possible drug reactions

[tuffy44]

I have been taking Tarceva for 11 days.  My right leg has become swollen from the knee down.  Could this possibly be a reaction to this medication?

[Fernando Roque, MD]

Hi. That enlarged node may need to be biopsied, to confirm if metastatic spread to that node has occurred.  If the node is positive for cancer metastases, this may imply disease progression in spite of Tarceva intake.  Tarceva may have to be replaced with another more effective chemotherapy drug.  Radiation therapy to shrink the node and relieve the swelling may also have to be done.  Consult with your oncologist as soon as possible so you can be properly assessed.

[tuffy44]

I do have an enlarged node in the lower right abdominal area.  If this is what's causing the swellling, is there anything that can be done?

[Fernando Roque, MD]

Hi.  Edema (fluid accumulation in any body part, resulting in swelling) has been reported as an adverse event in 37% of pancreatic cancer patients taking Tarceva, although this side effect has not been reported in lung cancer cases.

However, the type of edema associated with Tarceva use is either generalized or involves a swelling of both legs.  Swelling in only one leg may not be due to this drug.  Unilateral leg swelling may be due to a local infection (cellulitis) in that area. It may also be due to thrombophlebitis (blood clots causing inflammation of the veins). This can happen in patients who are bedridden and have not been moving their legs a lot, causing clots to form in their leg veins.

I have also had cancer patients who had unilateral leg swelling because of an enlarged lymph node in the inguinal or intra-abdominal areas, which impinges on the lymph vessels draining the leg.  This possibility also needs to be investigated, since an enlarged node may signify cancer metastases.