Balance issues and Paclitaxel

Hiya Moppers

Ahem, you can get dizziness and balance issues with Paclitaxel or Docetaxel. It may be because one uncommon side effect is it can lower your blood pressure slightly, but the more common reason is because it can affect your nerves causing Peripheral Neuropathy (link)

This can affect your balance, cause numb feet and fingers and increase your chances of taking a tumble, so be wary of this.

Several of the ladies here have had an episode of dizziness while on chemo, so hopefully will notice your message and reply back.

J was on Docetaxel and her GP said it was probably Labyrinthitis lasted about 7-10 days then went away never to return.

Hopefully this will ease off shortly.

Take care, G n' J

Thanks Dreamthief - that is interesting re symptoms J had . I didn’t have any dizziness that I was aware of , just muscle weakness and I put it to my consultant that I was experiencing motor rather than sensory peripheral neuropathy as a side effect . Was told this isn’t something that happens with Paclitaxel . Thought I’d ask on here as I reckon someone will have had something similar .

It has happily gone now but thought it may return with next treatment. 

Thanks again 

Morning Moppers

Sounds like a touch of both sensory and motor PN ? The sensory would account for the hot/burning feet and the nerves that control muscles motor.  It is surprising how quickly some parts of the body recover from chemo - in some cases just delaying your next session for a week or two is all it needs.

As you say though, you won't know if the same will occur next time around, or worse is accumulative :-/    Have they mentioned anything about reducing the next dose by 10% or so to see if that helps ?

J's dizziness was quite bad for a couple of days, room spinning when laying down and having to hang onto the walls to get anywhere as she couldn't walk a straight line. It would cost you a lot of wine money to get like that

G n' J

Morning - yes indeed the burning feet are due to sensory PN . It’s. the motor PN that is the challenging bit - this is what I’m told does not occur with Paclitaxel.  My consultant has never had any patient with this . I wonder if it is underreported as most people put their walking difficulties down to extreme fatigue and/or sensory symptoms.  My pretreatment assessment questions certainly seem to link sensory PN and fatigue with walking difficulties .Not aware of a separate question about walking difficulties as a stand alone question.I certainly was very fatigued but had been previously and had no difficulty walking or the feeling of lower leg muscle weakness.

Discussions re treatment options will be had before next treatment and yes hopefully the weeks rest is helpful.

Didnt have any of the vertigo type symptoms J seems to have had which I know are pretty awful. Never dizzy .

Thanks

Hi Moppers

Long shot question, but are you having any G-CSF (white cell boosting) injections as these can cause upper leg bone / muscle issues ?

G n' J

Hi Moppers , not quite thr same as you,  but I had 4 x EC followed by 7 Paclitaxel (stopped at 7 bc of PN). After my first dose on day 3 my left leg gave way so i nearly fell over. It happened again on day 6, and they felt a bit like jelly. The next couple of doses were ok, but than I started to drop things and my leg became wobbly around the 3-4 day mark again. My foot became numb on the toes,  as did my cheeks,  which were red on every cycle, and on cycle 7 I had to take 2 antihistamine tablets on days 2 and 3 for a rash on my face  and neck. It did go away,  though my big toe is a little numb on the  end five months later,  and I occasionally get numbness on my face. 

Are you going to have a break and start again?

Hi Londonmumof2 , thanks for your reply. I completely relate to your legs feeling like jelly . Both of mine felt like they might give way and was worse on day 3, so spent a whole day in bed .  I couldn’t walk in a straight line because they felt so weak and I was sure I would fall over . Over 3 days my legs improved and didn’t feel weak . Yes I should have had Paclitaxel today but my oncologist seemed to think symptoms I described don’t happen on the regime I’m on ( not had EC yet ) and has never happened before.  I am pretty convinced it’s due to Paclitaxel as listed as uncommon side effect in BNF and you have had it too! 

Plan is to restart next week and appointment booked. From what happened to you sounds like I might get it again . Interestingly I had an allergic reaction to first administration . Good to hear symptoms are improving over time . Were you supposed to have 12 rounds Paclitaxel?

My oncologist (10+ years experience)  didn't think that letrozole caused eye issues, but Moorfields do,  and there are lots of women here and on other forums who've had issues.  More unusual is still a lot of women considering how many have this chemo!

HI LMo2

I agree with you re Letrozole, and there are quite a few research papers that also confirm this for other Ais, SERMs, Chemo, and Bisphosphonates.  

This is a major concern for my wife because she has both corneal and retinal problems.  We had to alert the medics regarding the issue.  As per your oncologist, we have found a general lack of awareness on the matter, and we are not convinced that this has as yet been fully appreciated for her proposed care plan.

Is still say give out a go and see,  as it's a rarer side effect.  I'm on Femara (no a generic but the original) every other day now,  and the eyes are a lot better but still not quite right.