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VIDE

VIDE is a combination of chemotherapy drugs made up of:

  • vincristine
  • ifosfamide
  • doxorubicin
  • etoposide

It is a treatment for a type of bone cancer called Ewing's sarcoma. You have VIDE before surgery to remove the Ewing's sarcoma. 

As a part of VIDE you also have a drug called mesna. 

How it works

These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.

How you have it

Doxorubicin is a red fluid. All the other drugs are colourless fluids. You have the drugs into your bloodstream (intravenously). 

You have mesna as a drip into your bloodstream or tablets. 

Drugs 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.

Tablets

You must take tablets according to the instructions your doctor or pharmacist gives you.

You should take the right dose, not more or less.

Talk to your specialist or advice line before you stop taking a cancer drug.

When you have it

You usually have chemotherapy as cycles of treatment. You may have up to 6 cycles. Each cycle of treatment lasts 3 weeks.

So the whole course takes 18 weeks.

You have each cycle of treatment in the following way:

Day 1
  • You have vincristine as an injection into your bloodstream (intravenously) alongside a drip of salt water (saline).
  • You have doxorubicin as an injection into your bloodstream alongside a drip of salt water (saline).
  • You have etoposide as an injection into your bloodstream over 1 hour.
  • You have ifosfamide as an injection into your bloodstream over 3 hours.
  • You have a drug called mesna as a drip or as tablets – this is to stop the ifosfamide irritating your bladder and making it bleed.
Day 2
  • You have doxorubicin as an injection into your bloodstream alongside a drip of salt water (saline).
  • You have etoposide as an injection into your bloodstream over 1 hour.
  • You have ifosfamide as an injection into your bloodstream over 3 hours.
  • You have mesna as a drip or as tablets.
Day 3
  • You have doxorubicin as an injection into your bloodstream alongside a drip of salt water (saline).
  • You have etoposide as an injection into your bloodstream over 1 hour.
  • You have ifosfamide as an injection into your bloodstream over 3 hours.
  • You have mesna as a drip or as tablets.
Day 4 to day 21
  • You have no treatment.

You then start the next cycle of treatment.

Tests

You have blood tests before 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.

Side effects

We haven't listed all the side effects. It is very unlikely that you will have all of these side effects, but you might have some of them at the same time.

How often and how severe the side effects are can vary from person to person. They also depend on what other treatment you are having. For example, your side effects could be worse if you are also having other drugs or radiotherapy.

When to contact your team

Your doctor or nurse will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

  • you have severe side effects 
  • your side effects aren’t getting any better
  • your side effects are getting worse

Early treatment can help manage side effects better. 

Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

Common side effects

These side effects happen in more than 10 in 100 people (10%). You might have one or more of them. They include:

Increased risk of infection

Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, headaches, feeling cold and shivery and generally unwell. You might have other symptoms depending on where the infection is.

Infections can sometimes be life threatening. You should contact your advice line urgently if you think you have an infection. 

Breathlessness and looking pale

You might be breathless and look pale due to a drop in red blood cells. This is called anaemia.

Bruising, bleeding gums and nose bleeds

This is due to a drop in the number of platelets in your blood. These blood cells help the blood to clot when we cut ourselves. You may have nosebleeds or bleeding gums after brushing your teeth. Or you may have lots of tiny red spots or bruises on your arms or legs (known as petechia).

Tiredness and weakness (fatigue) during and after treatment

Tiredness and weakness (fatigue) can happen during and after treatment - doing gentle exercises each day can keep your energy up. Don't push yourself, rest when you start to feel tired and ask others for help.

Feeling or being sick

Feeling or being sick is usually well controlled with anti sickness medicines. Avoiding fatty or fried foods, eating small meals and snacks, drinking plenty of water, and relaxation techniques, can all help.

Hair loss

You could lose all your hair. This includes your eyelashes, eyebrows, underarm, leg and sometimes pubic hair. Your hair will grow back once treatment has finished. But it is likely to be softer. And it may grow back a different colour or be curlier than before. 

Inflammation around drip site

Tell your nurse straight away if you notice any signs of redness, swelling or leaking at your drip site.

Sore mouth and throat

It may be painful to swallow drinks or food. Painkillers and mouth washes can help to reduce the soreness and keep your mouth healthy. 

Pink or red urine

This won't harm you. It’s due to the colour of the chemotherapy and lasts for one or two days.

Skin problems

Skin problems include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes.

A brown marking can appear along the line of the vein where you have the injection. This usually fades over time.

Your skin might also appear to be flushed.

Irritation of bladder and kidneys 

This treatment can irritate your bladder and kidneys. Drink as much water as possible to flush out the drugs. And make sure that you pass urine often, especially before you go to sleep. You might also have a drug called mesna to protect your bladder and kidneys.

Constipation

Constipation is easier to sort out if you treat it early. Drink plenty of fluids and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your doctor or nurse if you are constipated for more than 3 days. They can prescribe a laxative.

Numbness and tingling in fingers and toes

Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment.

Loss of appetite

You might lose your appetite for various reasons when you are having cancer treatment. Sickness, taste changes or tiredness can all put you off food and drinks.

Changes to the way your liver works

You might have liver changes that are usually mild and unlikely to cause symptoms. They usually go back to normal when treatment finishes. You have regular blood tests to check for any changes in the levels of chemicals produced by the liver.

Changes to your heart

You may get heart problems, such as angina, heart failure or a heart attack. You will have regular heart checks during and after the treatment. Tell your doctor or nurse straight away if you have any chest pain.

High temperature (fever)

If you get a high temperature, let your doctor or nurse know straight away. Ask them if you can take paracetamol to help lower your temperature.

Flu like symptoms

You may have headaches, muscle aches (myalgia), a high temperature and shivering.

Headaches

Tell your doctor or nurse if you keep getting headaches. They can give painkillers to help you.

Feeling light headed

Don't drive or operate machinery if you have this.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (1 to 10%). You might have one or more of them. They include:

  • leukaemia - this might happen many years after treatment
  • dizziness
  • low blood pressure
  • not enough fluid in the body (dehydration) - remember to drink plenty of fluids
  • bleeding in your stomach, intestines or bowels
  • a sudden feeling of cold with shivering often with a rise in temperature and sweating (rigor)
  • pain in the feet, hands, muscles, joints, back, chest or lungs
  • excessive sweating
  • wind (flatulence)
  • a dry mouth
  • a clogged up nose
  • a cough
  • eye problems including red, itchy eyes (conjunctivitis) and blurred vision
  • nerve changes including increased sensitivity
  • difficulty getting to sleep (insomnia)
  • nightmares
  • swollen lymph nodes

Rare side effect

ThIs side effect happens in fewer than 1 in 100 people (1%):

  • a second cancer - this might happen many years after treatment

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know?

Other medicines, food 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.

Loss of fertility 

You may not be able to become pregnant or father a child after treatment with these drugs. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.

Pregnancy and contraception

This treatment may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drugs may come through in your breast milk.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisation

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 shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)
  • be in contact with other people who've had live vaccines as injections

Avoid close contact with people who’ve recently had live vaccines taken by mouth (oral vaccines) such as oral polio or the typhoid vaccine.

This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could make you ill. So, avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.

You should also avoid close contact with children who have had the flu vaccine nasal spray if your immune system is severely weakened. 

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Information and help

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