What is it used for?
- Breast cancer that has spread to other parts of the body (metastatic breast cancer).
- Advanced cervical cancer.
- Prostate cancer.
- Cancer of the pancreas.
- Stomach cancer.
- Bowel cancer.
- Cancer of the oesophagus (gullet).
- Cancer of the head and neck.
- Skin cancer.
- Liver cancer.
- Lung cancer.
- Superficial bladder cancer.
- Leukaemia and other non-solid tumours.
- Cancers affecting connective tissues (sarcomas).
How does it work?
Mitomycin C Kyowa injection contains the active ingredient mitomycin, which is a type of anticancer chemotherapy medicine called a cytotoxic antibiotic.
Cancers form when cells within the body multiply abnormally and uncontrollably. These cells spread, destroying nearby tissues. Mitomycin works by stopping the cancer cells from growing and multiplying.
Mitomycin inserts itself into the strands of genetic material (DNA) inside the cancerous cells and binds them together. This prevents the cells from making genetic material (DNA and RNA) and proteins. These actions prevent the cancerous cells from growing and multiplying and therefore shrink the cancer.
Unfortunately, mitomycin can also affect normal, healthy cells, particularly those that multiply quickly, such as the blood cells. The most important side effect is on the bone marrow, where blood cells are made. Mitomycin decreases the production of normal healthy blood cells, which can leave people susceptible to infection. Regular blood tests are needed to monitor the levels of blood cells.
Most chemotherapy is given in treatment cycles that involve a course of chemotherapy followed by a rest period. This allows normal healthy cells to recover from the adverse effects of the chemotherapy between courses. However, during this period, cancer cells will also recover and start to multiply again. Successful treatment depends on the administration of the next course of therapy before the cancer has regrown to its previous size. The idea is to decrease the amount of cancer with each successive course.
How is it given?
Mitomycin may be used on its own or in combination with other anticancer medicines.
It is usually given by slow injection into a vein (intravenous injection) once every six weeks. However, the interval between doses depends on the type and staging of the cancer and what other treatments are being used, as well as how well your blood cells recover after each dose.
Mitomycin may also be given by injection into an artery that delivers the blood supply to a particular organ, for example to treat cancer of the liver.
For treating bladder cancer mitomycin may be administered directly into the bladder via a catheter. It needs to be retained in your bladder for at least an hour, and during this time you will need to change position every 15 minutes so that the medicine comes into contact with the whole of the bladder lining. This treatment is repeated one to three times a week for a total of 20 doses.
- This medicine is very irritant to body tissues. While your treatment is being given it is important to tell your doctor or nurse immediately if you notice any pain, redness, stinging or burning around the vein or artery being used to administer the injection, or any leakage of fluid from the canula.
- Chemotherapy medicines such as this one can decrease the number of blood cells in your blood. A low white blood cell count can increase your susceptibility to infections; a low red blood cell count causes anaemia and a low platelet count can cause problems with blood clotting. For this reason, you will need regular blood tests to monitor your blood cells during treatment with this medicine. Tell your doctor immediately if you experience any of the following symptoms during your treatment, as they may indicate problems with your blood cells: unexplained bruising or bleeding, purple spots, sore mouth or throat, mouth ulcers, high temperature (fever) or other signs of infection, or suddenly feeling tired, breathless, or generally unwell.
- You will also need to have regular blood tests to monitor your kidney and liver function during treatment.
- Your ability to get pregnant or father a child may be affected by treatment with this medicine. It is important to discuss fertility with your doctor before starting treatment.
- This medicine may be harmful to an unborn baby and for this reason you should use effective contraception to avoid getting pregnant or fathering a child during treatment. You should continue to use contraception to prevent pregnancy for at least a few months after stopping this medicine. Women should consult their doctor immediately if they get pregnant during treatment.
Not to be used in
- People with an increased tendency to bleed or blood clotting disorders.
- People with a very low number of platelets or white blood cells in their blood (thrombocytopenia or neutropenia).
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Use with caution in
- People with decreased production of blood cells by the bone marrow.
- People with infections, in particular chickenpox.
- Decreased kidney function.
- Decreased liver function.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine should not normally be used in pregnancy as it is likely to be harmful to the developing baby.
- You should use effective contraception to avoid getting pregnant or fathering a child during treatment. You should continue to use contraception to prevent pregnancy for at least a few months after stopping this medicine. Women should consult their doctor immediately if they get pregnant during treatment. Seek further medical advice from your doctor.
- Significant amounts of this medicine may pass into breast milk and this may have serious side effects on a nursing infant. Mothers who need treatment with this medicine should not breastfeed. Discuss this with your doctor.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
- Decreased number of white blood cells in the blood (leucopenia).
- Increased susceptibility to infections.
- Decreased number of platelets in the blood (thrombocytopenia).
- Increased bleeding tendency.
- Loss of appetite.
- Nausea and vomiting.
- Feeling generally unwell.
- Feeling weak or tired.
- Weight loss.
- Decreased red blood cell count (anaemia).
- Sore mouth or mouth ulcers.
- Changes to the lungs. Tell your doctor if you notice any coughing or breathlessness, or if existing symptoms get worse.
- Rash or itching.
- Pain, redness, inflammation, ulceration or blistering at the site of injection (see also warning section above).
- Increased blood pressure.
- Hair loss (alopecia).
- Kidney or liver problems.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines during treatment this one, to make sure that the combination is safe.
There may be an increased risk of side effects if this medicine is used in combination with other medicines which can also suppress bone marrow function and affect blood cell counts, for example other chemotherapy medicines, or the antipsychotic clozapine.
Vaccines may be less effective in people receiving chemotherapy. This is because chemotherapy medicines reduce the activity of the immune system and can prevent the body forming adequate antibodies. Live vaccines should be postponed until at least six months after finishing chemotherapy because they may cause infection. Live vaccines include the following: oral polio; rubella; measles, mumps and rubella (MMR); BCG; chickenpox; yellow fever and oral typhoid vaccines.
Other medicines containing the same active ingredient
There are currently no other medicines available in the UK that contain mitomycin as the active ingredient.