Find out what carmustine is, how you have it and other important information about having carmustine for a brain tumour.
What chemotherapy is
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.
How carmustine works
Carmustine works by sticking to one of the cancer cell's DNA strands. The cell can't then divide into 2 new cells.
How you have carmustine
You have it as a drip into your vein. It usually takes 1 to 2 hours, sometimes longer.
Or you might have this drug in the form of an implant or wafer if you have a type of brain tumour called a glioma. Your surgeon places these during your operation to remove your tumour.
Into your bloodstream
You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.
You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.
Carmustine wafers (Gliadel)
Wafer implants are a way of giving chemotherapy for brain tumours into the area of the tumour. The wafer is made of gel that contains the chemotherapy drug carmustine.
During brain surgery to remove some or all of a tumour, the doctor puts up to 8 wafers in the space where the tumour was. Over the next few days, the wafers slowly release the chemotherapy drug carmustine into this area.
They are used to treat high grade (malignant) gliomas.
When you have it
You usually have carmustine as a course of several cycles of treatment. Your treatment plan depends on what type of cancer you have. Your doctor or nurse will talk you through your plan.
Carmustine treatment into your bloodstream usually takes 1 or 2 hours, sometimes longer.
Tests during treatment
You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
Other medicines, foods and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Don’t breastfeed during this treatment because the drug may come through in your breast milk.
You are more at risk of developing a blood clot during treatment. Drink plenty of fluids and keep moving to help prevent clots.
Treatment for other conditions
Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine
- be in contact with other people who've had live vaccines as injections
Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.
You also need to avoid anyone who has had oral polio or typhoid vaccination recently.
More information about this treatment
We haven't listed all the very rare side effects of this treatment. For further information see the electronic Medicines Compendium (eMC) website.
You can report any side effect you have that isn’t listed here to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.