This leaflet provides information on bendamustine chemotherapy. It will explain what this is and when and how it is given. It will also tell you about possible side effects. Contact telephone numbers and details of how to obtain further information on bendamustine are given at the end of the leaflet.
This leaflet should be read alongside the ‘General information for patients receiving chemotherapy’ leaflet. If you haven’t received this leaflet please ask your nurse for a copy.
What is bendamustine?
Bendamustine is a chemotherapy drug that is given in a drip.
Why am I having bendamustine?
Your doctor has prescribed this chemotherapy because it has been found to be effective in treating your type of cancer.
How often will I receive my bendamustine?
For this treatment to be most effective it is given at specific and regular time intervals known as cycles. It is usual to have a cycle of bendamustine every 4weeks for up to 6 cycles. You will be given bendamustine on the first 2 consecutive days of the 4 weekly-cycle
How often will I see the specialist team?
You will see the specialist team before each cycle. You will have regular blood tests and we will check how you are feeling and discuss any problems you may have. This is so we can check how the chemotherapy is affecting you. If your blood results are satisfactory, your chemotherapy will be prescribed.
How often will I have to visit the hospital?
You will need to visit the hospital three times in every four week cycle:
Outpatient clinic appointment – you will have a blood test and we will check how you are feeling and discuss any problems you may have. This is so we can check how the chemotherapy is affecting you. If your blood results are satisfactory, your chemotherapy will be prescribed. This appointment is usually a few days before your chemotherapy appointment.
Day 1 chemotherapy appointment – you will spend approximately 2 hours in one of the day case treatment areas; longer if you are receiving any additional treatments Please allow up to an hour longer for your first visit.
Day 2 chemotherapy appointment – you will spend approximately 2 hours in one of the day case treatment areas.
You are welcome to bring someone to stay with you during your treatment. Space is limited in the waiting areas and treatment room so there is not usually room for more than one person. Treatment areas are not suitable for young children.
Can I bring relatives and friends with me?
You are welcome to bring someone to stay with you during your treatment. Space is limited so there is not usually room for more than one person. Treatment areas are not suitable for young children.
How will my chemotherapy be given?
Bendamustine is given through a drip into a vein in the back of your hand or arm. If needed, we may suggest that a fine tube called a PICC is inserted into a large vein in your upper arm. This will remain in place throughout your treatment. Your doctor or nurse will discuss this with you, if required. We have a leaflet that tells you more about PICC lines.
What are the possible side effects?
There are a number of possible side effects which can occur. The doctor, nurses and pharmacists can give you advice or answer any questions you may have.
Hair loss
You should not lose your hair with this chemotherapy, although hair thinning may occur. If this affects you, please ask about a wig or other options, such as scarves.
Sickness
Nausea and vomiting are uncommon these days as we give you anti-sickness medicines which are usually extremely effective. If you are sick more than once in 24 hours despite taking regular anti-sickness medicine contact Velindre Cancer Centre. The telephone number is at the end of the leaflet.
Infection
You are at an increased risk of picking up infections because your white blood cells which help fight infections can be reduced by this treatment.
If you develop an infection whilst your white blood cells are low, you are at risk of sepsis, this can be life threatening.
Contact Velindre Cancer Centre immediately if you develop any signs of infection, for example flu like symptoms or a temperature above 37.5°centigrade or below 35.5°centigrade. The telephone number is at the end of the leaflet.
Bruising
Bendamustine may reduce the production of platelets (which help the blood to clot). This will increase your risk of bruising or bleeding. If you notice any excessive bruising on your body or bleeding such as nosebleeds or bleeding from your gums you should contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
Effects on your bowels
Bendamustine can cause either constipation or diarrhoea. If you have constipation it may be relieved by drinking plenty of fluids and eating enough fibre. Your doctor can prescribe medication to relieve constipation.
If you have diarrhoea it is important that you drink plenty of fluids. Medication is available to control diarrhoea. If you have 4 or more bowel movements in 24 hours above what is normal for you, you should contact Velindre Cancer Centre immediately. The telephone number is at the end of the leaflet.
Tiredness and fatigue
You may feel more tired than usual. It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able. Some people find it beneficial to take gentle exercise as well as rest, and we would recommend that you continue to be as active as possible.
Sore mouth
Your mouth may become sore or you may notice small ulcers. Please follow the advice on caring for your mouth in the general chemotherapy leaflet. Your doctor may prescribe mouthwashes or medication to prevent or clear any infection
Allergic type reaction
A small number of patients experience an allergic type reaction. If this occurs you may feel hot or flushed, itchy, light-headed or generally unwell whilst receiving your bendamustine. This can be easily treated. Please tell your nurse immediately if you experience any of the above symptoms.
Heart problems
Very rarely some people having bendamustine chemotherapy experience heart problems. If you have a heart condition or you take any heart medication, please tell your doctor before you start chemotherapy. Your doctors will monitor your potassium levels in clinic, as this can affect your heart.
If you do have any chest pain or feel your heart is beating faster than normal you should seek urgent medical attention.
Blood pressure
Bendamustine can sometimes cause high blood pressure. You should let your doctor know if you are already being treated for high blood pressure before starting treatment. It can also drop your blood pressure. Your blood pressure will be checked regularly.
Effect on your lungs
A small number of people may experience lung problems following bendamustine treatment. If you develop a dry cough or notice that you are short of breath please tell your doctor
Skin changes
Bendamustine may cause an itchy rash in some patients. Medication is available to treat this. If this occurs please contact Velindre Cancer Centre for advice. The telephone number is at the end of the leaflet.
Skin and tissue damage
Some chemotherapy drugs may damage the skin and surrounding area if they leak outside of your vein. This is known as extravasation. It is extremely rare but it is important that you tell us immediately if you notice any swelling, pain or burning at the site of the drip. If this occurs whilst the chemotherapy is being given, tell your nurse. If you notice pain, swelling or redness when you’re at home please contact us immediately (telephone number at the end of the leaflet).
Tumour lysis syndrome
Sometimes patients may have tumour lysis syndrome. This can occur approximately 2 days after the infusion. You need to drink approximately 3 litres of fluid a day. Your doctor will monitor your blood levels. If you feel unwell in any way, telephone the chemotherapy pager. If this is not treated, you can develop renal failure, which can be life threatening. Your doctor may give you medication to prevent this happening.
Blood clots
A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further. It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.
Other information
Some patients experience headaches, dizziness and insomnia. Inform your doctor if this happens.
You must avoid the yellow fever vaccine.
Bendamustine interacts with some medication. Inform your doctor what medication you are taking.
Women sometimes find that chemotherapy treatment affects their periods. They could become heavier, lighter or even stop altogether.
It is important you do not become pregnant or father a child whilst having chemotherapy treatment as chemotherapy could damage the unborn baby. Breastfeeding is not advised.
Chemotherapy may affect your ability to have children in the future. If you have concerns, please discuss this with your doctor or nurse.
Sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects.
A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further. It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information.
Manufacturer’s patient information leaflets
Velindre leaflets provide information about very common and commonly reported side-effects (we are unable to list all of the common side effects), for more information regarding these and the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy and/or on the internet at www.medicines.org.uk. Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from Velindre pharmacy
Contact telephone numbers
Velindre Cancer Centre 029 2061 5888
Ask for the treatment helpline if you are unwell at home and need immediate advice at any time of the day or night. For example you should phone if you:
Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines
Tenovus freephone 0808 808 1010
cancer helpline
This information is available in Welsh.
This leaflet was written by health professionals. The information is evidence based and has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.
Prepared February 2014
Reviewed September 2017