What should you know about rice chemotherapy?

RICE is a chemotherapy regimen; the letters refer to ifosfamide, carboplatin and etoposide. It may be considered when a cancer needs combination drug treatment, including some relapsed or difficult-to-treat situations. The exact schedule, dose, number of cycles and need for additional treatment are decided from the cancer type, previous therapy, kidney function, blood counts and overall health. It is not a single medicine or a treatment suitable for every cancer.

Before treatment, ask how the drugs will be given, whether a central line is needed, and which blood and kidney tests are required. Ifosfamide can affect the bladder and nervous system, so the team may provide protective measures, fluids and monitoring. Tell clinicians about all medicines, allergies, previous chemotherapy, urinary symptoms and plans for pregnancy or fertility. RICE may be discussed in conditions such as Acute Myeloid Leukaemia, Bladder Cancer, Brain Tumour, Breast Cancer, Cancer of Unknown Primary, Cervical Cancer, Childhood Cancer and Chronic Lymphocytic Leukaemia.

During or after RICE, contact the treatment team immediately for fever, chills, new confusion, severe drowsiness, blood in the urine, inability to pass urine, repeated vomiting, unusual bleeding or marked shortness of breath. Seek emergency help for collapse, seizure, chest pain or breathing difficulty. Use the team’s out-of-hours number rather than waiting for the next appointment when a warning symptom appears.

Ask why RICE is being recommended, what response will be assessed, and how kidney, bladder, liver and blood-count changes will be monitored. Ask about infection precautions, hair loss, nausea, fertility, transport home, medicines to take between visits and the symptoms that require urgent contact.