Taxotere and Icing Fingers and Toes

theresap60

Hi all,

I went through chemo back in April/May 2010 and decided to follow some discussion board advice and iced my fingers and toes while getting taxotere to prevent neuropathy and dying nails.  I used frozen peas/soybeans in ziploc baggies, then placed them in thin socks and put them on my toes and used those frozen ice pops that you get kids in the summer, placed one each in a thin sock and used those for my finger nails.

I had no neuropathy in my toes and had just a little in the nails on my left hand, but had some problems (deadening halfway down on my nails and tenderness on my fingertips) with the fingers and nails in my right hand.  It dawned on me why that happened, though.  I was reading a book each chemo session and got lazy with the ice on my right hand b/c I had to keep turning the pages.

When I tell that to my doctors and nurses (esp the doctors) they give me an almost patronizing smile ... kind of like I told them something utterly crazy. Even when I show them the difference in the nails.

Has anyone else experienced positive results from icing your fingers and toes while being administered taxotere?  I don't understand why it's not recommended more professionally.

Theresa

Shelly1953

Hi Theresa,

I iced my hands during taxotere by freezing small 8 oz water bottles and wrapping my hands around them.  I couldn't think of a way to do feet.  I have no neuropathy in my hands or fingers but a little in two toes on each foot.  I can live with that!  I'm still doing Herceptin and my nails look like cra*.  They are peeling in layers.  Don't know if that's left over from chemo or the Herceptin. 

 The nurses were very supportive of me reading about the "icing" on this website, and even asked if they could keep my water bottles for anyone who wanted to try it.  In my opinion, it definitely works!

Shelly

theresap60

Shelly,

I found the onc nurses were supportive, in fact, I have nothing but good things to say about onc nurses.  They wanted to do everything they could to make me comfortable.  The doctors were the ones giving me the strange looks! My nails on my left hand darkened a little and got brittle and they've grown out so that you can't tell anymore.  The nails on my right hand are mostly grown out and I don't have the finger tip sensitivity that I had just a month ago.  A month ago, I couldn't pick up items on a table, like paper or coins, without discomfort.

Yep, it works!

Theresa

208sandy

Hi Ladies:

 The onco nurses know about the icing but I didn't think I'd need it - yikes I should have done it - my onc did recommend Sally Hansen Hard As Nails for my fingernails and I did put it on starting with the second chemo and it worked - didn't get a chance to use it on toenails as they darkened right away and I still have neuropathy to this day and it's been almost two years...

stlcardsfan

I iced both fingernails and toenails. In fact, at my first treatment, before the Taxotere started, the nurses walked over with ziploc bags full of ice chips. One for each foot and one for each hand. I asked what they were for, and they replied to prevent nail issues. They offer this to everyone who does Taxotere. My DH got really good at wrapping my feet to keep the ice bags on my toes. I had a slight dry spot on my right thumb after #2 as it wasn't in the ice far enough.

On Herceptin only now, and nails are fine and growing strong. 

theresap60

208sandy and stlcardsfan, those were great stories.  I wish all the onc practices would recommend icing.  It would save a lot of pain and discomfort... as if we don't suffer enough with chemo.  You don't realize how much you use your nails until your nails hurt! - Theresa

AnnNYC

I can't believe how often I hear that oncology professionals are patronizing about icing!  In addition to everyone's experience reported here, there really HAVE been scientific studies showing that it works!

The links should take you to abstracts of these papers.

To prevent fingernail/toenail loss and hand/foot neuropathy:
http://www.ncbi.nlm.nih.gov/pubmed/15099971
http://www.ncbi.nlm.nih.gov/pubmed/18083217
"The use of ice packs around wrists and ankles is a simple and well tolerated prevention strategy and its efficacy is demonstrated in this study."

To prevent hair loss:
http://www.ncbi.nlm.nih.gov/pubmed/17664675
"Cooling the scalp during administration of chemotherapy can prevent hair loss. It reduces both skin blood flow and hair follicle temperature, thus affecting drug supply and drug effect in the hair follicle."

To prevent mouth/throat sores:
"Oral cooling with crushed ice for prevention of chemotherapy-induced oral mucositis"
http://www.ncbi.nlm.nih.gov/pubmed/18300265
http://www.ncbi.nlm.nih.gov/pubmed/8374882

imblessed2

Ann, thanks for the links.  My onco doc said that "It may be helpful but icing is your choice".  I would like to take her this thread.  I say, if there is a smidge of a chance that icing would prevent the neuropathy...heck yeah do it!  Exactly...we have gone through enough and if it can be prevented...well I just don't understand them.  My nurses on the other hand were very helpful.  I iced my toes.  I have some tingling in 2 of my toes on right foot...especially when I walk/run.  I would advise everyone not to gamble and ice! JMO;))

kira1234

Ann,

Thanks for the info. if I can stop the neuropathy I will do almost anything. I am a teacher, and if I can't use my hands I really can't be a very good teacher. My treatment place already told me they don't have any ice, so I think I will just make up some bags to take with me. I already had planned to take ice for the mouth.

Karen

loisNC

This info on nails--especially finger nails--is fantastic.  I will be trying this on my next chemo.  Evidently the cancer center that I go to is not aware of this "icing".  I also have ovarian cancer and while using Doxil I had experienced the "hand and foot" syndrome and had found on the internet that packing the wrist and ankles while receiving the Doxil prevented the hand and foot syndrome.  I had also shared this info with the cancer center for other patients.  Thanks so much.

Carrol2

Does this apply if your getting TC combined?

crazy4carrots

I didn't know about icing when going through  FEC and taxotere.  However, it was summer, with the A/C going full blast and I was wearing sandals.  No problems with my toes 'cuz my feet were always cold (!) but I did lose both thumbnails and the rest of my fingernails peeled and were very brittle.

Some clinics now have ice mittens and ice socks.  I hope, hope, hope all oncs will soon start listening to their patients and their nurses and start taking this issue seriously.  And, as AnnNYC has pointed out, there are studies which prove that keeping the blood from circulating too easily in the extremities keeps neuropathy and nail problems at bay.

Paula1231

What if you have your nails done with acrylic?  Should one quit having rebases?

loisNC

Icing of wrist and ankles.  During the last three taxol treatments I have been using ice in one form or another for my wrist and ankles.  I am currently, using the "Thera-Med Deluxe" hot and cold compresses.  Freeze the gel packs; insert into the wraps (which have velcro) and wrap around both wrists and ankles.  After three treaments using this, my fingers nails are no longer SORE.  My nails had got to the point of feeling like each nail had been mashed.  I also seem to have more feeling in both my hands and feet.  This is GREAT.  Also, I have been using the OPI Nail Envy for "sensitive & peeling" following product directions.  This has been the greatest thing I have tried for the peeling and spliting.  The cost of this was $16.95.  Money well spent.  How I wished this information was given to us by the cancer clinics.  Prevention would be so much better rather than treating the side effects.  More studies need to be done.  I feel like I have been thrown out in an ocean and give a life preserver (chemo) but the sharks (side effects) are nibbling away at my hands and feet.

Omaz

I bought insulated lunch sacks at Target and put bags of frozen peas in them for my hands and feet.  They get very cold.  I am on Taxotere.  I have heard that sometimes the nail problems don't start until after chemo but so far my nails are ok.  I do have neuropathy though, I don't know if the icing made any difference there.

theresap60

Omaz - the neuropathy that I had during treatment and right after was very sensitive fingertips mostly on my right hand.  But that's all gone now and my nails are healthy.  However, the balls of my feet are almost always sore, especially after sitting awhile.  I don't know if that's neuropathy or something else.

lago

Omaz that does sound like neuropathy. It can be numbness, pins & needles or sore feelings.I came across this link but I have seen several other similar listings: http://www.cancersupportivecare.com/nervepain.php

Just had my 2nd treatment of  taxotere, carpbloplatin & hercptin. My left heel started to get numb 2 days later this time. It gets better when I walk. Last time my left hand was a little numb/pins and needles. Now just off an on. Not sure if icing during treatment would help this. I have heard vitamin B6 helps but I want to ask my onc before I take anything new.

bdavis

Have any doctors complained that the chemo can't reach ALL parts of your body if you ice? Or is it not important for hands and feet as it can be for the scalp, and using cold caps?

Omaz

bdavis - The scalp cooling is very thin from my understanding, just the very outside layer.  There is obviously still circulation to the fingers and toes during cooling, the idea is to decrease the amount of drug that gets to the nailbed.  They aren't getting 0 just decreased during the infusion.  The taxotere is still in your circulation for quite a while after the infusion, it is just the 'acute' devlivery during the infusion while the drug concentration is at its highest that is decreased.  That is my understanding.  My onc was fine with my doing it, he didn't think it made any difference but if it made me feel better to try to help myself through the treatment he was ok with that.  Some tissues maybe soak up more of the drug and get a disproportionately high dose?  Or they are more sensitive to the drug, like the nailbed and hair follicle.  I don't know, definitely need more research.

lago

I have finished 5 tx and I wish I had iced my fingers (and maybe even toes). My fingers and toes are a mess. My thumb became infected and my fingers do  have some pain (had more before after tx4). Yes icing prevents the chemo from going there but I've never heard of anyone getting finger or toe mets. Usually mets  start in larger bones, lungs, liver, brain etc. I might not be comfortable icing my head though because of brain mets but there hasn't been any research to support that cold caps prevent chemo from getting to the brain.

Omaz

Lago - I hope your fingers and toes feel better soon!  Did anyone at your chemo center even mention icing to you?  I just happened to come across the articles just before I started chemo really by accident.  It seems a shame that women aren't offered this choice.  I agree that I have never heard of finger or toe mets.

lago

Nope. My onc mentioned icing when I told her my tongue got sore. I started sucking on ice after that and it worked. She never mentioned icing for the fingers. I did it last time but I think it's too late. Granted after icing my fingers didn't hurt as bad as last time… but they are still getting worse.

My chemo center gives you heated blankets. I wish they had those ice gloves and booties instead. I can bring my own blanket or dress warmly.

Omaz

lago - Maybe we should start a movement.

208sandy

Good idea to "start a movement" - I've done two cancer centers now and on line here BUT I am met with skepticism from the oncs - they just smile and ignore me - the onc nurses on the other hand listen and nodd and tell me about other patients who "believe the same thing.

It isn't beliefs people!  It is proven fact!  I wonder if BCO wants to put out a position paper (statement) or something - so that the oncs would at least talk to their patients - as for cold caps I know the oncs don't like that at all because of the possibility of brain mets but I wonder if that is even valid - it's going to take some research.  The clear nailpolish idea is from the drug company they hand out freebie bc kits when they bring in lunch for the staff at the centers and the kits contain clear nailpolish so they are well aware that taxotere is causing se's and what they are.

Glad you had your last treatment lago - don't worry your nails will come back and the pain will go away pretty quickly - just remember to wear gloves when doing anything around the house or garden (when spring comes).

Sandy

lago

Sandy I have my last TX next Tuesday… almost done.

208sandy

lago:

Oops, we'll celebrate next Tuesday too!

Hugs, Sandy

justjudie

Hi Ladies,

 

Just thought I would add my 2 cents too!  I finished 7 treatments of Taxotere (every 3 weeks) almost 3 months ago.  I developed pretty bad neuropathy around treatment 5 and the onc delayed one treatment and lessened the amount I was getting for the next 2 due to the neuropathy.  In fact, if it hadn't been so bad he would have preferred I complete 8 treatments but I just could not. Even now, 3 months later, I still have neuropathy in my hands and feet. It is a little better than it was, which I am relieved about, & hope it means it may continue to improve.  It is not very painful like it was, but it is weird and uncomfortable, for sure.  My nails held up pretty well until right at the end of treatment.  They suddenly got all wavy looking and now split & break very easily.  However they are not discolored nor have they fallen off or anything that bad.  Toes nails are fine.  Maybe I was just lucky on that score, or lessening the drug when he did saved those last really bad side effects. 

 

I wish I had been aware of icing for possible neuropathy before treatment.  I had seen something about it re: hair loss but I thought if it helped that much, everyone would certainly be doing it, so I pretty much discounted it.  I didn't hear or read anything about icing hands & feet tho.  I wish they would really study this and make it a legitimate part of treatment if it is indeed helpful.  You are so right that we go through ENOUGH without having to suffer further from something that might be prevented especially with something as simple as icing! I am definitely keeping this in mind if I have to have another chemo that causes neuropathy.  Thanks.

 

Judie 

 

lago

I found the Acetyl-L-Glutamine (500mg) worked well to prevent neuropathy for me. Started taking it after my 2nd tx. I still have a numb left heel but so far no other symptoms.

As far as the issues I am having with the nails lifting and hurting underneath… it happens but not as common as some other SE. Odd but they are not splitting.

Omaz

justjudie - I don't know if the icing helps with the neuropathy or just the nail problems. 

suzieq60

Over here in Oz we are given ice mits to put on but only for the hands. The staff told me they were supplied by the taxotere company - not sure if this was true. I still had most of my nails break off half way down, but I didn't lose the whole nail. They also said painting them black helps but I didn't try it. Wearing gloves out in the sun was also another suggestion. My toe nails were fine and weren't affected.

Sue

bdavis

I bought bags of peas today as well as ice packs that can be cut to size... so I will bring my cooler with peas, packs and ice and see how it goes...