Carboplatin

Carboplatin is a chemotherapy drug used to treat breast cancer. It’s usually given in combination with other drugs.

Carboplatin can be used to treat people who have:

• Secondary (metastatic) breast cancer – breast cancer that has spread to another part of the body, such as the bones, lungs, liver or brain
• Locally advanced breast cancer – breast cancer that has spread to the chest wall or skin of the breast, or the lymph nodes around the chest, neck and under the arm or breastbone, but has not spread to other areas of the body
• Triple negative primary breast cancer – triple negative breast cancer that has not spread beyond the breast or the lymph nodes under the arm

Research is continuing to look at the benefits of carboplatin for some primary breast cancers and breast cancer that’s developed due to inheriting an altered gene. You may be offered carboplatin as part of a clinical trial. Talk to your treatment team for more information about clinical trials.

Before starting your treatment, a member of your treatment team will talk through how and when you’ll have your chemotherapy and how side effects can be managed.

You’ll have blood tests and your height and weight will be measured. 

You may also have tests to check your heart function, such as: 

• An ECG (electrocardiogram), a simple test that checks your heart rhythm 
• An echocardiogram, an ultrasound scan of the heart 

You should be given a 24-hour contact number or told who to contact if you feel unwell at any time during your treatment, including overnight or at the weekends.

Carboplatin is given into a vein (intravenously).

This will usually be through a cannula, a small tube that’s inserted into a vein in the back of your hand or lower arm.

You could also have carboplatin through:

•  A skin-tunnelled catheter (Hickman line): a tube inserted into a vein in your chest
• A peripherally inserted central catheter (PICC): a tube inserted into a vein in your arm at or above the bend in your elbow
•  An implanted port: a small device with a tube that goes into a vein that’s put under the skin, usually in your chest or arm

If you have primary breast cancer, carboplatin may be given together with other anti-cancer drugs. It may be given before or after surgery.

If you have secondary breast cancer, you may have carboplatin on its own or together with other anti-cancer drugs.

How long does treatment take?

It takes about an hour to have carboplatin. It may take longer if you are having carboplatin with other drugs.

You’ll usually be given carboplatin once every 3 weeks. This is known as a cycle.

The gap between each cycle of treatment gives your body time to recover. Chemotherapy can reduce the amount of blood cells in your body. You might have a longer gap between cycles if your blood tests show that the number of blood cells hasn’t returned to normal.

The total number of cycles will depend on your situation. Your treatment team will discuss this with you.

Like any treatment, carboplatin can cause side effects. Everyone reacts differently to drugs and some people have more side effects than others.

It’s important to talk to your chemotherapy nurse or treatment team about any side effects you’re worried about, whether or not they’re listed here. These can usually be managed and those described here will not affect everyone.

If you’re having other chemotherapy or anti-cancer drugs with carboplatin, you may also have side effects from those drugs.

Common side effects of carboplatin

Effects on the blood

Carboplatin can temporarily affect the number of blood cells in the body. Blood is made up of red cells, white cells and platelets. 

You’ll have regular blood tests. If these show the number of blood cells is too low, your next cycle of treatment may be delayed or the dose of chemotherapy reduced. 

Your treatment team may change the dose of a drug to suit you and help manage its side effects. This may help you stay on the treatment for longer.

Risk of infection

Not having enough white blood cells can increase the risk of getting an infection.

Before starting chemotherapy, your treatment team should give you a 24-hour contact number or tell you where to get emergency care. 

You may need antibiotics. Sometimes your doctor may recommend injections of drugs called growth factors. This helps the body produce more white blood cells to reduce your risk of infection.

Anaemia

Having too few red blood cells is called anaemia. If you feel particularly tired, breathless or dizzy, let your treatment team know.

Bruising and bleeding

You may bruise more easily, have nosebleeds or your gums may bleed when you brush your teeth. Tell your treatment team if you have any of these symptoms.

Nausea and vomiting

You may feel sick (nausea) or be sick (vomit), although many people will not actually be sick. You’ll be given anti-sickness medication into your vein or as tablets on the day of treatment. You’ll also be prescribed anti-sickness drugs to take home to reduce nausea or vomiting. If you still experience nausea and vomiting, talk to your chemotherapy team.

Extreme tiredness

Cancer-related fatigue is extreme tiredness or exhaustion that doesn’t go away with rest or sleep. It’s a very common side effect of treatment and may affect you physically and emotionally. 

If you think you have fatigue, tell your GP or treatment team. They will fully assess you and offer advice on how to manage your energy levels.

Find out more about managing fatigue.

Effects on your concentration 

Treatment can affect your ability to concentrate and may make you more forgetful.

This is sometimes referred to as “chemo brain” or “chemo fog”, but your treatment team may call it cognitive impairment. It usually improves over time after treatment has finished.

Menopausal symptoms

Carboplatin may cause menopausal symptoms if you haven’t been through the menopause. This is because it affects the ovaries, which produce oestrogen.

Your periods may stop or become irregular during chemotherapy. Whether your periods return depends on:

• Your treatment and its dose
• Your age

Common menopausal symptoms can include:

• Hot flushes and night sweats
• Mood changes
• Joint aches and pains
• Vaginal dryness
• Changes to your sex drive

Tell your treatment team if you have any menopausal symptoms as they may suggest ways of managing these.

Find out more about menopausal symptoms and breast cancer.

Less common side effects of carboplatin

Loss of appetite

You may lose your appetite.

If you’re concerned about how much you’re eating and drinking speak to your treatment team. They can give you advice or refer you to a dietitian if needed.

Sore mouth 

Looking after your mouth, including your teeth and gums, is very important during treatment.  

You may be given mouthwash to try to reduce soreness and stop mouth ulcers developing. It’s a good idea to use a small, soft toothbrush during this time. 

See your dentist for a check-up before treatment with chemotherapy begins. Avoid dental work during treatment if possible.  

If you do need to have dental work during treatment, talk with your treatment team about the best time to have this. 

If you’re having difficulty registering with a dentist, let your treatment team know.

Taste changes

Carboplatin can change your sense of taste. Some food may taste different, for example more salty, bitter or metallic.

Your taste should return to normal once your treatment has finished.

Our information on diet during breast cancer treatment includes tips for dealing with taste changes.

Numbness and tingling in the hands or feet

You may have pain, numbness or tingling in your hands and feet after you have your treatment. This is due to the effect of carboplatin on the nerves and is known as peripheral neuropathy.

Other symptoms of peripheral neuropathy can include difficulty doing “fiddly” tasks like doing up buttons, a feeling of warmth or cold in your hands and feet, or loss of balance.

Symptoms are often mild to start with and can gradually get worse.

For some people the symptoms stay mild and go away soon after treatment stops. However, for most people, the symptoms will gradually improve over the weeks and months after treatment has finished.

Symptoms may take longer to improve and, in some cases, may not go away completely.

If you have symptoms of peripheral neuropathy, tell your treatment team so they can monitor them.

Hair loss

Carboplatin causes hair thinning and hair loss.

You may lose all your hair, including hair on your head, eyebrows, eyelashes and body hair.

You may begin to lose your hair around 2 weeks after your first treatment, but this can happen sooner.

Scalp cooling may stop you losing some or all of the hair on your ahead.

Any hair thinning or hair loss is usually temporary and for most people hair will begin to grow back in the weeks and months after treatment has finished.

Find out more about coping with hair loss.

Hearing problems

Carboplatin may cause ringing in the ears (tinnitus) or hearing loss. This is usually temporary and improves once treatment has finished. Let your treatment team know if you have hearing loss or tinnitus.

Diarrhoea or constipation

You may have diarrhoea or constipation. Your treatment team can prescribe medicine to help control it.

Contact your treatment team if you have diarrhoea 3 or more times in 24 hours, compared to what’s usual for you.

Liver or kidney changes

Carboplatin can affect your liver and kidneys. You’ll have blood tests before and during your treatment to make sure they’re working normally.

If carboplatin does affect your liver and kidneys, the effects are usually mild and will get better by themselves.

Skin reactions

You may develop a rash on your body, which may be itchy. Your treatment team can prescribe treatment to help with this.

Swelling

Occasionally you can get swelling (oedema) in the feet, hands and, extremely rarely, face. The swelling usually improves once treatment stops.

Tell your treatment team if you have any of these symptoms.

Reaction at the injection site

If carboplatin leaks out of the vein it’s being given in (called extravasation), it can damage the surrounding tissue.

Tell your treatment team immediately if you have any pain, stinging or a burning sensation around the cannula while the drug is being given.

After a few weeks you may notice tenderness, darkening and hardening around where the cannula was inserted. This should fade in time.

Allergic reaction

If you have an allergic reaction to carboplatin, it will probably happen within the first few minutes of your treatment.

It’s most likely to happen the first or second time you have the drug. Reactions can vary from mild to severe, but severe reactions are uncommon.

You’ll be monitored closely so that any reaction can be dealt with immediately.

Symptoms of an allergic reaction include:

• Itchy red or discoloured bumps on your skin (these may be harder to see on black or brown skin)
• Swelling in your lips, tongue or throat
• Breathlessness, wheezing, a bad cough or sudden difficulty breathing
• Tight chest or chest pain
• If you have a severe reaction, treatment will be stopped immediately.

Your treatment team may give you medication before future treatments to reduce the risk of further reactions.

Blood clots

People with breast cancer have a higher risk of blood clots. Having carboplatin also increases the risk of blood clots such as a DVT (deep vein thrombosis). 

If you have a DVT, there’s a risk part of the blood clot could break away and travel to the lung. This is known as a pulmonary embolism (PE). 

Blood clots can be life-threatening and should be treated quickly. 

Sex, contraception and pregnancy

You can still have sex during treatment. It’s thought chemotherapy drugs cannot pass into vaginal fluids or semen, but this cannot be completely ruled out. 

Most treatment teams will advise using barrier methods of contraception, such as condoms, during treatment and for a few days after chemotherapy is given.  

You’re advised not to become pregnant while having treatment because carboplatin can harm a developing baby. If you have not been through the menopause, talk to your team about the most suitable method of contraception for you. It’s still possible to become pregnant even if your periods are irregular or have stopped. 

Find out more about how breast cancer and its treatment can affect sex and intimacy and read more information on how to manage these changes.

Effects on fertility

Carboplatin can affect your fertility (ability to become pregnant) and may make you unable to get pregnant. This can be temporary or permanent. The risk of it being permanent increases with age.  

Some studies show that ovarian suppression using hormone therapy drugs may protect the ovaries during chemotherapy. This is because it temporarily “shuts down” the ovaries. However, the effectiveness of ovarian suppression for preserving fertility is still debated.

It’s important to discuss any fertility concerns with your treatment team before you start treatment. They may be able to refer you to a fertility specialist to discuss fertility preservation options.

Travel and vaccinations

If you’re planning a holiday or need to travel overseas, check with your treatment team first. 

You should not have any live vaccines while you’re having treatment.

For more information about vaccines, including COVID-19 and flu vaccines, see our information on vaccines and breast cancer.

Your treatment team and breast care nurse can help with any questions you have. You can also speak to our specialist nurses in our free helpline. See the bottom of this page for ways to get in touch,

You can find people going through treatment at the same time as you on our online forum.

You can also speak to someone who has had chemotherapy for primary breast cancer through our Someone Like Me service.

If you have secondary breast cancer, Living with Secondary Breast Cancer can help you meet others in a similar situation, and offers support and information in a relaxed environment. See the bottom of this page for more information.