Cancer drugs A to Z list
Gliadel is a wafer that contains the chemotherapy drug carmustine. Your brain surgeon (neurosurgeon) puts the wafer in during surgery to remove the brain tumour. It is a treatment for a brain tumour called glioblastoma multiforme (glioma) in adults.
Find out about having carmustine into your bloodstream
Gliadel wafers are small discs about the size of a 5p coin. The wafers release the chemotherapy drug carmustine as they dissolve. The carmustine in the wafer works by sticking to one of the cancer cell's DNA strands. The cell can't then divide into 2 new cells. This stops the cells growing and they die.
Your brain surgeon puts the wafers in during brain surgery to remove some or all of the tumour. They put up to 8 wafers in the space where the tumour was. Over the next few days, the wafers slowly release the chemotherapy drug carmustine into this area.
Recovering from brain tumour surgery
You might have blood tests before starting treatment and during your treatment. They check your general health and might check your levels of blood cells and other substances in the blood.
Side effects can vary from person to person. They also depend on what other treatments you're having.
Your doctor, nurse or pharmacist will go through the possible side effects. They will monitor you 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.
We haven't listed all the side effects here. Talk to your healthcare team if you have any new symptoms that you think might be a side effect of your treatment.
Remember it is very unlikely that you will have all of these side effects. But you might have some of them at the same time.
Surgery and Gliadel can cause side effects and because you have them at the same time it can be difficult to know which is causing any of the side effects you have.
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Gliadel can cause wounds to heal more slowly than usual. So it might take longer for the wound from your operation to heal. Your doctor or nurse will check the wound regularly to make sure it is healing well. If the wound is sore, swollen and red or leaking contact your health advice line straight away. And tell your doctor or nurse.
This can happen after surgery and is temporary. Contact your healthcare team if you have any of the following:
headaches
difficulty walking
weakness in your arms or legs
changes to how you speak
confusion
drowsiness
You might find you have a problem with how you speak, how you understand speech and your ability to read and write. Let your doctor or nurse know if you do.
You might have some mood changes while having this drug. Let your doctor or nurse know if you feel anxious or depressed.
Gliadel can make you feel weak.
You might have weakness or loss of movement on one side of your body. This could affect the way you walk.
More rarely you can loss control of body movements or have uncontrolled shaking or trembling (tremors). This can increase your risk of accidental injury.
Your veins might become inflamed which can affect how well your blood circulates. You might develop a blood clot.
More rarely you might have inflammation of the lining of the brain (meningitis).
Feeling or being sick is usually well controlled with anti sickness medicines. It might help to avoid fatty or fried foods, eat small meals and snacks and take regular sips of water. Relaxation techniques might also help.
It is important to take anti sickness medicines as prescribed even if you don’t feel sick. It is easier to prevent sickness rather than treat it once it has started.
is easier to sort out if you treat it early. Drink plenty and eat as much fresh fruit and vegetables as you can. Try to take gentle exercise, such as walking. Tell your healthcare team if you think you are constipated. They can give you a laxative if needed.
You could lose all your hair. This includes your eyelashes, eyebrows, underarms, legs and sometimes pubic hair. Your hair will usually grow back once treatment has finished but it is likely to be softer. It may grow back a different colour or be curlier than before.
Skin problems include a skin rash, dry skin and itching. This usually goes back to normal when your treatment finishes. Your healthcare team can tell you what products you can use on your skin to help.
Your condition could become worse.
Tell your healthcare team if you keep getting headaches. They can give you painkillers to help.
Increased risk of getting an infection is due to a drop in white blood cells. Symptoms include a change in temperature, aching muscles, cough, headaches, feeling cold and shivery, pain or a burning feeling when peeing, or generally feeling 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.
You might have a bladder infection. You might find it difficult to pass urine, want to go with some urgency or are going more often. There may be pain or burning when you go. You may see blood in your urine, or your urine might smell bad or look cloudy.
More rarely you might have white patches in the mouth or a sore, red mouth this could be a yeast infection.
Contact your healthcare advice line or tell your doctor or nurse if you have symptoms of an infection or think you might have an infection.
This treatment can cause pain in your muscles, bones or where the tumour site is. Let your doctor or nurse know if you have it so that they can give you painkillers.
Tell your doctor if you have any fits, twitching or jerking of your limbs.
More rarely you might have fits causing loss of consciousness and stiffness (grand mal seizure). Dial 999 or go straight to A and E if this happens.
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
blood clots that can be life threatening; signs are pain, redness and swelling where the clot is. Feeling breathless can be a sign of a blood clot in the lung. Contact your advice line or doctor straight away if you have any of these symptoms
an allergic reaction
raised levels of sugar in the blood - this can cause diabetes, tell your doctor if you feel thirsty all time, peeing more than usual, losing weight or feel tired
swelling of your arms and legs
increased blood pressure in your head caused by an abnormal build up of fluid
loss of ability to move your face (paralysis)
nerve changes including pain, decrease in the sense of touch, tingling or prickling (pins and needles)
dizziness
difficulty sleeping or getting to sleep
a drop in blood cells causing tiredness, looking pale, breathlessness and an increased risk of bleeding
an increased number of white blood cells
eye problems including pain, blurred, double or abnormal vision and swelling of the lining of the eyelids
diarrhoea
loss of bladder control (urinary incontinence)
a low amount of sodium and potassium in your blood
white patches in the mouth or a sore, red mouth (oral candida)
hallucinations, loss of memory, personality changes or changes to the way you think
tummy (abdominal pain)
This side effects happens in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:
bleeding in the brain
narrowing or blocking of the blood vessels in the brain
We have more information about side effects and tips on how to cope with them.
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.
It is not known whether this treatment affects in people. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
It is unknown whether treatment may or may not harm a baby developing in the womb. It is important not to become pregnant or get someone pregnant while you are having treatment. Let your team know straight away if you or your partner become pregnant while having treatment.
Talk to your doctor or nurse about effective contraception you can use during treatment. Ask how long you should use it before starting treatment and after treatment has finished.
It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.
If you are having tests or treatment for anything else, always mention your cancer treatment. For example, if you are visiting your dentist.
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having.
Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, and yellow fever.
You can usually have:
other vaccines, but they might not give you as much protection as usual
the flu vaccine (as an injection)
the coronavirus (COVID-19) vaccine
Talk to your doctor or pharmacist about the best time to have a vaccine in relation to your cancer treatment.
You can be in contact with other people who have had live vaccines as injections. If someone has had a live vaccine by mouth or nasal spray there may be a small risk the vaccine virus can be passed onto you if your is weakened.
Your healthcare team will let you know if you need to take any precautions if you are in close contact with someone who has had a live vaccine.
Read more about immunisations and cancer treatment
For further information about this treatment and possible side effects go to the electronic Medicines Compendium (eMC) website. You can find the patient information leaflet on this website.
You can report any side effect you have to the Medicines and Healthcare products Regulatory Agency (MHRA) as part of their Yellow Card Scheme.
Last reviewed: 28 Dec 2022
Next review due: 28 Dec 2025
Primary brain tumours are cancers that start in the brain.
Gliomas start in the glial cells and are the most common type of brain tumours. Astrocytomas, oligodendroglioma and glioblastomas are all types of glioma.
You might have surgery to remove all or part of your tumour. Or or to drain a build up of fluid (hydrocephalus) on your brain.
It can take some time to recover from your brain tumour surgery. There are some immediate and long term problems. Help and support is available.
Cancer drugs have side effects and these can vary from person to person. But there are things that you can do to help you cope.
Carmustine is a treatment for brain tumours, non-Hodgkin's lymphoma and Hodgkin's lymphoma. Find out how you have it and other important information.
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What to ask your doctor about clinical trials.
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