Paclitaxel weekly treatment side effects

Evening D  / Villa82

Anti Histamine should help with the chemo glow but foot issue sounds like a little more than numbness (peripheral neuropathy) which is listed as a side effect with Paclitaxel. Paclitaxel is usually less of a problem but some people just can't tolerate it at the dose given.

This has come on quickly after your first session so you should notify your Onco Unit about this as adjustments can be made as this could get gradually worse. It may be 'baggage' from your EC but this is more of a problem with the Taxane type of chemo drugs Paclitaxel and Docetaxel.

Sounds more like this could be the onset of what is called Hand / Foot syndrome also known as Palmar Plantar (link)

One thing that can make this worse is friction, be careful when climbing stairs or hills try to keep your feet flat to keep the weight off the balls of your feet. Be wary of unscrewing bottle or jar caps as this can also affect the hands.

Keeping your feet creamed will also help but a better one to use is Udderley Smooth with 10% Urea (Amazon stocks this) but if you order some make sure it is the type that contains urea. It was developed to protect cows teets in winter from cracking and getting sore.

There is some info about it on their website here

Do phone your Onco soon though and inform them as Palmar Plantar can cause cracked foot and/or hand skin that can also blister and shed making walking a nightmare.

Several of the ladies in the breast group have had this so you could ask there as well ?

Hope this is of some help, G n' J

Thank you very much Dreamthief..

i rang the Christie hotline number first thing this morning they gave me the advice to follow. They said if it got worse to ring back....they have informed my oncologist and chemotherapy nurses at the hospital I attend....I hope that they will review this before this Thursdays administration....

Dreamthief.  you mention baggage from EC....?   What’s that...

with EC I had pins and needles in toes and finger tips, and nails on fingers gone a bit brittle... is this the baggage you describe.... I had no burning feeling in feet. Though..

i will I’ll check out that cream you mention today..

many thanks for a swift and helpful reply...

Hi Villa82

How are you feeling this morning ?

Yup, just that; all the 'baggage' you get left with as souvenirs after chemo :-/ Luckily most rectify themselves after being chemo free for a while 

EC works differently to the Taxane types so side effects and post chemo issues can also differ. EC is mostly about nausea, hairloss, intestinal probs and slight peripheral neuropathy.

The Taxanes can take 2 or 3 days to get into your system before they kick in - and are mostly about aching bones/joints white cells bottoming out causing neutropenia (some say hit by a truck) but that is mostly Docetaxel and the possibility of PN and Palmar Plantar if it takes a dislike to you.

Possible options they may offer you if they feel a tweak is needed is a lowering your next dose by 10% or 20% to see how that goes, or switching you back to EC and knocking the Paclitaxel on the head.

The taxanes (Paclitaxel and Docetaxel) are powerful chemo drugs and can throw up some weird side effects. J lost all 20 finger and toenails within 6 months of finishing her Docetaxel and still has numb big toes and this was 8 years ago - luckily the nails grew back fine - a corn which she had on her little toe for around 5 years freakily disappeared.

Chemo = Always expect the unexpected; it's the gift that keeps giving but it works...

Do let us know what they decide to offer you.

Take care, G n' J

Good morning Dreamthief 

well currently I’m really not sure how I feel, my feet are not hurting as much as yesterday but I have not walked anywhere yet ... I feel very whoozie and slightly spaced out...my mastectomy scar pain and rib area has returned big time...so that means the steroids have worn off usual sign..

my vision is still blurry, and face a bit red, but I’ve taken anti histamine again..

Dreamthief I was due to go back to work tomorrow three days a week as my treatmeant is in a Thursday...

I May have to judge that decision later on to day.....

i think I took the feedback from the chemo nurses that  Paclitaxel would be kinder than EC , to literally....

it suprised me how quick it kicked in and affected me...I hope it subsides, and I will ring the chemo nurses in the morning to start that conversation as to how to mitigate these side effects... I don’t drive, and I walk everywhere....so I need to have good foot health so to speak.

thank you so much for your in-depth and knowledgable reply Dreamthief so appreciate it...

Loosing all toe and finger nails sounds excruciating........   please Please I hope that doesn’t  happen to me...

best wishes to you and your wife 

Morning D  / Villa82

I'm assuming work has been cancelled for today ? If not, hope your feet hold out... Chances are if you phone the unit they may wish to see you.

Unless they have personal experience of chemo most Dr's and nurses tend to underplay the drugs used and their side effects but it can be a bit overwhelming at times and really knocks the stuffing out of you on the bad days.

The nail loss 'thing' isn't as bad as it sounds. If this is going to occur they tend to delaminate from the nail bed but will have a thin new nail underneath. The only issue is avoiding the skin tearing at the sides (infection risk route) so if any do get wobbly they can be stuck down with micropore surgical tape to avoid them catching on clothing / bedding until they give way.  You have a lesser chance of this occurring with Paclitaxel than the much stronger 3 weekly Docetaxel but the risk is still there.

Whatever you have planned for today, hope it is hassle free.

G n' J

Good morning Dreamthief

No I haven’t gone to work today....I have asked the GP for another 2 weeks in the hope this all settles down. I rang the chemo nurses this morning and they are going to find out what they can do on Thursday to mitigate the side effects.....

My feet are buzzing but not as bad as Saturday...but from my feet to my groin, I keep getting the weirdest pains....like restless leg syndrome but gnawing away all the time...then zap a shock somewhere that jolts the whole body...

im so cheesed off as I really thought starting this new drug was going to be easier to manage, but so far it’s not...

hopefully they will will reduce the dose .......or offer some pain relief....I can’t take anti inflammatory meds as I have a triple A... so I’m limited on pain relief options....yet I need to control pain as it raises blood pressure which will affect the triple A....catch 22

thanks again  Dreamthief

Morning D  / Villa82

Triple A sounds scary, hope you are being well monitored for that :-/

Were any tweaks/changes made by the chemo unit for you yesterday - and are you feeling any better in yourself now ?

G n' J

hello Dreamthief

Yes had chemo yesterday with as you said, a 10% reduction on the dose, with instructions to call if I get further adverse reactions.

So far I’m ok, but it took 24-36 hours for side effects to really kick in last week...when the steroids wore off I think...

The triple A is of concern, but it’s well monitored....scans every 3 months....My main concern with it is...I have to keep control of pain...as it can raise blood pressure....which can cause the triple A to grow...the quicker it grows the greater the risk of Rupture, or Surgery.

My problem is...I can’t take anti inflammatory meds for chemo pain...as I’m on meds to thin blood for  triple .A....and currently if I take co codamol..or even paracetamol...I get chronic constipation,   Followed after by pain lasting hours after having a poo....I’m taking laxative regularly...plus the other irritant to raising blood pressure is stress...and sadly chemo and just having cancer by default adds to anxiety  and stress...so now everyday I listen to reiki type music at least twice a day for an hour....just so I can zone out from absolutely everything...

It’s all about finding balance..as many things are contra indicating upon themselves ... what makes one thing well makes another part I’ll and vice-versa. 

all I hope re the triple A is that all my cancer treatment is completed way before any elective surgery is reached...

Best wishes to you both G&J