Gliadel wafers

Gliadel is a chemotherapy drug. It is used to treat brain tumours called high-grade malignant glioma and glioblastoma multiforme.

It is best to read this information with our general information about chemotherapy and the type of cancer you have.

Gliadel wafers are put in during surgery to remove the brain tumour. This will be discussed with you before your operation. Like all chemotherapy drugs, Gliadel can cause side effects. Some of the side effects can be serious, so it is important to read the detailed information below.

Your healthcare team can give you advice on how to manage any side effects. Tell your doctor or nurse straight away if you:

  • have a temperature
  • feel unwell
  • have severe side effects, including any we do not mention here.

Rarely, side effects may be life-threatening. Your surgeon will explain the risk of these side effects to you.

If you need medical attention for any reason other than cancer, always tell the healthcare staff that you are having this treatment.

What are Gliadel wafers?

Gliadel wafers are small discs. They are about the size of a five pence (5p) coin. They are sometimes used to treat high-grade brain tumours called gliomas along with surgery and occasionally radiotherapy.


How Gliadel wafers are given

The operation is carried out by a neurosurgeon. This is a surgeon who specialises in brain surgery.

The surgeon placesthe wafers into the area in the brain where the tumour has been removed. Usually, up to eight wafers are used. The wafers release a chemotherapy drug called carmustine directly to the surrounding cells as they dissolve. This usually takes around two to three weeks. They do not need to be removed.

Gliadel wafers may only be suitable in certain situations. Your surgeon can tell you if this treatment is appropriate for you. Some people may be given it as part of a clinical trial.

If a drug is not available on the NHS, there may be different ways you can still have it. Your healthcare team can give you advice. We have further information on what to do if a treatment isn’t available.


Possible side effects of Gliadel wafers

Both Gliadel and surgery can cause side effects. Sometimes, it can be difficult to know if a side effect is caused by the Gliadel or the surgery.

We explain the most common side effects of this treatment here. We also include some less common side effects. You may get some of the side effects we mention, but you are unlikely to get all of them.

Although this list might look worrying, you are unlikely to get all of these. Your healthcare team will talk to you before your operation. They can answer any questions you have about the treatment and the possible side effects.

Always tell your doctor or nurse about any new symptoms you get, or if symptoms get worse. They can give you advice about how to manage these and any drugs that may help. We have more information about side effects of brain surgery.

Serious and life-threatening side effects

Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

Contact the hospital

Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.


Possible effects on the nervous system

These side effects can also happen after surgery to the brain. Your doctors and nurses will monitor you very closely.

Seizures (fits)

You may be more likely to have seizures. This is usually within the first five days after your operation. You doctor may prescribe medicines for a short time to help prevent these. If you have already been having seizures, you can talk to your surgeon about the medicines you take.

Headaches

Headaches are common after brain surgery and with Gliadel treatment. Your doctor will tell you which painkillers will help. Tell them if the headaches get worse.

Temporary swelling of the brain

This can happen after surgery to the brain and treatment with Gliadel. You doctor or nurse will usually give you steroids to help reduce this.

Let your doctors or nurse know straight away if you:

  • have headaches (although these are common after surgery)
  • have any weakness in your arms or legs (on one or both sides) or difficulty walking
  • become confused, drowsy or have difficulties with speaking. If someone with you notices you developing these symptoms, contact the hospital.

An infection in the brain

Your doctors and nurses will be checking you closely for any signs of infection. Tell them if you have:

  • a temperature
  • flu-like symptoms
  • headaches
  • neck stiffness
  • sensitivity to bright light.

Slow wound healing

It may take longer for your operation wound to heal. This is because chemotherapy can affect the healing process. Your doctor or nurse will check your wound regularly. If you notice any leakage from the wound, swelling or redness in the area, tell your doctor or nurse straight away.


Other possible side effects

The following side effects may be related to your surgery, Gliadel or other treatments you are having.

Lower number of white blood cells

This is rare with Gliadel because not much of the carmustine drug is absorbed into the bloodstream. This means there is less risk of infection than with chemotherapy into the vein. But it can still happen.

Chemotherapy can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is called neutropenia.

If you have an infection, it is important to treat it as soon as possible. Contact the hospital straight away on the 24-hour contact number you have if:

  • your temperature goes over 37.5°C (99.5F)
  • you suddenly feel unwell, even with a normal temperature
  • you have symptoms of an infection.

Symptoms of an infection include:

  • feeling shivery
  • a sore throat
  • a cough
  • diarrhoea
  • needing to pass urine.

Feeling sick or being sick

If you feel sick, this can be controlled by taking anti-sickness (anti-emetic) drugs that your doctor can prescribe for you. Tell your doctor if the sickness does not improve so they can prescribe other anti-sickness drugs which may work better for you.

Skin rash

This treatment may cause a mild skin rash. If this happens, tell your doctor or nurse. They may give you creams or medication to help.

Blood clot risk

Cancer and treatment with chemotherapy can increase the risk of a blood clot. Symptoms of a blood clot include:

  • pain, redness or swelling in a leg or arm
  • breathlessness
  • chest pain. 

If you have any of these symptoms, contact a doctor straight away. 

A blood clot is serious, but can be treated with drugs that thin the blood. Your doctor or nurse can give you more information.

Raised blood sugar levels

Your blood sugar levels may be higher than usual. This may be due to some of the other medicines you are taking after the operation. Your doctor will talk to you about how to manage this.


Other information about Gliadel wafers

Contraception

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. You can talk to your doctor or nurse about this.

Breastfeeding

Women are advised not to breastfeed while having this treatment and for some time afterwards. This is because the drugs could be passed to the baby through breast milk.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having chemotherapy. Give them the contact details for your cancer doctor so they can ask for advice.

If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having chemotherapy.