UTI - again!

[caya]

I have always been prone to UTIs, and had 2 or 3 while on chemo. I have one more Herceptin infusion to go, and tonight I am starting another UTI - the third one in four months. This is getting really old - luckily I have some CIPRO XL on hand and will start on it tonight, go to my GP in the next day or 2 to get more.

I'm wondering if anyone else had this many, I have read it is a possible s/e of Herceptin- (like what isn't?). Any suggestions on what to do - will it get better after Herceptin finishes? I'm wondering whether I should ask my GP to put me on a low-dose of antibiotic for the next month until I finish my Herceptin treatments.

Any advice would be appreciated.

Thanks
all the best
caya

[Becky]

Dear Caya

I had 5 UTIs in 7 months. All were while on Herceptin (and I hadn't had any in my life prior to that, even while on chemo). However, my doctors felt it was due to vaginal atrophy from having an oophorectomy and then going on Arimidex. Not only is the vaginal lining thinned but the bladder is affected as well. My first one was about 5 months after the ooph/beginning of Arimidex. What solved the problem is that they seemed to be associated with intercourse. Since I had so many infections in a short time, my PCP wanted me to see a urologist. That Doctor put me on a propholactic dose of Macrobid 100. I had to take one tablet after sex. This pretty much solved the problem and I think I only had one in a very long time.

My bc is not highly hormone positive so eventually I used some topical estrogen cream but I use that very little now. I used more in the beginning to get the tissues "back in shape" but only use 1/4 of the dose 2X per month and I am good (and no more UTIs either - but I always have something with me because I know I'll be away on business and get one).

Also - take Cranberry tablets. They really do help. I take AZO brand (4-6 per day).

[hutchibk]

Hi Caya=

I had recurrent UTIs on Taxol/Carbo/Herceptin and Taxol/Herceptin, but not on Herceptin alone, so I always attributed it to the Taxol. I ended up at a Urologist who determined for me that it was an issue of the drying and atrophy effects of lack of estrogen combined with the irritation of fairly harsh chemo passing through the urinary tract. He suggested that I use Estrace vaginal cream 5 times a week to add back in the nourishing effects of estrogen to the "female tissue" and it worked like a charm. No more UTIs after that.

Don't know if it works for everyone, but that's what worked for me... and since being off Taxol and Herceptin, I haven't had a single UTI...

[caya]

Thanks Becky and Brenda for your ideas. My onc. and GP have also attributed my UTIs to vaginal atrophy, lack of estrogen now due to chemopause and now Tamoxifen, harsh chemo and possibly Herceptin. I had UTIs before BC, so that area has always been my "weak spot".
I did find the UTIs would start after sex, but this current one did not - just out of the blue.
I don't think my onc. will let me use any of the estrogen based vaginal creams as I am highly ER+ (90%) and PR+(50%). However I think it is a good idea to see a urologist. Thanks for your words of wisdom.
And Becky I have been taking a good cranberry supplement, but not that many. I will up it to 4 -5/day. It can't hurt.

all the best
caya

[kareneg]

Hi Caya,

I just got over one about a month ago and I feel like I am getting another one. I am going to have them check it for me tomorrow, they are the worst! Take care of your self.

Love Karen

[SoCalGal]

Yes-me too. Can't have sex without a prob now. VERY distressing so complained to new onc and am trying some kind of estrogen pills that come pre-loaded in an applicator. Never took pills in *there* before. Boy - never a dull moment in BC world. Hopefully the pills will help. I also take cranberry extract pills everyday. Am trying to avoid the prophylactic antibiotic after sex - I think it's a lot of antibiotics with all the other crap I'm taking. I see a new ob gyn this month so we'll see what she has to offer. Last month I took Cipro with Avastin and had an itchy rash for 2 weeks. Since I had Avastin last week with no rash I now think it was an allergy (suddenly) to Cipro. Oy. I exhaust myself with this crap. Good night!
xo Flori

[chris76]

I cant get anything in my vagina due to tightness and dryness since chemo (last fall). I bought some natural lubrication from the health store and my gyn gave me these different sized medical rubber things to help stretch my vaginal muscle. They look generic dildos. I think I might try to upgrade to the rabbit..... first I have to get the small tampon sized one in first. <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>
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[hutchibk]

I have been very confused about Estrace cream vs Estring vs Vagifem, and which is safest to use as a bc patient... (I have occasionally used Estrace Cream - especially for my bouts with UTIs, but don't know if it is the best option due to systemic effect...)

Tonight I found this, http://www.susanlovemd.com/breastcancer/content.asp?L2=3&L3=7&SID=132&CID=611&PID=22&CATID=33
and I found it very helpful, because I think Dr. Susan Love is a very credible source for this type of info...

And I now think I will ask my doc to switch me to Vagifem based on her info...

Hope it helps someone else here...

[SoCalGal]

Hello - just wanted to tell you that I started VAGIFEM which is a pill inserted one a night for a week and then twice a week. After just one week I am back to normal meaning I am not having pain and tearing tissue.

I know that even if I were to give up sex (haha-no way-I already gave up wheat and dairy) it wasn't just sex that was causing the problem but in general a constant feeling of irritation and also SEVERAL UTI's.

Note to Caya- I went in and gave a urine sample and they told me that cipro (especially the short course that is currently in favor) is ineffective to my bacteria. They gave me the choice of keflex or macrobid. Keflex is the superior choice. My cousin who is a leading urologist told me that cipro has been so over used that there is resistance to it and that they don't even use it in their practice any longer. He also felt that young women with a UTI can respond in 3 days but for my situation I needed a regular course of antibiotics. He said if chronic the other thing to try is a prophalactic dose after love-making. I think the Vagifem has made a huge change and quickly.

Have a good day ladies!
xxoo Flori

[hutchibk]

It looks like I will be following your lead, Flori...

And my UTIs are always resistant to Bactim, but respond to Cipro. Just goes to show that everyone is so different!

[Carolyns]

Thank you so much for raising this issue!!!!!!!

Some times I think I am losing my mind and I feel like the only one with these problems. I am on Carbo and Abraxane for 2 months and am on my second round of antibiotics...Cipro. I am headed to the Gyno. on Monday and plan to print and bring these responses. Once she weighs in on it I will bring the emails to my Oncologist to consider.

Dealing with cancer is bad enough and it helps to know some answers to these really annoying issues that can be side effects from treatment.

THANK YOU ALL!!!!!!!!!!!!!!!!!!!!!

[caya]

Thanks for the info Flori and Brenda. I spoke to my onc. about this today before my Herceptin infusion (the final one - hooray!) and he said I could use one of the estrogen creams vaginally, but he wants my gyn. to discuss and prescribe this with/for me. I am going to make an appointment with her tomorrow.

Flori - interesting about the CIPRO resistance. When I get the UTIs my dr. gives me CIPROXL for 14 days (not the usual 3)- but they keep coming back. She gave me Macrobid 100 (as Becky suggested) for after-sex, but I am so uncomfortable right now. I am really hoping that once I get one of the estrogen creams I will improve. The Replens and the KY Liquid Beads just aren't doin' it for me. I have started using Vitamin E capsules (inserted, not oral), just for a few days, so who knows if that will help.

Carolyns - You are so right, we have enough to issues to worry about with the BC - You can bet if it were men in our position, the propellorheads would have found answers by now.

Thanks everyone, we should not have to suffer in silence.

all the best
caya

[caya]

Well Flori, it's UTI time again, but this time I printed your post re - the Vagifem and the Keflex instead of the CIPRO. My onc. said I could use Vagifem, so my GP wrote me the script and also prescribed Keflex... so let's keep our fingers crossed and hope it all works.

all the best
caya

[Unregistered]

So Sorry To Hear About Your Uti Problems. I Know First Hand How Uncomfortable They Can Be. I Never Had One During My Herceptin Treatments But Had A Few During Chemo. Congrats On Almost Being Done With Treatments And I Hope You Have A Big Celebration Planned.

[SoCalGal]

Hi Caya-
Oy and sorry to hear of yet another UTI. I hope the vagifem works for you. I am now convinced that I am feeling side effects from this drop of estro-whatever it is...some hot flashes & mild headaches & weepy. I'll try to not use it twice a week to once a week and see how I do.

I hope that the UTI is after a sex-marathon weekend and not just random. I prefer my UTI's that way. (Sorry - there is just NOTHING funny about a UTI. They are painful and torturous and unfair and once you've had cancer you should be excused from ALL other problems).

BTW - my gyn did a urine test to see which antibiotic would be best. I hope you get some rest and feel better in the morning. Tylenol can actually help with the pain and discomfort.

Keep us "posted".
xxoo Dr. Flori - always on call.

[Believe51]

Oh Caya, I am so sorry to read yet another UTI, I have never had one so I cannot offer any advice but it looks like the girls gotcha covered. I wanted to just take a moment and send love and prayers your way. Hang in there my friend and try not to get discouraged, we are all here for you!!>>Believe51

PS: Flori, you are too much, sending you special smiles today!!

[Jackie07]

I am so glad that I found this link. I've been having UTI problems since stopping Herceptin. And it has created quite some problems for my poor hubby.

Thanks to all you have posted on this link. So good to know that I am not 'crazy' (as my husband would comment sometimes) and I am not alone.

[Ruth]

Caya ~ I am so sorry that you have it again. I was put on 2 weeks dosage of Cephalexin 500 mg (4 pills a day) and 4-6 cranberry pills a day (like Becky suggested). I'm allergic to Sulpha based drugs so I couldn't do the stronger stuff. It is so painful and I am so sorry for you. Please rest when you can, drink your cranberry juice and hopefully the Keflex will work.

Hugs ~ Ruth

[Jen]

Although I don't have cancer, I too have been plagued with UTI's. When I was little I used to get kidney infections frequently which have left BOTH my kidneys scarred (Thank God ya only need 1 to live~right). After I had 2 kidney&bladder surgeries I was pretty much UTI free UNTIL I started becoming sexually active. I notice I tend to get a UTI if I don't drink enough fluids and also it is extremely important to urinate shortly after intercourse to flush out any bacteria. I just finished a course of Macrobid 100mg BID and they also gave me Pyridium for the urinary discomfort.

[Becky]

Also, I needed a drug change in the middle of the run of UTIs. Cipro only worked on the first 2 then I started getting Augementin which always worked (till I started the once a week premarin cream now I'm good with not getting UTI's)

[caya]

Thanks for all the support. I am 2 days into the Keflex and am feeling better UTI wise, but the Keflex is making me very tired. I guess you just can't win.
Jen, I also have the Pyridium for the pain when urinating, it is a godsend.

I hope this works- I am on 4 x Keflex 500 mg./day for 10 days, taking 4 - cranberry pills and also taking 3 acidopholus pills/day to ward off a yeast infection... oh the fun. I am going to start the Vagifem next week after I finish the course of the Keflex.

Flori - I am thrilled to see your markers are dropping. Mazel Tov.

Marie - Glad to see that Ed is doing so well too.

[Jen]

Yes Caya Pyridium is a God send. I just finished my course of Macrobid last week and already I feel like I have another UTI. Girl I FEEL your pain.

[Terri B]

Caya,

Thanks for bringing up this subject. I woke this morning to a raging UTI. Looks like fruit punch in the bowl. OWWWWW! (sorry, tmi?)

Since this is my second one in less than a month, my gyno put me on macrobid twice daily for 7 days, then 1 daily for the remainder of my chemo. She said "we need to keep your bladder sterile".
She also said that macrobid bypasses the liver, so shouldn't cause any problems with other meds.

FYI.

[caya]

Terri,

Sorry to hear you have joined the UTI club. I hope the Macrobid regime works for you. I also found that a warm sitz bath a couple of times a day helps too.

I finished my Keflex last week and I am going to start Vagifem tonight. Keeping my fingers crossed...

all the best
caya

[Jen]

Well ladies I too have another UTI. This time the doc put me on Bactrim DS which gave me a yeast infection. I honestly don't know which is worse the pain of a UTI or the God awful itching (that ya can't scratch) of a yeast infection. Went to my gyne appointment he gave me a script for Gynazole -1 to take when I finish the 10 day course of Bactrim DS.

Also he said I need to have a mammogram.

[lilyecuadorian]

Doctors suggest some additional steps that a woman can take on her own to avoid an infection:

Drink plenty of water every day. Some doctors suggest drinking cranberry juice, which in large amounts inhibits the growth of some bacteria by acidifying the urine. Vitamin C (ascorbic acid) supplements have the same effect.
Urinate when you feel the need; don't resist the urge to urinate.
Wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra.
Take showers instead of tub baths.
Cleanse the genital area before sexual intercourse.
Avoid using feminine hygiene sprays and scented douches, which may irritate the urethra.

[caya]

Thanks Lily for this information, unfortunately even though many women follow most, if not all, of these rules, due to "instant" meno/chemopause, and the severity of chemo in general on our bodies - we need MORE.

I finished my 2 week course of Keflex (thanks again Dr. Flori) and started Vagifem this week - In only 5 days I can feel the difference. I will finish the 2 weeks of daily use, then drop off to 2x./week, then eventually 1x/week if I can.

all the best
caya