GC

GC is the name of a combination of chemotherapy drugs used to treat bladder cancer and non small cell lung cancer. It is also known as Gemcis or Gemcisplat. It is made up of the drugs

• Gemcitabine (Gemzar)
• Cisplatin

The links above take you to information about the individual side effects of each drug.

The side effects of a combination of drugs are usually a mixture of those of each drug. The combination may increase or decrease your chance of getting each side effect or it may change the severity. The side effects associated with GC are listed below. You can use the underlined links to find out more about each one. For general information, see our cancer drugs side effects section.

You have GC drugs into your bloodstream (intravenously). You can have them through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment. Or you may have them through a central line, a portacath, or a PICC line. These are long, plastic tubes that give the drugs directly into a large vein in your chest. You have the tube put in just before your course of treatment starts and it stays in place as long as you need it.

You usually have GC chemotherapy as cycles of treatment. You have each cycle of treatment over 3 or 4 weeks. You will have between 4 and 6 cycles of GC treatment, taking from 3 to 6 months.

If you have the 3 weekly cycle, you have both gemcitabine and cisplatin on the first day. Then you have gemcitabine a week later. You then have no treatment for 2 weeks and the cycle starts again.

If you have the 4 weekly cycle, you have both gemcitabine and cisplatin on the first day of the cycle. You then have gemcitabine a week later followed by another dose a week later. You then have no treatment for a week until the cycle starts again.

With these drugs, many people have a temporary drop in the number of blood cells made by the bone marrow, leading to the following side effects

• Increased risk of getting an infection from a drop in white blood cells – it is harder to fight infections and you can become very ill. You may have headaches, aching muscles, a cough, sore throat, pain passing urine or feel cold and shivery. 
• Tiredness and breathlessness due to a drop in red blood cells (anaemia) – you may need a blood transfusion
• Bruising more easily due to a drop in platelets – you may have nosebleeds, bleeding gums after brushing your teeth, or lots of tiny red spots or bruises on your arms or legs (known as petechia).

Some of these side effects can be life threatening, particularly infections. You should contact your doctor if you have any of these side effects. Your doctor will check your blood counts regularly to see how well your bone marrow is working.

Other common side effects include

• Fatigue during and after treatment – most people find their energy levels are back to normal within 6 months to a year
• Numbness or tingling in fingers and toes affects half the people having treatment (50%) and can cause difficulty with fiddly things such as doing up buttons – this starts within a few days or weeks and usually goes within a few months of finishing treatment
• Feeling or being sick happens in about 1 out of every 2 people (50%), but is usually mild and can be controlled with anti sickness drugs. If it is not controlled let your doctor or nurse know as you can have other anti sickness drugs that may work better for you
• Constipation occurs in 1 out of 2 people (50%) – your doctor or nurse may give you laxatives to help prevent this but do tell them if you are constipated for more than 3 days
• A skin rash, which may itch, happens in about 1 in 4 people (25%)
• Flu like symptoms affect 4 out of every 10 people (40%) and include a raised temperature, muscle aches (myalgia), and shivering – these start a few hours after the gemcitabine drip and you can take paracetamol tablets 6 to 8 hourly to help
• Swelling in the face, hands and feet occurs in about 3 out of every 10 people (30%) – this usually goes away on its own, but tell your doctor or nurse if you have it
• Kidney changes may occur – you will have fluids through your drip before and after treatment to try to prevent damage and it helps to try to drink plenty of fluid. You will have regular blood tests to check how well your kidneys are working
• This drug may have a harmful effect on a developing baby – do talk to your doctor about contraception before having treatment if there is any chance that you or your partner could become pregnant
• Women may stop having periods but this may be temporary
• Loss of fertility – we don’t know exactly how this drug affects fertility so do talk with your doctor before starting treatment if having a baby is important to you
• Ringing in the ears (tinnitus) – this nearly always gets better on its own once treatment ends
• Loss of taste or a metallic taste
• Hearing changes

Some people may have one or more of the following side effects

• A sore mouth
• Hair thinning – this is usually mild and your hair will grow back once the treatment ends
• Inflammation of the lungs causing wheeziness or breathlessness affects about 1 in 12 people (8%)
• Drowsiness (somnolence) occurs in about 1 in 10 people (10%) and you may become extremely sleepy after your treatment – this usually goes away on its own, but mention it to your doctor or nurse if you have it
• Diarrhoea – drink plenty of fluids and tell your doctor or nurse if it becomes severe or continues for more than 3 days
• Some people have an allergic reaction while having GC treatment, usually at the first or second treatment – let your treatment team know immediately if you have any skin rashes, itching, feeling hot, shivering, going red in the face, feeling dizzy, headaches, shortness of breath, anxiety or a sudden need to pass urine

Not everyone will get these side effects. You may have one or two or several. A side effect may get worse through your course of treatment. Or you may have more side effects as the course goes on. This depends on

• How many times you've had a drug before
• Your general health
• How much of the drug you have (the dose)
• Other drugs you are having

Talk to your doctor, pharmacist or nurse about all your side effects so they can help you manage them. Your nurse will give you a number to call if you have side effects.

Tell your doctor about any other medicines you are taking, including vitamins, herbal supplements and other over the counter remedies – some drugs can react together.

You should not have immunisations with live vaccines while you are having this treatment or for at least 6 months afterwards. In the UK, these include rubella, mumps, measles (usually given together as MMR), BCG and yellow fever. You can have other vaccines, but they may not give you as much protection as usual until your immune system has fully recovered.

It is safe for you to be in contact with other people who've had live vaccines as injections. There can be problems with oral vaccines, but not many people in the UK have oral vaccines now. So there is usually no problem in being with any baby or child who has recently had any vaccination in the UK. You might need to make sure that you aren't in contact with anyone who has had oral polio, cholera or typhoid vaccination recently, particularly if you live abroad.