Important Facts About Taxol

One of the most familiar treatments for breast cancer is a drug called Taxol (paclitaxel). It's among several medications in a class called taxanes that are derived from the yew tree. (The yew tree is in the genus Taxus). 

Taxol is an especially versatile cancer drug. It can be effective for breast cancer in the early stages as well as for metastatic breast cancer (in which the disease has spread to other parts of the body), and typically is given after combination anthracycline and Cytoxan therapy. It also is used as an adjuvant to surgery to shrink a tumor before it's removed.

Besides breast cancer, Taxol can be used to treat several other types of cancer, including ovarian cancer, lung cancer, and Kaposi’s sarcoma (a type cancer that affects people with AIDs in which patches of abnormal tissue grow under the skin, causing visible blotches).

If you or someone in your care is prescribed Taxol for any reason, here are some important things to know about this powerful drug.

To understand how Taxol works, it helps to understand that tumor cells grow by a process called mitosis—the medical name for cell division. Taxol is a mitotic inhibitor: It targets rapidly growing cancer cells by getting inside of them and attaching to the scaffold-like structure of the cells called microtubules. In this way, the drug prevents the cancer cells from dividing.

Taxol is a clear, colorless fluid that's mixed with Cremophor EL (polyoxyethylated castor oil) and given by infusion—in other words, it's administered directly into a vein, meaning you'll have to go to a hospital or clinic to receive it.

It's a clear colorless fluid, but it's also thick and sticky, so a pump is necessary to properly infuse it. It can be given as high-dose chemo, once every two or three weeks, or in low doses once a week. In some cases, Taxol is given slowly during a 24-hour infusion.

You may be relieved to know that most people tolerate Taxol really well, especially in low doses. It does have potential side effects, but these usually are mild.

• Peripheral neuropathy (tingling and numbness in hands and feet due to irritation of nerves)
• Anemia 
• Neutropenia (greater risk of infection)
• Bone and muscle aches
• Hair loss
• Fatigue
• Nausea
• Vomiting
• Mild diarrhea
• Mucositis (irritation of mucous membrane inside the mouth)
• Amenhorrea (if you're a woman who's still menstruating, you'll temporarily stop having your period)
• Brittle or yellowed nails​

Some people may have an allergic reaction to Taxol or to Cremophor EL. It also is associated with future infertility. And if you're pregnant, Taxol could harm your developing baby. 

There are ways to prevent some of the problems these side effects can cause, though. Before you begin treatment with Taxol, your doctor will probably have you take supplements of an amino acid called L-Glutamine to prevent neuropathy; you also may have injections of either Neupogen (filgrastim) or Neulasta (pegfilgrastim) to boost white blood cell counts.

You'll be advised not to drink while you're being treated with Taxol, and to use birth control if you're sexually active. You probably shouldn't have any vaccinations, since your immune system will be compromised and you shouldn't take aspirin. As for those yellow nails: You can protect them with nail polish.