Bevacizumab is a targeted therapy drug used to treat different types of cancer. It is best to read this information with our general information about the type of cancer you have.
Bevacizumab is usually given into a vein. You usually have it as an outpatient. Your cancer doctor or nurse will tell you how often you will have it.
Like all targeted therapy drugs, bevacizumab can cause side effects. Some of the side effects can be serious, so it’s important to read the detailed information below. How targeted therapy affects people varies from person to person. Your healthcare team can talk to you more about this and give you advice on how to manage any side effects.
Tell your doctor or nurse straight away if you:
Rarely, side effects may be life-threatening. Your cancer doctor or nurse can 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.
Bevacizumab is a type of drug called a monoclonal antibody. These drugs are sometimes called targeted therapies. They work by ‘targeting’ specific proteins (receptors) on the surface of cells.
Bevacizumab targets a protein called vascular endothelial growth factor (VEGF) that helps cancer cells grow a new blood supply.
Targeting VEGF reduces the supply of oxygen and nutrients so that the tumour shrinks or stops growing.
This animation shows how targeted therapies work and what effect they have on the body.
This animation shows how targeted therapies work and what effect they have on the body.
Bevacizumab may be given if a cancer has spread to other parts of the body. It may be given with chemotherapy for:
It can also be given with interferon for kidney cancer.
Bevacizumab may only be available in some situations. Your cancer doctor can tell you if it 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 are still able to have it. Your cancer doctor can give you advice. We have further information on what to do if a treatment is not available.
A nurse will give you bevacizumab as a drip into a vein (intravenous infusion). It is usually given once every two or three weeks, depending on the type of cancer you have.
You have the first treatment slowly over 90 minutes. If you don’t have any problems, you can have the next treatment over 60 minutes. After this, you can usually have it over 30 minutes.
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. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.
Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.
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.
Some people may have a reaction to bevacizumab. This is rare and if it happens it is usually mild. A reaction is more likely with the first or second infusion so you have these more slowly.
Your nurse will closely monitor you while you are having the infusion. Tell your nurse or doctor if you feel unwell or have any of the following:
A reaction can usually be treated by stopping the drip until you feel better. Rarely, a reaction can happen a few hours after treatment. If you have these symptoms or feel unwell after you get home, contact the hospital straight away for advice.
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.
We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.
This treatment can reduce the number of blood cells in your blood. You will have regular blood tests to check your blood cell levels. If the number of white blood cells, or blood-clotting cells (platelets), gets too low, your doctor may delay your treatment until the levels improve.
This treatment 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:
Symptoms of an infection include:
It is important to follow any specific advice your cancer treatment team gives you.
The number of white blood cells will usually return to normal before your next treatment. You will have a blood test before having more treatment. If your white blood cell count is low, your doctor may delay your treatment for a short time.
This treatment can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this.
If you are very anaemic, you may need a drip to give you extra blood cells. This is called a blood transfusion.
This treatment can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor or nurse if you have any bruising or bleeding that you can’t explain. This includes:
This treatment can cause high blood pressure. You will have your blood pressure checked regularly. If you have headaches, nosebleeds or feel dizzy, let your doctor know. They can prescribe tablets to control high blood pressure.
If you have high blood pressure before you start treatment, your doctor will monitor you closely during treatment.
Your doctor can give you anti-sickness drugs to help prevent or control sickness. If you still feel sick, tell your doctor. They can prescribe other anti-sickness drugs that may work better for you.
Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.
If you have diarrhoea, contact the hospital for advice. Try to drink at least 2 litres (3½ pints) of fluids every day. It can help to avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods.
This treatment can cause constipation. Here are some tips that may help:
If you have constipation, contact the hospital for advice. Your doctor can give you drugs called laxatives to help.
This treatment may cause headaches. If this happens, tell your doctor or nurse. They can give you painkillers.
Your mouth may become sore or dry and you may get small ulcers. This can make you more likely to get an infection in your mouth. Gently clean your teeth or dentures morning and night and after meals. Use a soft-bristled or children’s toothbrush. Your nurse might advise you to use mouthwashes. It is important to follow any advice you are given and to drink plenty of fluids.
Tell your nurse or doctor if you have any problems with your mouth. They can prescribe medicines to prevent or treat mouth infections and reduce soreness.
This treatment can affect your appetite. Do not worry if you do not eat much for a day or two. But if your appetite does not come back after a few days, tell your nurse or dietitian. They will give you advice. They may give you food or drink supplements.
Bevacizumab can sometimes affect the kidneys. You may have urine and blood tests to check that your kidneys are working well.
You may have pain and stiffness in your joints, and sometimes in your muscles. Tell your doctor or nurse if this happens. They can prescribe painkillers and give you advice.
This treatment may affect the nerves, which can cause numb, tingling or painful hands or feet. You may find it hard to fasten buttons or do other fiddly tasks. Tell your doctor if you have these symptoms.
Your eyes may become watery. Your doctor can prescribe eye drops to help with this. Always tell your doctor or nurse if you notice any changes in your vision.
You may notice some voice changes or hoarseness. Talk to your doctor if you are worried about this.
Kate on treatment and side effects
'Considering where I started, I can't quite believe my progress.'
This treatment can increase the chances of a blood clot. A clot can cause:
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.
Wounds may take longer to heal while you are being treated with bevacizumab. If you have any wounds which are not healing or look infected, speak to your doctor straight away.
If you have any surgery planned, bevacizumab will be stopped about four weeks before the operation and not started again until the wound is fully healed.
This is rare. It is most likely to affect people who have heart disease or who have had radiation to the chest or some types of chemotherapy drugs. If you have chest pain, difficulty breathing or ankle swelling, let your doctor know. These could be signs that bevacizumab is affecting your heart.
Bevacizumab can cause a hole (perforation) in the bowel but this is not common. It is more likely if you have also had radiotherapy to the pelvis (lower part of the tummy). Tell your doctor straight away if you have sudden or severe pain in your tummy (abdomen).
Very rarely, bevacizumab can cause a fistula. A fistula is an abnormal opening that connects two or more parts of the body. If this happens, it is more likely in the part of the body affected by the cancer.
Rarely, bevacizumab may cause osteonecrosis of the jaw. This is when bone tissue in the jaw becomes damaged and dies. Symptoms of osteonecrosis can include pain, swelling, redness of the gums and loose teeth. Tell your cancer specialist and dentist straight away if you have any of these symptoms.
Gum disease, problems with your dentures and some dental treatments, such as having a tooth removed, can increase the risk of this. Before you start taking the drug, you will be advised to have a full dental check-up.
It is important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they are not mentioned above.
Some medicines, including ones you buy in a shop or chemist, can be harmful while you are having this treatment. Tell your cancer doctor about any drugs you are taking, including vitamins, herbal drugs and complementary therapies.
Your doctor will advise you not to get pregnant or father a child while having this treatment and for some time afterwards. The drugs may harm the developing baby. It is important to use effective contraception.
Women are advised not to breastfeed while having this treatment. This is because the drugs could be passed to the baby through breast milk.
If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having cancer treatment. 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 this treatment.
Order booklets or audio CDs about targeted (biological) therapies, how they work, having treatment and how it might affect you.
All types of treatment can have different side effects. Know what to expect to help you find the best way for you to handle them.
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