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Severe reaction to CMF chemo for early stage breast cancer

I am a 55 year old young women recently diagonsed with early stage 1 breast cancer . .6cm tumor - removed with clear margins, negative sentinal node involvement, estrogen/progesterone positive HER 2 negative breast cancer. I was very pleased with the surgery results. My ONC score is 21 so I opted to have 8 treatments , once every three weeks, of CMF chemo for my long term (better results).  I have had 4 treatments so far, however, after each infusion I wind up in the Emergency room of my local hospital having to be monitored all night for extreme swelling of my face, throat, tongue. My oncologists are stumped by this reaction, they have never seen it before with CMF chemo. Since the second reaction I now do 150 mg of prednisone the night before the chemo infusion as well as a benadryl 50 mg dose before we start will all the other pre-medications that I get and then the chemo.  I still wind up in the Emergency room. I am asking if anyone else has ever experienced this reaction. I can't believe it's just me.  I am so desperate for any information anyone could provide that may help me understand how to relieve these post chemo reactions that I get.  Thanks....Jamie
Best Answer
962875 tn?1314210036
Hi,

What a terrible--and no doubt terrifying-- thing to go through each time you have a chemo tx!

An allergic reaction, also referred to as a hypersensitivity reaction, is an overactive or misdirected immune response that results in local tissue injury or changes throughout the body in response to a foreign substance. These reactions can be caused by many factors, including chemo treatments.

Hypersensitivity allergic reactions have been reported with most chemotherapy drugs, although they are generally infrequent.  They occur more commonly with L-asparaginase, paclitaxel, docetaxel, teniposide, procarbazine, and cytarabine.  

One of the main things that is commonly done  to minimize the effects of chemotherapy-induced allergic reactions is for prophylactic medications to be given before the drug is given again.  But since you are still having reactions despite such medications that are severe enough to require ER tx,  a different drug may have to be substituted, esp. if the reactions you are having have been labeled life-threatening.

Another possibility, if that IS the case and your oncologists can't come up with a suitable alternative  chemo regimen,  since your score was in the low end of the intermediate range for recurrence risk, would be to consider forgoing further chemo. It might be good to arrange a 2nd opinion consult, with an oncologist from a completely separate practice, to help you make this decision.

Please let us know how things are going and what you decide to do by posting additional comments on this same thread, using the box below.

Best wishes,
bluebutterfly
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Avatar universal
Funny that you mention Neulesta shot...I had my last chemo on July 20th and they saFid that i needed this shot because my white blood count was low. So after having chemo that Friday the 20th I went to the ER that night to be monitored, I went to the oncologist office the following Monday for that shot.  I was surprised that I did not have any side effects....well Friday of that week at 4:ooam I woke up with back breaking pain so severe that I had to call the ambulance to take me to the ER....I live 4 blocks from the hospital but the pain was so bad i could not manage.  They kept me in emergency for hours giving me pain killers until I could get that under control.  It was so scary. I knew this journey was going to be difficult, but it seems like for me, these effects from chemo have been totally unexpected.

Each time I face chemo, I never know what is going to happen to me.
Helpful - 0
962875 tn?1314210036
To further clarify the point I was trying to make above, I should mention that there  is a major difference between "drug side effects" and "allergic reactions."

The commonly experienced side effects of chemo drugs (nausea, vomiting, diarrhea, hair loss, fingernail and toenail changes, etc.) are related to  CHARACTERISTICS OF THE DRUGS, and are therefore experienced to a greater or lesser extent by just about everyone who takes them. Chemo drugs are intentionally toxic, in order to be able to kill cancer cells (fast dividing/growing cells), but cannot specifically target ONLY those cells, so they also affect to some degree other fast growing cells (hair and nails, mucus membranes in the mouth and GI tract, etc.). "Stronger" drugs may therefore result in stronger side effects of the types mentioned.

Allergic or hypersensitivty reactions, on the other hand, are related to CHARACTERISTICS OF A PERSON'S IMMUNE SYSTEM, and therefore are highly indivdualistic in nature. This explains by some people can eat peanut butter every day, or take penicillin or amoxicillin every time they have an ear ache or bronchitis, or get stung by a bee with the only response being "OUCH!", or exercise to their heart's content, whereas other people may  have severe allergic reactions, sometimes even life-threatening anaphylaxis, from exposure to the same triggers.

This is one reason it's important NEVER to dismiss a person's symptoms as being "all in their head!"

It's also why I said a "stronger" chemo might NOT be worse for you than what you are going through with your current chemo regimen.

Warm regards,
bb
Helpful - 0
962875 tn?1314210036
Hi again,

I have a question for you: Have you by any chance been receiving Neulasta in connection with your chemo?

It can cause SEVERE side effects:
Severe allergic reactions (rash; hives; itching; difficulty breathing; dizziness; fast heartbeat; increased sweating; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); fast breathing; fever; left-sided shoulder tip pain; left-sided upper stomach pain; a lump, swelling, or bruising at the injection site; severe or persistent bone, chest, joint, or stomach pain; shortness of breath; swelling of the hands, feet, arms, or legs; wheezing.

Also a comment: stonger chemo drugs might NOT be worse, or even as bad, if you are NOT allergic to them, but ARE allergic to CMF. (A loved one of mine had ACT, which is considered very strong, and of course had some side effects, but nothing of the magnitude you have experienced with CMF!)

I'm so glad you have an understanding onco now, who is taking your problems very seriously and trying to find a solution.

Keep us posted--we care!

bb
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Avatar universal
Thank you very much for your response, makes alot of sense. I have actually switched oncologist as a result of the reaction from the first time and HIS (male oncologist)..."it's all in your head" response.  I am now with another oncologist team who have been really trying to get me through treatment. They have suggested changing my CMF cocktail to another more aggressive breast cancer drug, but in my mind if I can't handle the easier CMF drug, how would I survive a stronger chemo. I know that chemo for many people is no walk in the park, but being told that I am the only one in their practice that they have ever seen with the reaction has been pretty devestating.  I am know reading a book on self hypnosis in anticipation of my next chemo in August to try and help me get through this experinece.
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