Chemotherapy Drugs by Name: — What Each One Does

Paclitaxel is a taxane — a class of drugs that prevents cancer cells from completing division by stabilising a structure inside the cell called the spindle. It is given as an intravenous infusion, usually on a three-weekly or weekly schedule depending on the regimen. Pre-medication with steroids and antihistamines is given before each dose to reduce the risk of an allergic reaction, which the solvent used to dissolve paclitaxel can otherwise trigger. The most common side effects are peripheral neuropathy (numbness, tingling, or pain in the hands and feet), hair loss, fatigue, and a drop in white blood cell count. Neuropathy can persist after treatment ends. Tell your team at each visit how your hands and feet feel, because dose adjustment may reduce the long-term effect. Sourced from NCCN drug information for paclitaxel.

Docetaxel is also a taxane and works by the same mechanism as paclitaxel, preventing cell division by acting on the spindle. It is given intravenously, typically once every three weeks. Steroid pre-medication starting the day before infusion is used to reduce fluid retention — a recognised side effect of docetaxel that can cause swelling in the legs and, less commonly, fluid around the lungs. Other common side effects include hair loss, nail changes, fatigue, mouth sores, and a drop in white blood cell count. Mouth sores tend to be more prominent with docetaxel than with paclitaxel. Report new swelling, shortness of breath, or fever to your team promptly. Sourced from NCCN drug information for docetaxel.

Carboplatin belongs to the platinum class of chemotherapy. It works by binding to DNA inside cancer cells and creating damage the cell cannot repair, preventing replication. It is given as an intravenous infusion, often on a three-weekly schedule, and is frequently combined with other drugs. Carboplatin is generally better tolerated than cisplatin, particularly with respect to nausea and kidney effects. The most common significant side effect is a drop in platelet count, which affects the ability to stop bleeding. Tell your team if you notice unusual bruising or prolonged bleeding from minor cuts. Nausea is common but is usually managed well with anti-emetic medicines. Sourced from NCCN drug information for carboplatin.

Cisplatin is a platinum compound that damages cancer-cell DNA in a similar way to carboplatin, but it is more potent and has a more demanding side-effect profile. Large volumes of intravenous fluid are given before and after the drug to protect the kidneys — this is a standard requirement, not an optional step. The most important side effects are kidney damage, hearing loss (which can be permanent), severe nausea and vomiting, and a drop in blood counts. Your kidney function and hearing may be monitored throughout treatment. Tell your team immediately if you notice ringing in your ears, any change in hearing, or a significant drop in how much urine you are passing. Sourced from NCCN drug information for cisplatin.

Doxorubicin is an anthracycline — a class of chemotherapy derived from a naturally occurring compound. It works by inserting itself into cancer-cell DNA and blocking the enzymes needed for division. It is given intravenously. The urine may turn red or pink for one to two days after infusion; this is the drug being excreted and is not a sign of bleeding. The most clinically significant side effect is a cumulative effect on the heart's pumping function. Your oncologist will monitor your cardiac function throughout treatment. Hair loss begins within two to three weeks of the first dose and is almost universal. Mouth sores and nausea are also common. Sourced from NCCN drug information for doxorubicin.

Cyclophosphamide is an alkylating agent — it attaches chemical groups to cancer-cell DNA that prevent the cell from replicating. It can be given intravenously or as an oral tablet depending on the regimen, and is often used in combination with other drugs. A specific side effect is irritation of the bladder lining, caused by a breakdown product called acrolein. Adequate fluid is given alongside treatment to reduce this risk. Tell your team immediately if you notice blood in your urine at any point. Hair loss and suppression of the immune system are the other most common significant effects. This drug can affect fertility in both men and women; discuss this before treatment begins if it is relevant to you. Sourced from NCCN drug information for cyclophosphamide.

5-Fluorouracil, or 5-FU, is an antimetabolite. It mimics a DNA building block and is incorporated into dividing cancer cells, stopping them from replicating. It is usually given as a prolonged intravenous infusion delivered over one to four days via a portable pump you take home, rather than a single chair-based infusion — which means your practical experience of this drug differs from most. Mouth sores and diarrhoea are among the most common significant side effects. A small number of people carry a gene variant called DPD deficiency that means they break down 5-FU much more slowly, causing more severe toxicity from the outset. Testing for this before starting is standard practice in many centres. Tell your team about any unexpectedly severe symptoms in the first cycle. Sourced from NCCN and ESMO guidance on fluoropyrimidines.

Capecitabine is an oral tablet that the body converts to 5-fluorouracil inside the tumour tissue. Because it is taken at home on a fixed daily schedule rather than given as an infusion, the practical experience differs from most chemotherapy — but it remains a full chemotherapy drug with significant side effects requiring careful monitoring. The most distinctive side effect is hand-foot syndrome: redness, soreness, blistering, and peeling of the palms and soles of the feet. Moisturising the hands and feet frequently and avoiding tight footwear reduces the severity. Diarrhoea is also common. DPD deficiency testing is relevant here as with intravenous 5-FU. If you develop severe diarrhoea, significant hand-foot pain, or mouth sores in the first cycle, contact your team rather than waiting for the next appointment. Sourced from NCCN drug information for capecitabine.

Gemcitabine is an antimetabolite given as an intravenous infusion, typically once a week for two or three consecutive weeks followed by a rest week. It is often given alongside a platinum compound. The most common side effects are suppression of blood cell production — causing fatigue, increased infection risk, and a tendency to bruise or bleed — and a flu-like syndrome of fever, chills, and muscle aches that typically appears several hours after the infusion and settles within 24 hours. Paracetamol is usually effective for the flu-like symptoms; tell your team if fever persists or is high rather than assuming it is the expected reaction. Gemcitabine does not commonly cause significant hair loss, which some people find reassuring. Sourced from NCCN drug information for gemcitabine.

Oxaliplatin is a platinum compound given intravenously, most often alongside 5-FU or capecitabine in regimens for colorectal cancer. Its most distinctive and well-documented side effect is a cold-triggered nerve reaction: touching cold objects or drinking cold liquids causes an unpleasant tingling or cramping sensation in the hands and throat, particularly in the first few days after each infusion. Avoiding cold during this window reduces the severity. A longer-term peripheral neuropathy — numbness and tingling in the hands and feet that does not depend on cold — can also develop and may persist after treatment ends. Tell your team how your neuropathy is changing at each cycle visit, because dose adjustments can help. Nausea is common. Sourced from NCCN drug information for oxaliplatin.