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Skin Reactiom from Doxil
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Skin Reactiom from Doxil

I have had 3 doses of Doxil and after the 3rd dose got severe hand and foot burn, blisters and bleeding sores.
Since it is working I was wondering what to do ahead of time to hopefully keep it from getting so bad again and if it recurrs what tx can I do to combat these sores and terrible pain. Onc was no help and I have spent a month being miserable
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8 Comments
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Hello, I have spoken to other women who have experienced this on chemo, especially Doxil.  The condition is called PPE and if you come to my medhelp page, there is a copy of a handout I was given to prevent this condition in the section where my photos are.  It has helped me with prevention and I was told the tips are expecially important to follow during that first week immeidately after treatment.  I hope this helps you find relief.  Take care, Angie
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I get so angry when I read about the doxil reactions, why don't these chemo providers tell  those recieving doxil what to do prior and during treatment?  My daughter had the hand and foot reaction, it is terribly painful, she missed weeks of work and was unable to proceed with  doxil till it got bnetter.  When she found out about the cooling  and her hands got better she was able to continue with a reduced dose for several times.  Take ice packs to  the treatment with you, suck ice chips, cool showers, not hot spicey foods, avoid sun,  loose clothes around ankles, wrists and waist, avoid doing dishes  and any thing that puts heat onto your skin, I am going to ask Medhelp to put up a sticky  with how to avoid Doxil reactions, we need to keep  you all from getting this, it is bad anough to have the damn cancer, you don't need this pain.  doxil does have a web site that tells all about  this but most just take their providers word.   Marty
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I'm sooo with Marty/SimplyStar on this...Why did your doctor NOT tell you how to combat this treatment?  I only did 4 treatments but, thanks to this site had read up on what to do to avoid or at least minimize the hand foot problems of doxil.  Marty's post is right on,,,the only thing I'd add is to constantly drink cold Iced drinks constantly.  Not just during treatment but for days after...It's not hard to do...I drank Sonic Iced tea with extra ice...and Passion herbal tea.  Also used ice packs for several days whenever my feet or hands looked red and swollen.  

Shame on the doc's that didn't prepare you and help you possibly avoid this awful side effect.  I hope you find relief and that the treatment continues to work for you.

Teresa
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Be Proactive
Two of the most common side effects, hand-foot syndrome (HFS), and stomatitis can be actively managed and/or possibly prevented.

Managing and Preventing Hand-Foot Syndrome
Applying ice packs to the wrists and ankles during the administration of DOXIL therapy may have a protective effect against hand-foot syndrome (HFS). In a recent study, 94% of patients that applied regional cooling during administration experienced no HFS or mild HFS. Ask your nurse about incorporating regional cooling into your DOXIL administration.

My daughter also took COQ10  to prevent heart damage and had regular EKG's to look for any problems. If care is taken 94% do not experience any reactions.


To help control HFS after administration, follow these guidelines for at least 1 day before and 3 to 5 days after each treatment:

Managing and Preventing Hand-Foot Syndrome

Things to Avoid:


•Avoid repetitive or friction-causing activities (e.g., avoid rough towels, sexual activity, sweeping, or typing)
•Avoid heat, including hot water or steam, on your skin (e.g., take cool, short showers or baths; avoid washing dishes)
•Avoid the drying out of the skin on your hands and feet by using plain, mild skin lotions or creams for itching that do not contain irritants such as perfumes
•Try not to put pressure on your skin (e.g., don’t kneel for long periods, sit on hard surfaces or lean on your elbows)
•Avoid using adhesive bandages
•Don’t chop hard foods such as raw vegetables

Things to do:


•Wear comfortable, well-ventilated, low-heeled shoes or slippers
•Wear sunblock (SPF 15 or higher) every day on all exposed skin; avoid using sunblock that contains irritants such as perfumes
•Stay in cool places and out of direct sunlight
•Use mild soaps and pat skin dry after bathing; don’t rub
•Check hands and feet, between fingers and toes in particular, for signs of irritations
•Apply gel ice packs to your hands and feet or soak them in cold-tepid water when possible
•Wear loose clothing

Preventing Stomatitis
For at least 1 day before and 3 to 5 days after treatment follow the routine below:

Things to do:

•Practice careful oral hygiene
    -  Use a soft toothbrush
    -  Rinse your mouth with cold water frequently
•Drink plenty of cool or room temperature liquids; suck on ice chips or sip cool beverages as often as possible

Things to avoid:


•Hot or spicy foods
•Salty foods
•Acidic foods (e.g., tomatoes and tomato-based sauces)
•Citric fruits and juices
•Alcoholic beverages
•Tobacco products

    









  Doxil (doxorubicin HCl), is a prescription medicine that is administered intravenously by your healthcare professional. DOXIL is used to treat patients with ovarian cancer that has progressed or recurred after platinum-based chemotherapy.

Please read Important Safety Information below, and talk to your healthcare professional to learn more about DOXIL.

Important Safety Information

Serious and possibly permanent heart-related side effects that may lead to congestive heart failure can occur in patients treated with DOXIL. Inform your doctor of any history of heart disease, radiation to your chest, or prior chemotherapy. Your doctor may monitor your heart function.

Infusion reactions may occur during administration. Be sure to tell your doctor if you have any symptoms during infusion, including: flushing, shortness of breath, facial swelling, headaches, chills, back pain, tightness in your chest or throat, dizziness, or lightheadedness. For most patients, these reactions have resolved within several hours to a day once the infusion is stopped, or for some patients with slowing of the infusion rate. However, in some cases, these reactions may be serious and sometimes life threatening, though they are rarely fatal.

DOXIL may severely reduce the number of blood cells (red blood cells, white blood cells, and platelets) in your body. Your doctor may adjust or delay your dose of DOXIL if this occurs.

Your doctor may adjust your dose of DOXIL if you have liver problems.

You should not take DOXIL if you are nursing. If you are pregnant or are planning to become pregnant, inform your doctor.

You should not take DOXIL if you are allergic to doxorubicin HCI or the components of DOXIL.


The most common side effects of DOXIL are:
•Hand-Foot Syndome (HFS): Tingling or burning, redness, flaking, bothersome swelling, small blisters, or small sores on palms of hands or soles of feet
•Stomatitis: Painful redness, swelling, or sores in the mouth
•Fever: A fever of 100.5ºF or higher
•Neutropenia: Low white blood cell count
•Nausea, vomiting, tiredness, weakness, rash, shortness of breath, or mild hair loss
•Loss of appetite
•Diarrhea

Be sure to tell your doctor immediately if you experience any of these or other symptoms.

DOXIL may make the side effects of other anticancer therapies worse when used in combination.

Following administration, DOXIL may turn urine and other bodily fluids a reddish-orange color.  
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Timely post for me.  Today  I start Caelyx, a Doxil family drug.  I am especially prone to stomatitis, used to get chancre sores with every menstrual period.  
Thanks for the info!
Sharon
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Please follow the advise that SimplyStar/Marty has given you. I too broke out with sores. I also used bag balm which helped alot.
Hugs and Prayers, Terry
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I, too, am  on Doxil.  I am scheduled for round 2 on Monday.  My onco. nurses told me everything Marty posted above.  I took ice chips with me to tx.  I used ice packs during tx and at home for a few days after tx.  I wore only a loose shift .. avoiding all elastic .. including socks that had snug bands at the top.  I was also told to avoid excessive typing or even holding on to a phone for too long (pressure). Do not chop veggies, use a broom, or vacuum. I took lukewarm showers and applied skin cream (without perfume) after the shower.  Drank lots of cool drinks and ate ice cream, popsicles, etc. I found that even pretzels bothered my mouth.  Good luck.  Judy
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