Aa
Sun and Nexavar
Hi
I have stage 4 HCC out side the liver with hep C cirrous. I am 61 years old and feel mostly OK. My oncologist wants me to start taking nexavar, but she said that I could not spend time in the sun. Being a surfer and would like to take some time in MX. This drug does not sound to good for the amount of time (3.5 to 3 moths of life extension) that it boast will give me. has any one had any experience with nexavar and the sun?
Michael in Astoria OR
I have stage 4 HCC out side the liver with hep C cirrous. I am 61 years old and feel mostly OK. My oncologist wants me to start taking nexavar, but she said that I could not spend time in the sun. Being a surfer and would like to take some time in MX. This drug does not sound to good for the amount of time (3.5 to 3 moths of life extension) that it boast will give me. has any one had any experience with nexavar and the sun?
Michael in Astoria OR
Okay I found the references to sunlight....
Treatment of Liver Cancer with Nexavar® (sorafenib) - Information for patients
http://www.medconnect.com.sg/LinkClick.aspx?fileticket=oKnB6Xjmtt4%3d&tabid=77
'Some patients report that heat irritates their skin; if this is the case, avoid contact with hot water and saunas, and do not sunbathe.'
'Managing side effects
It is important to tell your healthcare team as soon as you notice any side
effects. Treating side effects early may prevent them from getting worse. The following pages contain some suggestions for managing the most common side effects of Nexavar® therapy.
What is hand–foot skin reaction (HFSR)?
HFSR is a group of disorders that affects the hands and/or feet of patients
receiving certain drugs. This reaction usually affects both sides of the body. The most severe symptoms are usually experienced at areas of the body exposed to pressure (for example, the soles of your feet).
If you are going to experience this side effect, it often develops between the second and fourth week of Nexavar® treatment and may go away by itself. In addition, there are things that you can do to help minimize the symptoms of HFSR.
Managing HFSR
Management of HFSR can begin before any symptoms occur. Several measures may be taken that prevent or reduce the severity of HFSR.
● It may be helpful to remember the 3 Cs: calluses, cushion and creams:
– calluses: as soon as you are prescribed Nexavar®, remove any pre-existing calluses on your hands or feet
– cushion pressure points or irritated areas on your hands or feet
● wear padded gloves when using tools or knives that may rub or damage the skin on your hands
● wear soft shoes, cotton socks and/or inner soles to protect rubbed or
pressured areas
– apply moisturising creams as recommended
● different types of cream might be helpful at different times during your
treatment; discuss this with your healthcare provider
It is important to tell your doctor or healthcare professional as soon as
you notice any signs or symptoms of HFSR. Treating these symptoms
early when they are mild may prevent them from getting worse.
These simple actions may minimize HFSR symptoms and allow you to stay on your anticancer therapy for a longer period of time.
Your doctor may decide to send you to see a dermatologist, depending on your condition.
If your HFSR doesn’t get better, your doctor may be able to briefly modify your Nexavar® treatment dose so that your symptoms go away and you still get the benefit of your anticancer treatment.
● If your dose of Nexavar® is lowered, you may be able to return to full dose once your HFSR improves.
● If treatment interruption is required, your doctor will work with you to determine when to resume treatment; many patients are able to return to their full dose of Nexavar®'
Some patients may develop rashes on their body and/or face while taking Nexavar®
.
These rashes are different from HFSR. The three types of rash that may develop are:
● A facial rash that is usually red with slight peeling of the skin.
● A raised rash on your body, called a ‘maculopapular rash’.
● A red body rash with small blister-like bumps (rarely occurs).
Managing rash
Doctors and other healthcare professionals offer the following suggestions to reduce discomfort and prevent these types of rashes from getting worse:
● From the start of your therapy, use moisturising creams on your skin immediately after a shower and before going to bed. Look for moisturisers that do not have perfumes or preservatives and apply them gently.
● Use antidandruff shampoo on your scalp or as a body wash.
● Use anti-itch formulas of moisturising creams if the rash itches.
● Use colloidal oatmeal lotions.
● Wear loose-fitting clothing.
● Use a mild soap and avoid hot showers.
● Avoid direct sunlight and wear a broad-brimmed hat while outside.
● Use sun protection cream with at least a sun protection factor of 30.
I hope this helps!
Hector
Treatment of Liver Cancer with Nexavar® (sorafenib) - Information for patients
http://www.medconnect.com.sg/LinkClick.aspx?fileticket=oKnB6Xjmtt4%3d&tabid=77
'Some patients report that heat irritates their skin; if this is the case, avoid contact with hot water and saunas, and do not sunbathe.'
'Managing side effects
It is important to tell your healthcare team as soon as you notice any side
effects. Treating side effects early may prevent them from getting worse. The following pages contain some suggestions for managing the most common side effects of Nexavar® therapy.
What is hand–foot skin reaction (HFSR)?
HFSR is a group of disorders that affects the hands and/or feet of patients
receiving certain drugs. This reaction usually affects both sides of the body. The most severe symptoms are usually experienced at areas of the body exposed to pressure (for example, the soles of your feet).
If you are going to experience this side effect, it often develops between the second and fourth week of Nexavar® treatment and may go away by itself. In addition, there are things that you can do to help minimize the symptoms of HFSR.
Managing HFSR
Management of HFSR can begin before any symptoms occur. Several measures may be taken that prevent or reduce the severity of HFSR.
● It may be helpful to remember the 3 Cs: calluses, cushion and creams:
– calluses: as soon as you are prescribed Nexavar®, remove any pre-existing calluses on your hands or feet
– cushion pressure points or irritated areas on your hands or feet
● wear padded gloves when using tools or knives that may rub or damage the skin on your hands
● wear soft shoes, cotton socks and/or inner soles to protect rubbed or
pressured areas
– apply moisturising creams as recommended
● different types of cream might be helpful at different times during your
treatment; discuss this with your healthcare provider
It is important to tell your doctor or healthcare professional as soon as
you notice any signs or symptoms of HFSR. Treating these symptoms
early when they are mild may prevent them from getting worse.
These simple actions may minimize HFSR symptoms and allow you to stay on your anticancer therapy for a longer period of time.
Your doctor may decide to send you to see a dermatologist, depending on your condition.
If your HFSR doesn’t get better, your doctor may be able to briefly modify your Nexavar® treatment dose so that your symptoms go away and you still get the benefit of your anticancer treatment.
● If your dose of Nexavar® is lowered, you may be able to return to full dose once your HFSR improves.
● If treatment interruption is required, your doctor will work with you to determine when to resume treatment; many patients are able to return to their full dose of Nexavar®'
Some patients may develop rashes on their body and/or face while taking Nexavar®
.
These rashes are different from HFSR. The three types of rash that may develop are:
● A facial rash that is usually red with slight peeling of the skin.
● A raised rash on your body, called a ‘maculopapular rash’.
● A red body rash with small blister-like bumps (rarely occurs).
Managing rash
Doctors and other healthcare professionals offer the following suggestions to reduce discomfort and prevent these types of rashes from getting worse:
● From the start of your therapy, use moisturising creams on your skin immediately after a shower and before going to bed. Look for moisturisers that do not have perfumes or preservatives and apply them gently.
● Use antidandruff shampoo on your scalp or as a body wash.
● Use anti-itch formulas of moisturising creams if the rash itches.
● Use colloidal oatmeal lotions.
● Wear loose-fitting clothing.
● Use a mild soap and avoid hot showers.
● Avoid direct sunlight and wear a broad-brimmed hat while outside.
● Use sun protection cream with at least a sun protection factor of 30.
I hope this helps!
Hector
Hello Michael. Welcome.
I am very sorry to hear of your diagnosis. It is tragic that your HCC has metastasized. In order for you to enjoy the time you have, there are a couple of things I might suggest for you.
* As far as experience with HCC I believe am the only one on this web site with liver cancer. I have never taken Nexavar because I have intermittent Stage B HCC and am waiting for a transplant soon. I have only had a number of TACE with Doxorubicin to down size my tumors.
* You may want to send a private message to eureka254. Her husband I believe treated with Nexavar.
Please post this question to Thomas D Schiano, MD in the 'Liver Transplant Expert Forum'.
http://www.medhelp.org/forums/Liver-Transplant/show/274
Dr. Schiano is a UNOS-certified Liver Transplant physician. He is a hepatologist at The Mount Sinai Medical Center in NYC and I am sure he is experienced in treating patients with Nexavar.
I am happy you are feeling relatively well so far. I believe I understand your plans to enjoy the time you have remaining. What worries me is that the side effects of Nexavar may interfere with your plan to travel and surf in Mexico.
So I think you should have a complete, detailed and frank discussion with your hepatologist and oncologist about the pros and cons of treatment is needed for you to be aware of the pros and cons. In the end only you can decide but you should have all the the information before you make any decisions.
Also I would think you would have to have periodic blood tests to monitor your condition to make sure the Nexavar isn't causing major serious issues. Can you do that in Mexico?
Nexavar can have some very severe complications and side effects.
'The most common side effects with NEXAVAR may include: rash, redness, itching or peeling skin; hair thinning or loss; diarrhea; nausea/vomiting; loss of appetite; abdominal pain; tiredness; or weight loss.'
'A skin problem called hand-foot skin reaction. This causes redness, pain, swelling or blisters on the palms of your hands and soles of your feet. Your doctor may change your dose or stop treatment for a while.
serious skin and mouth reactions. Tell your doctor if you have skin rash, blistering and peeling of the skin, blistering and peeling on the inside of your mouth.'
If you develop these skin problems it may affect your ability to walk or surf.
--------------------------------------------------------------------------------------------
You can read the prescribing information at the Nexavar website.
I don't see anything about contraindications dew to exposure to sunlight.
http://www.nexavar-us.com/scripts/pages/en/patient/index.php
'Treatment with Nexavar is proven to have certain benefits but can also carry serious side effects, so it is especially important to continually communicate with your health care team about what you can expect on your treatment plan.
Important Safety Information
Do not take Nexavar if you have a specific type of lung cancer (squamous cell) and receive carboplatin and paclitaxel. Before starting NEXAVAR, tell your doctor if you have: allergies; heart problems (including a problem called "congenital long QT syndrome") or chest pain; bleeding or bruising problems; high blood pressure; or kidney or liver problems. NEXAVAR may interact with certain other medicines so tell your doctor about all medicines you take including prescription and over-the-counter (OTC) medicines, vitamins, or herbal supplements. It is especially important to tell your doctor if you take warfarin (Coumadin).
NEXAVAR may cause serious side effects, including:
* Decreased blood flow to the heart and heart attack. Get emergency help if you have chest pain, shortness of breath, feel lightheaded or faint, have nausea or vomiting, or you are sweating a lot.
* Bleeding problems. Tell your doctor if you have any bleeding or easy bruising while taking NEXAVAR.
* High blood pressure. Your blood pressure should be checked every week during the first 6 weeks of starting therapy and then regularly, thereafter. If your blood pressure is high, it may need to be treated.
* A skin problem called hand-foot skin reaction. This causes redness, pain, swelling or blisters on the palms of your hands and soles of your feet. Your doctor may change your dose or stop treatment for a while.
serious skin and mouth reactions. Tell your doctor if you have skin rash, blistering and peeling of the skin, blistering and peeling on the inside of your mouth.
* An opening in the wall of your stomach or intestines (perforation of the bowel). Tell your doctor right away if you get high fever, nausea, vomiting or abdominal (stomach) pain.
* Wound healing problems. If you have a surgical or dental procedure, tell your doctor you are taking NEXAVAR. Your treatment may be stopped until after your surgery or until your wound heals.
* Changes in the electrical activity of your heart called QT prolongation. QT prolongation can cause irregular heartbeats that can be life-threatening. Tell your doctor right away if you feel faint, lightheaded, dizzy, or feel your heart beating irregularly or fast while taking NEXAVAR.
* Inflammation of your liver (drug-induced hepatitis). Your doctor may stop your treatment with NEXAVAR if you develop changes in certain liver function tests. Call your doctor right away if you develop yellowing of the skin or white part of your eyes (jaundice), dark "tea-colored" urine, light-colored bowel movements (stools), worsening nausea, worsening vomiting, abdominal pain.'
Please have a complete and detailed discussion with your hepatologist and oncologist.
If I find some other info on Nexavar I will post it here.
I wish you time to do all the things you want to do.
Thinking of you ((((((((((Michael)))))))))))
Hector
I am very sorry to hear of your diagnosis. It is tragic that your HCC has metastasized. In order for you to enjoy the time you have, there are a couple of things I might suggest for you.
* As far as experience with HCC I believe am the only one on this web site with liver cancer. I have never taken Nexavar because I have intermittent Stage B HCC and am waiting for a transplant soon. I have only had a number of TACE with Doxorubicin to down size my tumors.
* You may want to send a private message to eureka254. Her husband I believe treated with Nexavar.
Please post this question to Thomas D Schiano, MD in the 'Liver Transplant Expert Forum'.
http://www.medhelp.org/forums/Liver-Transplant/show/274
Dr. Schiano is a UNOS-certified Liver Transplant physician. He is a hepatologist at The Mount Sinai Medical Center in NYC and I am sure he is experienced in treating patients with Nexavar.
I am happy you are feeling relatively well so far. I believe I understand your plans to enjoy the time you have remaining. What worries me is that the side effects of Nexavar may interfere with your plan to travel and surf in Mexico.
So I think you should have a complete, detailed and frank discussion with your hepatologist and oncologist about the pros and cons of treatment is needed for you to be aware of the pros and cons. In the end only you can decide but you should have all the the information before you make any decisions.
Also I would think you would have to have periodic blood tests to monitor your condition to make sure the Nexavar isn't causing major serious issues. Can you do that in Mexico?
Nexavar can have some very severe complications and side effects.
'The most common side effects with NEXAVAR may include: rash, redness, itching or peeling skin; hair thinning or loss; diarrhea; nausea/vomiting; loss of appetite; abdominal pain; tiredness; or weight loss.'
'A skin problem called hand-foot skin reaction. This causes redness, pain, swelling or blisters on the palms of your hands and soles of your feet. Your doctor may change your dose or stop treatment for a while.
serious skin and mouth reactions. Tell your doctor if you have skin rash, blistering and peeling of the skin, blistering and peeling on the inside of your mouth.'
If you develop these skin problems it may affect your ability to walk or surf.
--------------------------------------------------------------------------------------------
You can read the prescribing information at the Nexavar website.
I don't see anything about contraindications dew to exposure to sunlight.
http://www.nexavar-us.com/scripts/pages/en/patient/index.php
'Treatment with Nexavar is proven to have certain benefits but can also carry serious side effects, so it is especially important to continually communicate with your health care team about what you can expect on your treatment plan.
Important Safety Information
Do not take Nexavar if you have a specific type of lung cancer (squamous cell) and receive carboplatin and paclitaxel. Before starting NEXAVAR, tell your doctor if you have: allergies; heart problems (including a problem called "congenital long QT syndrome") or chest pain; bleeding or bruising problems; high blood pressure; or kidney or liver problems. NEXAVAR may interact with certain other medicines so tell your doctor about all medicines you take including prescription and over-the-counter (OTC) medicines, vitamins, or herbal supplements. It is especially important to tell your doctor if you take warfarin (Coumadin).
NEXAVAR may cause serious side effects, including:
* Decreased blood flow to the heart and heart attack. Get emergency help if you have chest pain, shortness of breath, feel lightheaded or faint, have nausea or vomiting, or you are sweating a lot.
* Bleeding problems. Tell your doctor if you have any bleeding or easy bruising while taking NEXAVAR.
* High blood pressure. Your blood pressure should be checked every week during the first 6 weeks of starting therapy and then regularly, thereafter. If your blood pressure is high, it may need to be treated.
* A skin problem called hand-foot skin reaction. This causes redness, pain, swelling or blisters on the palms of your hands and soles of your feet. Your doctor may change your dose or stop treatment for a while.
serious skin and mouth reactions. Tell your doctor if you have skin rash, blistering and peeling of the skin, blistering and peeling on the inside of your mouth.
* An opening in the wall of your stomach or intestines (perforation of the bowel). Tell your doctor right away if you get high fever, nausea, vomiting or abdominal (stomach) pain.
* Wound healing problems. If you have a surgical or dental procedure, tell your doctor you are taking NEXAVAR. Your treatment may be stopped until after your surgery or until your wound heals.
* Changes in the electrical activity of your heart called QT prolongation. QT prolongation can cause irregular heartbeats that can be life-threatening. Tell your doctor right away if you feel faint, lightheaded, dizzy, or feel your heart beating irregularly or fast while taking NEXAVAR.
* Inflammation of your liver (drug-induced hepatitis). Your doctor may stop your treatment with NEXAVAR if you develop changes in certain liver function tests. Call your doctor right away if you develop yellowing of the skin or white part of your eyes (jaundice), dark "tea-colored" urine, light-colored bowel movements (stools), worsening nausea, worsening vomiting, abdominal pain.'
Please have a complete and detailed discussion with your hepatologist and oncologist.
If I find some other info on Nexavar I will post it here.
I wish you time to do all the things you want to do.
Thinking of you ((((((((((Michael)))))))))))
Hector
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