This leaflet provides information on a course of chemotherapy called IAd. The leaflet will explain what this is and when and how it will be given. It will also tell you about common side effects that you may experience. Contact telephone numbers and details of how to obtain further information on IAd 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 please ask your nurse for a copy.
What is IAd chemotherapy?
IAd chemotherapy consists of two drugs:
Together these two drugs are known as IAd for short.
Why am I having IAd chemotherapy?
Your doctor has recommended this chemotherapy because it has been found to be effective in treating your type of cancer.
How often will I receive my IAd chemotherapy?
For this treatment to be most effective, it is given at specific time intervals. These are known as cycles. It is usual to have a cycle of IAd every three weeks for up to six cycles. Your doctor will discuss with you the exact number of cycles you will receive.
Will I need any tests before I start my chemotherapy?
Yes. Before you start your chemotherapy you will have a series of blood tests and investigations. You will also have what is known as a MUGA scan to assess your heart function. Please ask if you would like any further information.
Will I need to stay in hospital to have my chemotherapy?
Yes. To have this chemotherapy you will need to be admitted to one of the wards at Velindre for four days
How will my treatment be given?
The chemotherapy will be given through a drip connected to a small needle which is placed in your hand or arm. Alternatively it may be suggested that a fine tube called a PICC line is inserted into one of the large veins in your upper arm. This line can remain in place for the whole of your treatment. Your doctor or nurse will explain this in more detail.
We have a leaflet that tells you more about PICC lines. Please ask if you would like a copy.
Your drip will be attached to a portable stand with wheels so you will be able to move around the ward area. If you need assistance the nurses will be there to help you.
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.
What are the possible side effects?
There are a number of possible side effects which can occur with this chemotherapy. The doctor, nurses and pharmacy team can give you advice or answer any questions you may have.
Hair loss
Unfortunately you will lose your hair with this chemotherapy. This is only temporary. Your hair will grow back when your treatment has finished.
We have a leaflet that tells you more about coping with hair loss. Please ask your nurse for a copy.
Sickness
Nausea and vomiting are uncommon these days as we will 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 for advice. 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 if your temperature is below 35.5°. The telephone number is at the end of the leaflet.
Diarrhoea
Diarrhoea is not common with this chemotherapy. However, if you have four or more bowel movements in 24 hours above what is normal for you please contact Velindre Cancer Centre immediately. The telephone number is at the end of the leaflet.
Tiredness and fatigue
Chemotherapy can make you 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 taking rest.
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.
Cystitis (bladder irritation)
Ifosfamide can sometimes irritate your bladder and cause cystitis. This means you may notice some burning and pain when passing water, and need to pass water frequently. This is not common as we will give you a drug called mesna which should prevent this happening. If you still get cystitis please tell your nurse or doctor.
Effects on your heart
Doxorubicin can cause heart problems. Please tell your doctor if you have any heart problems or you take any heart medicines. Before you start your chemotherapy treatment, a scan called a MUGA scan is usually done to check for any heart problems. This may be repeated later on in your treatment.
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 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. The telephone number is at the end of the leaflet.
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 side effects
A small number of patients who have ifosfamide may feel drowsy, become confused and hallucinate. These symptoms are very rare and usually go away within 48 hours of stopping treatment. If you have any of these symptoms or your family notice any changes in your behaviour, please tell your nurse or doctor.
Doxorubicin will harmlessly discolour your urine red for a day after your chemotherapy. If this lasts for more than 24 hours please contact Velindre Cancer Centre for advice.
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.
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.
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
Macmillan freephone Helpline 0808 808 0000
Tenovus freephone 0808 808 1010
cancer helpline
This information is also available in Welsh
This leaflet was written by health professionals. The information contained in this leaflet is evidence based. It has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.