Quick Question re Long Term Effects of Treatment

[chicagoetc]

[Merry Christmas and/or Happy Holidays and/or Just Happy Thoughts!]

Given everybody else's serious problems, I have a MINOR (good) one to ask about.

Does anyone know about long term effects of Taxol (and/or A/C or Herceptin)? By long term I mean longer than two or three years. Reason is I seem to be experiencing peripheral neuropathy that I had not experienced since Taxol. Nowhere near the same level but it reminds me of it. It seems to be affecting both feet and hands. More of a nuisance than anything...and probably totally unrelated. But I can't seem to find info re this elsewhere...

Thanks!
Melanie

[tricia keegan]

Hi Melanie,

I did read of a report recently about long term heart issues from a/c and herceptin but nothing on neuropathy, I'm sorry I cant help but do have a friend who suffered this right after her taxol treatment and still walks with a cane to this day due to taxol and hope you get some answer's.

[BonnieR]

I have had some lingering neuropathy since I finished treatment in 08. It is only occassional and usually after a tiring day. My toes especially will get numb.
If you find yours seems to be getting worse, you probably should bring that to your doctors attention.
Keep the faith

[sarah]

hello,
no neuropathy but I'm now 7 years out but I do have severe breathing problems in cold weather - so far the docs (GP, onc, cardiologist) all say it's the radiation. I'll see a lung doc next week and see what he says. Also the radiation also has caused a pinched or burnt nerve in my back//shoulder area. Still all this is worth it, if the cancer stay NED. The breathing problem has come on slowly and now is severe.
I do remember having lots of little problems during, and for a couple of years after treatment - pains, skin, fatigue so I think it all takes time. If it's worse in cold weather, try to stay warm, if it's the opposite, stay cool. Neuropathy is a common occurrence so hopefully someone on the site, who's had it and found a solution, will answer you.
keep bugging your doctors until you find a solution, pain is not good.
health and happiness
love sarah

[karen z]

I continued to have some neuropathy (feet/finger tips) for quite awhile after getting treated in 2005 and still do not have all of the feeling back in my fingertips (and will occasionally get some symptoms in my feet- but rarely now). I think lingering problems that may diminish or not are common. Haven't hear of something showing up when there had been nothing although I am not totally surprised. Ask your doc as she/he has heard it all.

[Jackie07]

Hi,

Below are two abstracts on the subject of neuropathy:

Int J Clin Oncol. 2011 Nov 22. [Epub ahead of print]
Paclitaxel-induced peripheral neuropathy in patients receiving adjuvant chemotherapy for breast cancer.
Tanabe Y, Hashimoto K, Shimizu C, Hirakawa A, Harano K, Yunokawa M, Yonemori K, Katsumata N, Tamura K, Ando M, Kinoshita T, Fujiwara Y.
Source
Department of Breast Oncology and Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Abstract
BACKGROUND:
The long-term outcomes and risk factors of paclitaxel-induced peripheral neuropathy (PIPN) have not yet been fully elucidated.
METHODS:
We identified 219 breast cancer patients who received paclitaxel as adjuvant chemotherapy between 2002 and 2009. We retrospectively analyzed the incidence, time to onset, duration, and risk factors for PIPN by chart review.
RESULTS:
Of the 219 patients, 212 developed PIPN (97%) during a median follow-up time of 57 months (range 5.3-95.5). Median time to PIPN onset was 21 days (range 11-101) for the entire patient population: 35 days (range 14-77) for weekly administration and 21 days (range 11-101) for tri-weekly administration. PIPN caused termination of paclitaxel treatment in 7 patients (4%). Median duration of PIPN was 727 days (range 14-2621 days). PIPN persisted in 64 and 41% of patients at 1 and 3 years after initiating paclitaxel, respectively. Age ≥60 years and severity of PIPN were significantly associated with PIPN duration.
CONCLUSIONS:
PIPN persists longer in older patients and in those who experience severe neuropathy. Further studies to identify the risk factors for PIPN are warranted.


Gan To Kagaku Ryoho. 2011 Nov;38(11):1773-6.

[Chemotherapy-induced peripheral neuropathy].
[Article in Japanese]
Noguchi E, Maeda Y.
Source
Dept. of Chemotherapy, Tokyo Metropolitan Cancer and Infectious Diseases Center, Tokyo, Japan.
Abstract
Chemotherapy-induced peripheral neuropathy(CIPN)is one of chemotherapy's common and disabling adverse effects. It may be caused by many chemotherapeutic agents including the taxanes(paclitaxel, docetaxel), the vinca alkaloids(vincristine, vinorelbine, vinblastine), the platinum analogues(cisplatin, carboplatin, oxaliplatin), bortezomib and thalidomide, among others. Once the symptoms have developed, they may lead to compromising patients' quality of life(QOL). For medical oncologists, the management of CIPN remains an important challenge. At the present time, no agent has shown enough solid beneficial evidence to be recommended for the treatment or/prophylaxis of CIPN. The standard of care for CIPN includes awareness and early detection of neuropathy, and dose reduction and/or discontinuation of the problematic agents.

[chicagoetc]

Karen Z/Bonnie R/Tricia/Sarah,

I don't think this has shown up new...just seems to be more evident or exacerbated recently. It's uncomfortable at times, a bit painful at moments but nothing I can't live with. If it gets worse I would check with my doctor (some tend to ask every time they see me anyway). I'm guessing it is a residue of the Taxol. Or maybe the Herceptin? It helps to hear that others have/do experience something similar.

Melanie

[chicagoetc]

Jackie,

I think that makes sense. Thanks for the references. I think as survival is extended, side effects are increasingly evident. [Not that I'm sure.]

Melanie

PS: I think is this is probably why my oncologist held back on the Taxol as symptoms increased.