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Chemo side effects - neuropathy - bruising under fingernails
Hi,
I have Stage I OC. I've finished 5 out of six chemo sessions with taxotere and carboplatin at Johns Hopkins. (Lucky!) I've been feeling very well except for some days of aches & pains & minor nausea. I've also had some neuropathy - mostly in my feet. It feels like I'm walking on grit most of the time. Again not much of a difficulty. My hands feel hot a good bit of the time.
Recently, I have developed pain in my finger tips that seems to be getting worse. I've got bruising under my nails and today the pain has increased to where it hurts to type this. Is this normal and/or serious? Am I likely to lose my fingernails from pressure? I use a computer all day for my job & wonder if this is going to affect my ability to work. I need good eye/hand coordination to draw maps.
My doctor prescribed Taxotere when I told him what I do for work, supposedly to prevent neuropathy - I'd hate to see what things would be like with Taxol!
I have Stage I OC. I've finished 5 out of six chemo sessions with taxotere and carboplatin at Johns Hopkins. (Lucky!) I've been feeling very well except for some days of aches & pains & minor nausea. I've also had some neuropathy - mostly in my feet. It feels like I'm walking on grit most of the time. Again not much of a difficulty. My hands feel hot a good bit of the time.
Recently, I have developed pain in my finger tips that seems to be getting worse. I've got bruising under my nails and today the pain has increased to where it hurts to type this. Is this normal and/or serious? Am I likely to lose my fingernails from pressure? I use a computer all day for my job & wonder if this is going to affect my ability to work. I need good eye/hand coordination to draw maps.
My doctor prescribed Taxotere when I told him what I do for work, supposedly to prevent neuropathy - I'd hate to see what things would be like with Taxol!
MEDICAL PROFESSIONAL
Hi There,
It could be all due to the neuropathy. But I worry that it could be something more like an infection under your nail. Please see your doctor for an exam
best wishes
It could be all due to the neuropathy. But I worry that it could be something more like an infection under your nail. Please see your doctor for an exam
best wishes
Thanks for the good advice! I called my oncology nurse who conveyed my problem to the doctor. Apparently I didn't describe this very well above.
This is not neuropathy - which is a standard side effect from taxol but a different side effect from the taxotere where there is pain in the finger tips and toes and blood in the nail beds. She said the the pressure can increase to the point where you can lose the nail!
My doctor left instructions for my hands to be cooled during my chemo treatment. They gave me a tub of ice. I found it to be more comfortable to cool an ice/hot pack in the ice and hold it around my fingers - the ice was too cold.
I've been doing the same at home & the pain has lessened considerably. My hands have been feeling hot for several weeks now.
I imagine something more should be done if this had happened during my first or second chemo treatment.
This is not neuropathy - which is a standard side effect from taxol but a different side effect from the taxotere where there is pain in the finger tips and toes and blood in the nail beds. She said the the pressure can increase to the point where you can lose the nail!
My doctor left instructions for my hands to be cooled during my chemo treatment. They gave me a tub of ice. I found it to be more comfortable to cool an ice/hot pack in the ice and hold it around my fingers - the ice was too cold.
I've been doing the same at home & the pain has lessened considerably. My hands have been feeling hot for several weeks now.
I imagine something more should be done if this had happened during my first or second chemo treatment.
MEDICAL PROFESSIONAL
Hi There,
thank you so much for the follow up. I did a search of nail toxicity and taxotere. Here is one abstract. It does look like it is pretty common.
best wishes
Nail Toxicity after Treatment with Docetaxel: A Prospective Analysis in Patients with Advanced Non-small Cell Lung Cancer.
Hong J, Park SH, Choi SJ, Lee SH, Lee KC, Lee JI, Kyung SY, An CH, Lee SP, Park JW, Jeong SH, Nam E, Bang SM, Cho EK, Shin DB, Lee JH.
Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 405-760, Rep of Korea. ***@****.
OBJECTIVE: Nail toxicity is one of the most frequent non-hematologic toxicities of docetaxel and often deteriorates patients' quality of life, leading to treatment discontinuation. To define the incidence of nail change as well as its association with specific risk factors, we prospectively investigated data of 84 consecutive patients with advanced non-small cell lung cancer who received first-line docetaxel/cisplatin combination chemotherapy. METHODS: Chemotherapy-naïve patients were treated with docetaxel, either 3-weekly or weekly, in combination with cisplatin. All patients received adequate premedications including corticosteroids, antiemetics and intravenous hydration. Toxicity was evaluated using National Cancer Institute (NCI) CTCAE version 3. RESULTS: Twenty-two patients (26%) developed nail changes, including nine (11%) with grade 3. Nine patients who developed grade 3 nail changes (seven of whom received weekly docetaxel) were not able to complete planned chemotherapy despite topical and/or oral antibiotic treatment. Most occurrences of nail changes were diagnosed in patients who were treated with weekly schedule (P = 0.02). The number of chemotherapy cycles and cumulative docetaxel doses were strongly associated with the development of nail changes. The cumulative hazard of developing nail changes increased above 10% after 2.8 months up to 40% at 6 months. A multivariate analysis of factors associated with the development of nail changes identified the following to have independent adverse significance: weekly docetaxel administration (odds ratio, 0.084; 95% CI, 0.014-0.510; P = 0.01) and the number of chemotherapy cycles given (odds ratio, 0.232; 95% CI, 0.067-0.805; P = 0.02). CONCLUSION: Nail changes occur with more frequent and prolonged use of docetaxel.
Jpn J Clin Oncol. 2007 Jun;37(6):424-8. Epub 2007 Jun 21
thank you so much for the follow up. I did a search of nail toxicity and taxotere. Here is one abstract. It does look like it is pretty common.
best wishes
Nail Toxicity after Treatment with Docetaxel: A Prospective Analysis in Patients with Advanced Non-small Cell Lung Cancer.
Hong J, Park SH, Choi SJ, Lee SH, Lee KC, Lee JI, Kyung SY, An CH, Lee SP, Park JW, Jeong SH, Nam E, Bang SM, Cho EK, Shin DB, Lee JH.
Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 405-760, Rep of Korea. ***@****.
OBJECTIVE: Nail toxicity is one of the most frequent non-hematologic toxicities of docetaxel and often deteriorates patients' quality of life, leading to treatment discontinuation. To define the incidence of nail change as well as its association with specific risk factors, we prospectively investigated data of 84 consecutive patients with advanced non-small cell lung cancer who received first-line docetaxel/cisplatin combination chemotherapy. METHODS: Chemotherapy-naïve patients were treated with docetaxel, either 3-weekly or weekly, in combination with cisplatin. All patients received adequate premedications including corticosteroids, antiemetics and intravenous hydration. Toxicity was evaluated using National Cancer Institute (NCI) CTCAE version 3. RESULTS: Twenty-two patients (26%) developed nail changes, including nine (11%) with grade 3. Nine patients who developed grade 3 nail changes (seven of whom received weekly docetaxel) were not able to complete planned chemotherapy despite topical and/or oral antibiotic treatment. Most occurrences of nail changes were diagnosed in patients who were treated with weekly schedule (P = 0.02). The number of chemotherapy cycles and cumulative docetaxel doses were strongly associated with the development of nail changes. The cumulative hazard of developing nail changes increased above 10% after 2.8 months up to 40% at 6 months. A multivariate analysis of factors associated with the development of nail changes identified the following to have independent adverse significance: weekly docetaxel administration (odds ratio, 0.084; 95% CI, 0.014-0.510; P = 0.01) and the number of chemotherapy cycles given (odds ratio, 0.232; 95% CI, 0.067-0.805; P = 0.02). CONCLUSION: Nail changes occur with more frequent and prolonged use of docetaxel.
Jpn J Clin Oncol. 2007 Jun;37(6):424-8. Epub 2007 Jun 21
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