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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
Find out how we produce our information|
This information is about bevacizumab, which is commonly known as Avastin®. It is used to treat people with bowel|, breast| or kidney| cancer, and people with non-small cell lung| cancer. Avastin may also be used to treat other types of cancer as part of a research trial|.
Avastin is a type of cancer drug known as a monoclonal antibody|.
Monoclonal antibodies recognise and lock on to specific proteins (receptors) on the surface of cancer cells. They are sometimes called targeted therapies because they are designed to target cancer cells.
Once the monoclonal antibody has attached to the receptor it can:
Avastin stops the cancer from developing new blood vessels. This reduces its supply of oxygen and nutrients, so the tumour shrinks or stops growing. Drugs that interfere with blood vessel growth in this way are called angiogenesis inhibitors or anti-angiogenics.
Avastin is licensed to treat some types of cancer that have spread from where they first started (advanced or metastatic cancers). It may be used to treat advanced non-small cell lung cancer or advanced cancers of the bowel, breast or kidney.
Although Avastin is licensed and can be prescribed in the UK, it has not been approved for use by the National Institute for Health and Clinical Excellence (NICE|). NICE currently gives advice on which new drugs or treatments should be available on the NHS. As a result, Avastin may not be widely available on the NHS.
We can give you more information on what you can do if a treatment isn't available|.
Avastin is a colourless fluid.
Avastin may be given in combination with chemotherapy| drugs or, when used to treat kidney cancer, with interferon|.
Avastin is given as a drip into a vein (intravenous infusion). It's usually given once every two or three weeks. The first two infusions are given slowly; the first one over 90 minutes and the second over 60 minutes. After this the infusions take 30 minutes.
Each person’s reaction to cancer treatment is different. Some people have very few side effects while others may experience more. The side effects described here won't affect everyone who has Avastin. The drug is often used in combination with chemotherapy, so patients will also have side effects from the chemotherapy. The side effects mentioned below are those caused by Avastin.
We've outlined the most common side effects, but have not included those that are very rare and therefore extremely unlikely to affect you. If you notice any effects that aren't listed here, please discuss them with your doctor or nurse.
Side effects of Avastin fall into two groups:
These are uncommon and affect fewer than 5% of people (5 in 100) having Avastin. If reactions occur, they are usually mild but rarely they can be more severe.
Reactions are most likely to happen with the first or second infusion, so these infusions are given more slowly to reduce the chance of a reaction. If you have a reaction this can usually be treated by stopping the drip until you feel better.
You’ll be monitored closely during your treatment but tell your nurse or doctor if you feel unwell or have any of the following symptoms:
Rarely an infusion-related reaction can happen a few hours after treatment. If you develop these symptoms or feel unwell after you get home, contact the hospital straight away for advice.
If this happens, it may begin a few hours after the treatment is given and last for up to a few days. Your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting|. If the sickness is not controlled, or if it continues, tell your doctor, who can prescribe other anti-sickness drugs that may be more effective.
If you experience fatigue| you will need to rest but, if possible, try to balance periods of rest with some gentle exercise such as walking.
This can usually be well controlled with medicine, but tell your doctor if it's severe or continues. It's important to drink plenty of fluids if you have diarrhoea|.
Avastin can cause an increase in blood pressure in some people. Your blood pressure will be checked regularly during your treatment. If you have headaches, nosebleeds or feel dizzy, let your doctor know. High blood pressure can usually be controlled with tablets prescribed by your doctor.
Let your doctor know if you have headaches while you are having Avastin.
Tell your nurse or doctor if you have any of these problems, as they can prescribe mouthwashes and medicines to prevent or clear mouth infections. You might it helpful to watch our slideshow with tips about how to cope with a sore mouth|.
You may find that you don't feel like eating. A dietitian or specialist nurse at the hospital can give advice on boosting your appetite| and eating well.
You may be at increased risk of developing a blood clot in your veins or arteries while you're on Avastin. Tell your doctor if you or anyone in your family has had problems with blood clotting in the past. Possible blood clot symptoms include:
Contact your doctor straight away if you have any of these symptoms as you may need urgent treatment. Blood clots are treated with medicine to thin your blood, dissolve any blood clots and stop more clots from developing.
Wounds may take longer to heal while you're being treated with Avastin.
Let your doctor know if you become constipated|. This can often be relieved with a high-fibre diet or laxatives.
Avastin may cause bleeding problems. Tell your doctor if you take any medicines that may affect bleeding, such as aspirin, warfarin or vitamin E.
Contact your doctor straight away if:
Avastin can reduce the number of white blood cells in the body, making you more prone to infection|. You will have a blood test before each treatment to make sure that your white blood cell numbers have recovered.
Occasionally it may be necessary to delay your treatment if your white blood cell levels are low.
This is rare. It's most likely to affect people who have heart disease or who've had either radiation to the chest or some types of chemotherapy, such as doxorubicin or epirubicin. Let your doctor know if you have chest pain, difficulty breathing or ankle swelling as these could be signs that Avastin is affecting your heart.
Avastin can sometimes affect the kidneys. You may have tests done on samples of your urine and blood to check that your kidneys are working well.
Some people may have pain in the area of the tumour.
It's important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they're not mentioned above.
Some other medicines can be harmful to take when you're having Avastin. Let your doctor know about any medications you're taking, including non-prescribed drugs such as complementary therapies and herbal drugs.
It's not advisable to become pregnant or father a child while having Avastin, as it may harm the developing baby. It’s important to use effective contraception while having this drug, and for at least a few months afterwards. You can discuss this with your doctor.
It’s not known whether biological therapies can be present in semen or vaginal fluids. To protect your partner it’s safest to either avoid sex or use a barrier form of contraception for about 48 hours after treatment.
This information is based on our Bevacizumab (Avastin®) fact sheet and has been compiled using information from a number of reliable sources, including:
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.