Oncologists frequently prescribe carmustine for their patients with certain types of cancers. It is one of the group of cancer medications called nitrosoureas. Nitrosoureas work by causing the DNA strands of cancer cells to cross-link, thus preventing DNA, RNA, and protein synthesis. This activity is not confined to a specific stage of cancer cell growth. Another very important characteristic of carmustine and other nitrosoureas is that they are able to pass through the blood-brain barrier. Carmustine is also known by the brand name BiCNU.®
Cancers Treated With Carmustine, and Methods of Treatment
Due to its ability to pass the blood-brain barrier, carmustine is most often used to treat brain tumors. It is also used to fight spinal cord tumors and tumors of the bone marrow. Additionally, carmustine can be effective against lymphomas, both Hodgkin's and non-Hodgkin's. Malignant melanoma is another type of cancer treated with carmustine; it can also be used against multiple myeloma.
Like many other types of chemotherapy, carmustine can be administered through an intravenous catheter in an infusion center or a hospital. When carmustine is used to fight brain tumors, however, it is sometimes administered via a gel wafer under the brand name Gliodel.® This can only be done if the patient undergoes brain surgery to have the tumor removed or resected. In these cases, the wafer is implanted in the space from which the cancerous tissue has been removed. The surgeon must take care, however, not to leave the wafer in a space with communication to the brain's ventricles, or the wafer may migrate and cause hydrocephaly.
Side Effects of Carmustine
Carmustine can cause nausea and vomiting in patients, and can cause the suppression of new blood cell manufacture. The peak effect of the latter often comes four to six weeks after administration, and for this reason treatments with carmustine are often given six to eight weeks apart. The medication can also have toxic effects on a patient's liver or kidneys. If carmustine is given too rapidly, it can cause a patient to feel warm and the patient's skin to flush.
One of the more serious side effects of carmustine is called pulmonary fibrosis. This causes scar tissue to form in the lungs, with subsequent breathing difficulties. In patients receiving carmustine, it can show up as a cough, shortness of breath, or full-scale sudden respiratory failure. The pulmonary fibrosis caused by long-term treatment with carmustine is irreversible.
Sources
- Polovich, Martha, Julie M. Whitford, and MiKaela Olsen, eds. Chemotherapy and Biotherapy Guidelines and Recommendations for Practice. Pittsburgh, PA: Oncology Nursing Society, 2009.
- Wilson, Billie, Margaret T. Shannon, and Kelly M. Shields, Prentice Hall Nurse's Drug Guide 2009. Upper Saddle River, NJ: Prentice Hall, 2008.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health profe3ssional. Any reader who is concerned about his or her health should contact a doctor for advice.
Elizabeth Thomas - Elizabeth was born and raised in Mt. Clemens, Michigan, though she now lives in a suburb of Austin, Texas. She holds a bachelor's and ...
