Decitabine chemotherapy is used in the treatment of myelodysplastic syndrome (MDS) and is in trials for various other cancers. It is an anti-cancer drug classified as antimetabolite and a demethylating agent. It is given intravenously as an infusion. The exact dose depends on the height, weight and other health conditions of the patient.

 Working of Decitabine

Decitabine works in two ways as an antimetabolite and a demethylating agent.

Decitabine is categorized as DNA demethylating agent. Methylation of DNA is a process that regulates gene expression in the cells i.e. when DNA methylation activity increases, the suppressor genes are blocked. These suppressor genes regulate normal cell growth and cell division process. Hence, when these suppressor genes are blocked cell division becomes abnormal and unregulated and this leads to cancer.

Decitabine interferes in the methylation of DNA hence inhibiting the abnormal cell growth by restoring the suppressor genes. This drug works in a similar way as the drugs prescribed during gene therapy for cancer treatment.

Decitabine is also an antimetabolite. Antimetabolites resemble certain substances in the cell. This allows the drug to penetrate into the cell and interact with certain targeted substances within the cell. This causes a direct cytotoxic effect on the cancer cell that leads of all the rapidly dividing cancer cells.

Side Effects of Decitabine Chemotherapy

Like any other chemotherapy drugs side effects, decitabine also has its own side effects but they seem to be relatively mild. Some of the most common side effects are-

• Low blood counts- This leads to a drop in the number of red blood cells, white blood cells or platelets. This causes anemia, decreased immunity or bruising respectively. This is temporary but due care needs to be taken. Blood tests are often done prior to the chemotherapy to check the blood counts.
• Fatigue
• Fever
• Nausea
• Cough
• Constipation
• Diarrhea
• Increased blood sugar levels

Some of the less common side effects are:

• Headache
• Insomnia
• Swelling
• Low protein and sodium levels
• Chills
• Low potassium levels
• Random Bruising
• Skin Rash
• Dizziness
• Unexplained pains
• Loss of appetite
• Sore throat
• Abdominal pain
• Mouth sores
• Drowsiness
• Abnormal liver function
• Confusion and anxiety
• Heartburn

Precautions for Decitabine Chemotherapy

It is essential to let your doctor know in case of increased or uncontrolled symptoms. Do not take any medications on your own. It is important to keep a close follow up with your doctor. Constant monitoring of blood counts and other vital organs like liver and kidney is essential. Decitabine often makes blood counts worse before they improve.

• It is important to let you doctor know your case history, any medicines that you are taking or you have taken in the past. This includes all the OTC medications, prescribed ones, supplements, alternative therapies, etc.
• Do not take aspirin or aspirin based products without consulting your doctor.
• Do not get yourself immunized with any live vaccines without your doctor’s permission.
• It is essential to discuss conception issues, with your doctor,  if you or your partner plan to have children in future as some of these drugs cause infertility.
• A woman should not be pregnant while taking this treatment as this possibly harms a developing fetus.
• Women should not breast feed while taking Decitabine.

Decitabine chemotherapy is relatively less toxic as per some clinical trials and has been tried even on certain senior citizens suffering from cancer. This has led to relief and extended survival in these patients although more research is being done on the same. Also, questioning about chemotherapy  treatment before decitabine chemotherapy treatment would help the patient in his/her treatment, as he would be able to keep a track of the progress of his treatment.