VAD Chemotherapy

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This leaflet concerns the medicine that you are going to receive. For more detailed information, please refer to your doctor or chemotherapy nurse. Your consultant has advised you to have this chemotherapy treatment, which is effective in the treatment of Myeloma. Further information about your type of cancer is available from Macmillan Cancer Care, a national cancer charity at www.macmillan.org.uk [accessed August 2010] or free phone 0808 808 0000.

Your treatment

V is for Vincristine - a colourless medicine. A is for Doxorubicin (Adriamycin) - a red medicine. Vincristine and Doxorubicin are given over 4 days through your central line using a small portable pump. D is for Dexamethasone - tablets taken for 4 days.
Advice on how to take these tablets will be provided.

You should normally receive your treatment once every 3 weeks for a total of 6 cycles. You will have your treatment in the Day Unit and will not need to stay in hospital overnight. Monday - Friday 9am - 5pm
Day Unit: 0117 323 5089
Clinical Nurse Specialist, mobile phone: 07545 421893 Evenings / night time / weekends
0117 950 5050
(Ask switchboard for Haematology doctor on call)

Common side effects

You may experience some of the following side effects during your treatment. These are usually temporary. It is important to tell your doctor or nurse about any side effects that you experience, so that they can be monitored and treated when necessary. 2
CVAD Chemotherapy

Bone marrow suppression Your bone marrow is where your blood cells are made (red cells, white cells and platelets). Chemotherapy especially Fludarabine, can interfere with this process and the number of cells in your blood can become lower than normal. If this happens you could become: Prone to infection (low white cells) Your treatment will cause a temporary reduction in the number of white blood cells sometimes referred to as neutropenia. Being neutropenic can make you more susceptible to catching an infection. You may develop a sore throat, cough, fever and/or shivering or feel generally unwell. If your temperature goes above 38C contact the hospital at once. Anaemic (low red cells) If your red cells become low, you may notice that you feel dizzy, excessively tired, short of breath and look pale. Contact the hospital if you are concerned about this. If your chemotherapy does cause a temporary anaemia you may require a blood transfusion. Prone to bleeding (low platelets) If your platelets become low you may experience nosebleeds or unexplained bruising or bleeding. Contact the hospital straight away. You will have a routine blood test prior to each cycle of chemotherapy to monitor the effects on the bone marrow.

Nausea and vomiting The severity of this varies from person to person. An antisickness injection or tablet will be given along with your chemotherapy to help prevent sickness. You will also be given anti-sickness tablets to take home. If you are sick after your chemotherapy treatment, your anti-sickness medications may need to be changed or increased. Contact your GP.
CVAD Chemotherapy

If you do experience any nausea, you may lose your

appetite. Your sense of taste can also be altered by the
chemotherapy, which may change your preference for
certain food and drink.
With chemotherapy treatment it is important to drink about 2 litres of fluid per day.

Constipation Both chemotherapy and anti-sickness drugs can cause constipation. Try to drink plenty of fluids and eat foods high in fibre. Report constipation to your doctor who may prescribe a suitable laxative. Hair loss Hair loss is usually total. It will gradually start falling out 10 -14 days following your first dose of chemotherapy. Some patients experience scalp tenderness just before and during the time when the hair is falling out. Hair loss is a temporary side effect and your hair will grow back after your treatment has finished. We can arrange for you to see the hairdresser and be fitted for a wig. Tingling and numbness in fingers and toes Usually this side effect is only mild and temporary. Please report these symptoms to your doctor on your next visit to the Day Unit. Sore mouth Sometimes the chemotherapy treatment can cause the lining of the mouth and throat to become sore and sometimes ulcerated. You will be given a mouthwash to help prevent this happening. Try to follow these simple steps:

Keep your mouth clean using a soft toothbrush. Drink plenty of fluids. Avoid eating salty or spicy foods.

If you need dental work, tell your dentist you are receiving chemotherapy, as your mouth is such a vulnerable area for infection. 4
CVAD Chemotherapy

Lethargy (tiredness) Chemotherapy can cause you to feel tired and lacking in energy. It can be frustrating when you feel unable to cope with routine tasks. Gentle exercise such as walking can be beneficial. If you feel tired take a rest and if necessary take time off work. Fertility Chemotherapy may affect your ability to have children in the future. Please discuss this with your hospital doctor or chemotherapy nurse. It is important that you or your partner do not become pregnant while receiving chemotherapy. A reliable form of contraception should be used.

General information

Because Doxorubicin is red in colour, it may cause you to

have red or pink urine 1 - 2 days post treatment.
If alcohol is consumed within 48 hours of receiving
chemotherapy it may cause nausea or sickness.

This leaflet gives a list of common side effects of chemotherapy.

As with any medicine, there may be more rare side effects. If
you are feeling unwell in any way, please do not hesitate to
contact the hospital.
NHS Constitution. Information on your rights and responsibilities.
Available at www.nhs.uk/aboutnhs/constitution
[Last Accessed March 2010]

CVAD Chemotherapy

How to contact us:

Monday - Friday 9am - 5pm Day Unit: 0117 323 5089 Clinical Nurse Specialist, mobile phone: 07545 421893 Evenings / night time / weekends: 0117 950 5050 (Ask switchboard for Haematology doctor on call)

www.nbt.nhs.uk If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.
North Bristol NHS Trust. First Published July 2008. This second edition August 2010. NBT002281