to excess production of pigment. This usually returns to normal a few months after the treatment has finished.

Hair loss This is rare, but hair may thin or occasionally be lost completely. If this happens it usually begins about 3–4 weeks after starting treatment, although it may occur earlier. Hair loss is temporary, and your hair will regrow once the treatment is finished.

Allergic reaction Signs of an allergic reaction include skin rashes and itching, a high temperature, shivering, redness of the face, a feeling of dizziness, a headache, breathlessness, anxiety and a need to pass urine. You will be monitored for any signs of an allergic reaction during the treatment. Tell your doctor or nurse if you have any of these signs.

Long-term changes in the way your bone marrow works Long-term thiotepa treatment may permanently damage the bone marrow. This can affect the production of healthy blood cells and may lead to the development of myelodysplasia (a condition affecting the function of the bone marrow) or leukaemia (cancer of the white blood cells). The risks of long-term damage are outweighed by the benefits of the drug. Your doctor can discuss this with you further.

Additional information

The side effects mentioned above are most likely to occur if thiotepa is given into a vein (intravenously). The other ways of giving thiotepa are less likely to cause side effects.

If thiotepa is given into the bladder, it may irritate the bladder lining. This may mean that you want to pass urine more often (cystitis). Your doctor can prescribe medicine to reduce this feeling. Other side effects are very rare when thiotepa is given in this way.

If thiotepa is given into the fluid around the spinal cord it can temporarily cause dizziness and headaches.

Thiotepa eye drops may be used to treat a non-cancerous condition of the eye. The eye drops may cause some irritation of the skin around the eye. There may also be loss of colour in the skin in this area. Other side effects do not occur.

While thiotepa is being given intravenously it can cause pain at the place where the injection is given, or along the vein. If you feel pain, tell your doctor or nurse.

Other medicines Some medicines can be harmful to take when you are having chemotherapy. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs

Fertility Your ability to become pregnant or father a child may be affected by taking this drug. It is important to discuss fertility with your doctor before starting treatment.

Contraception It is not advisable to become pregnant or father a child while taking thiotepa, as the developing foetus may be harmed. It is important to use effective contraception while taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor.