Gliadel ® implants (carmustine)
Gliadel implants contain the chemotherapy drug called carmustine They are sometimes used to treat a newly diagnosed brain tumour called a high-grade malignant glioma. Or they may be used to treat a brain tumour called glioblastoma multiforme that has come back, if it is possible to do an operation to remove some or all of the tumour.
This information should ideally be read with our general information about chemotherapy and your type of brain tumour.
We have more information about gliomas, including glioblastoma multiforme.
How Gliadel implants are given
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Gliadel implants are small wafers or discs about the size of a five pence (5p) coin. They dissolve after they are placed in the brain. During an operation to remove the brain tumour, the surgeon will put in up to eight implants. They put them into the area where the tumour has been removed. The implants dissolve slowly over two to three weeks, releasing carmustine into the brain tissue. The implants do not need to be removed, so you will not need another operation.
In England and Wales, Gliadel implants can be used on the NHS for people with newly diagnosed high-grade glioma if 90% of their tumour has been removed. Your doctors will discuss this with you before the operation. In Scotland, Gliadel implants can be used on the NHS for people with newly diagnosed high-grade glioma along with surgery and radiotherapy. In Northern Ireland, you can find out if Gliadel implants are available on the NHS from your hospital team.
Contact the hospital
Ask your nurse who you should call if you feel unwell or need advice. They should give you telephone numbers for any time of day or night. Save these numbers in your phone or keep them somewhere safe.
Possible side effects of Gliadel implants
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The implants are put in when you have an operation to remove the brain tumour. Some side effects may be caused by the tumour or the operation to your head (craniotomy).
It's important to tell your doctor about any new or worsening symptoms, such as:
weakness in your arms or legs
confusion or disorientation
feeling or being sick
slow wound healing
This list might look worrying, but remember these effects are not common. We have listed them just so you know what to look out for. Your surgeon will talk to you before your operation. They can answer any questions you have about the treatment and possible side effects.
A very small amount of carmustine will get into your bloodstream. This can reduce the number of white blood cells in your blood, making you more likely to get an infection. You'll be asked to have a blood test around ten days after the implants are put in, to check the number of white blood cells.
It’s important to tell your doctor or nurse straight away if you feel ill or have any severe side effects. This includes any that we don’t mention here.
Other information about Gliadel implants
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Blood clot risk
Cancer increases the chance of a blood clot (thrombosis) and chemotherapy can add to this. A clot can cause symptoms such as pain, redness and swelling in a leg, breathlessness and chest pain. Contact your doctor straight away if you have any of these symptoms. A blood clot is serious but your doctor can treat it with drugs that thin the blood. Your doctor or nurse can give you more information.
Some medicines can interact with chemotherapy or be harmful when you are having chemotherapy. This includes medicines you can buy in a shop or chemist. Tell your doctor about any medicines you are taking, including over-the-counter drugs, complementary therapies and herbal drugs.
Chemotherapy can affect your fertility (being able to get pregnant or father a child). If you are worried about this, you can talk to your doctor before treatment starts.
Your doctor will advise you not to become pregnant or father a child during treatment. This is because the drugs may harm a developing baby. It’s important to use contraception during and for a few months after chemotherapy. You can talk to your doctor or nurse about this.
Changes to your periods
Chemotherapy can sometimes stop the ovaries working. You may not get a period every month and they may eventually stop. In some women, this is temporary, but for others it is permanent and they start the menopause.
Women are advised not to breastfeed during treatment and for a few months after. This is in case there is chemotherapy in their breast milk.
Medical and dental treatment
If you need to go into hospital for any reason other than cancer, always tell the doctors and nurses that you are having chemotherapy. Give them contact details for your cancer doctor.
Talk to your cancer doctor or nurse if you think you need dental treatment. Always tell your dentist you are having chemotherapy.
This section has been compiled using a number of reliable sources, including:
electronic Medicines Compendium (eMC). medicines.org.uk (accessed September 2013).
British National Formulary. 65th edition. 2013. British Medical Association and Royal Pharmaceutical Society of Great Britain.
National Institute for Clinical Care: Carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma. June 2007.
Micromedex 2.0 ®. 2013. Truven Health Analytics Inc. Available at: micromedexsolutions.com (accessed September 2013)
With thanks to: Christine Clarke, Lead Pharmacist Oncology & Haematology, who reviewed this edition.
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