Herceptin/tearing

[Sandy H]

I was curious how many still have tearing from the eyes on the 3 week herceptin schedule? They mentioned in San Antonio that tearing is a side effect on the weekly schedule and not so on the 3 weeks one. I know they also recommended the 3 week schedule when it is given with no chemo. With chemo its weekly. I talked to my oncologist about changing to 3 weeks instead of weekly but he said he has done it with his patients that were in remission with no recurrence. He said he would change me if I wanted him to but he believes if something is working don't change it! I am thinking about changing over. Wanted to check with those first. I am trying eye drops because if we are tearing then its from dry eyes to see if they make a difference. Sandy

[LOPSIDED]

HI SANDY, I'M SORRY I DON'T HAVE AN ANSWER FOR YOUR QUESTION, BUT I DIDN'T REALIZE TEARING WAS A SIDE EFFECT TO HERCEPTIN. WHEN I DID TAXOTERE, I STARTED TEARING WITH MY LAST 3 TREATMENTS AND IT DROVE ME CRAZY. I WAS SO HAPPY WHEN IT ENDED AND NOW I WILL BE STARTING HERCEPTIN ON MAY 16 FOR 1 YEAR WKLY TREATMENTS, IF YOU FIND ANY SOLUTIONS TO STOP THE TEARING PLEASE LET ME KNOW----IF I HAVE TO GO THRU TEARING FOR A YEAR I DON'T KNOW WHAT I'LL DO---I GUESS I'LL WILL FIND A WAY, THERE ARE WORSE THINGS THAT COULD HAPPEN. BEST OF LUCK TO YOU, SHEILA

[Becky]

When I started Herceptin, I did the weekly - wasn't combined with chemo - but started this way to see how well I tolerated it. I was very teary and my eyes would get red too. So much that my coworkers asked me if I was okay (because they thought I was crying). After about 14 weeklies, I changed to the 3 week cycle and the tearing is very, very much improved - there was nothing at all except the first 24 hrs (I get it late in the day on Friday so I wake up Saturday with some symptoms). I used antihistamine eyes drops (over the counter - Opcon A by Bausch & Lomb - it is OTC but used to be a prescription). It helped alot. It makes sense it would help since many side effects of Herceptin seem to be "allergy" type (runny nose, skin rashes etc).


Have a great weekend.

Becky

[Sheila]

Sandy
I havebeen on the every 3 weeks schedule for 2 1/2 years and my eyes are TERRIBLE...I look like I am crying all the time, and wind or air makes it worse...I never did the weekly but it has never gone away...let me know if you find something that helps....I am tired of wiping my eyes!

[tricia keegan]

Sandy HI
My eyes started this on a/c but cleared up when I finished.I'm now on 3 weekly herceptin and still have the runny nose at times but no problem with eyes.
Tricia

[Sherryg683]

I was also having terrible tearing and eye aggrivation, dont' know if it was the Taxotere or the Herceptin. I talked to my Oncologist about it and he said that sometimes these drugs will cause the tear ducts to open. He prescribed me a steroid, cortisone eye drop and it has helped tremendously. I still get a little teary in the morning but not near as bad. My eyes were so bad I couldn't stand them. Now they are so much better. I put the drops in at night, they make your eyes a little blurry at first and burn some but have helped me so much..sherryg683

[Sandy H]

Thanks for all your posts. I started using fresh eye drops this morning and guess what, no tearing rest of the day. It never occurred to me to use drops until my dear husband suggested it. Tearing is from dry eyes and I knew that because I have had tear duct reconstruction done and the tearing was terrible until I had it done. Felt like I had sand in my eye. I can handle using eye drops as long as I can remember to put them in!!! I really can't see what difference it would make with the herceptin weekly or 3 weeks. hugs, Sandy

[Lani]

tried to post this this morning but I guess it didn't post!

Even if you are not currently on docetaxel it may be possible it is a delayed effect, an effect when Herceptin given after docetaxel, an effect of Herceptin or an effect of one or the other on people with a particular genetic makeup who are particularly sensitive:

1: Med Oncol. 2006;23(1):57-62. Related Articles, Links

Epiphora (excessive tearing) and other ocular manifestations related to weekly docetaxel: underestimated dose-limiting toxicity.

Tsalic M, Gilboa M, Visel B, Miller B, Haim N.

Department of Oncology, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Purpose: Epiphora due to canalicular stenosis is a recently described side effect of weekly docetaxel. We prospectively evaluated the incidence of this complication and other ocular manifestations in patients treated at our medical center. Patients and methods: Twenty-one consecutive patients (breast cancer: 14; metastatic non-small cell lung cancer: 6; metastatic nasopharyngeal carcinoma: 1) (female/male: 14/7; age range: 34-78 yr) were treated with weekly docetaxel (35 mg/m2/wk iv for 6 wk, cycles repeated every 49 d). A standard questionnaire regarding epiphora was completed before each dose of docetaxel. Patients who complained of excessive tearing underwent a thorough ophthalmologic evaluation before receiving the next dose. Results: Epiphora due to stenosis of the lacrimal puncti and canaliculi developed in seven (33%) patients following a cumulative dose of 208-645 mg/m2 (median: 400 mg/m2). Two patients developed complete canalicular stenosis requiring surgery. Epiphora was accompanied by madarosis and ectodermalization of the palpebral and bulbar conjunctiva, complete in five patients. Treatment was discontinued due to epiphora in two (10%) patients. After a median follow-up of 11 mo, four patients still had epiphora. Conclusion: Epiphora due to canalicular stenosis is a frequent complication of weekly docetaxel and might be dose limiting. Irreversible damage requiring surgical intervention may develop despite close monitoring.

PMID: 16645230 [PubMed - in process]

Hope this helps!

[Lani]

Herceptin seems to effect development in the embryo and repair of in the adult epithelial lining cells such as those in the airways (hence the dry noses and sinuses), gastrointestinal tract and linings of the lacrimal glands.

Genentech is supposed to do "post marketing surveillance" to see what patients complain about once the drug is used in a bigger population than it was in the trials.

I have previously posted requesting those who finish their herceptin to list what symptoms they had while on herceptin (particularly those who were on herceptin only quite a while after finishing chemo so that symptoms are more likely to be those of Herceptin rather than chemo) and which resolved after finishing herceptin.

There is a lot still to learn.

[Sandy H]

I should have clarified myself in saying that I had my tear duct reconstruction done about 4 years before my diagnose with cancer. I needed to have one because I had, had many sinus infections through out my whole life and it caused severe scarring of my tear duct on the right side. Following the reconstruction I was told to stay away from all cigarette smoke because that would close the duct off. A patient was in the next room from me and the specialist told him if he did not stop smoking he would be back in for another surgery of the same within the year. That is when I learned that if a person tears they do not have enough tears. It is easy to think if one is tearing then its too many but that is not the case. Thanks for all your replies. I am much better with the fresh tears and will continue to use them. hugs, Sandy

[Blondey]

I too have excessive tearing of my eyes while on Herceptin. Always carrying tissues with me. :)

[Sandy H]

Well, I have to be honest with you the fresh tears (eye drops-over the counter) seem to be working for me. I try to use them 3 to 4 times a day. Have not needed to carry tissues with me the past few days. Hope it will work for others here. hugs, Sandy

[catlin]

I am on Herceptin only since 1/06 but was on taxol/Herceptin weekly before that. I have had dry eye for years and already have plugs in my lower tear ducts. My ophthamologist recently recommended Soothe eyedrops which are OTC but contain oil which helps with evaporation. Refresh endura contains an oil as well but only comes in single does size and is more expensive. Ointments are good at nights and are in the eye section. A humidifier at night (cool kind) can also greatly help. There is also a product called Nature's Tears eye mist you can buy online and I can even mist my eyes while driving. My eyes have been far worse the last few months on Herceptin alone but could also be haivng delayed effects from the other drugs. Oh, and there are eye vitamins but basically fish oil is #1 and some pills combine it with flax seed for the help in dry eye. It does help and I just take the Costco brands of fish oil capsules(2 per day) and flax seed oil capsules (1 per day). It can take a month or so to see if it works for you. I think Bausch and Lomb may make combo capsule, my optimetrist had them, but a lot more expensive. Catlin

[Karen t]

What a surprise to check the website today and read about dry eyes, tears, etc. Always learn something new from everyone! I just returned from a 10-day trip to Rome and Tuscany that was wonderful but marred by blurred vision. Saw an opthamologist on Monday who said dry spots on my corneas were causing the problem. It was so bad in Italy that for a couple days it was even hard to see people's facial features. Needless to say, I was in a panic, especially since I have traveled alone.

I'm on weekly Herceptin for two years now and Navelbine (3 wks on/one wk off) for nearly a year. My eyes tear a lot but I never made the connection. Prior to going to Italy, I had a high fever for a week, took an antibiotic for bacterial infection of the lung for 10 days, then started in with allergies and was using Claritin, Sudafed and Opcon A. The day my eyesight went blurry, I started out that morning with tears unexpectedly streaming down my face. By afternoon, my eyesight seemed diminished and by the next morning I could hardly see anything. It's been over a week and my sight is better but still blurred.

I am fortunate in having fairly good eyesight (use glasses only for things like watching movies even though I am 59). This was my first time ever with an eye problem. From my experience, I would caution everyone against taking antihistamines or anything else that would cause eyes to dry out!!!