Lymphedema and Xeloda

No personal experience with Xeloda but am interested in it. An oral agent, it is essentially a "pill" form of 5-fluorouracil (abbreviated, I think appropriately, as 5-FU). That drug has been part of cancer protocols for decades. Perhaps a medical literature search using that reference would come up with information on LE exacerbation. Hope your complications will be minimal, if any! 

Hi Diane,  

I started on Xeloda and Taxotere chemo on Dec 23, 2005.  This was 18 days after my bilateral mastectomy and total left ALND with 23 nodes removed.  I also was on a 2 weeks on / 1 week off schedule initially with the Xeloda. I was taking 3000mg /day divided into 2 doses of 1500mg each morning and night.  Individual sensitivities and responses will vary, but I developed Hand/Foot syndrome fairly quickly on the Xeloda.  Both my hands and feet were affected by severe inflammation, swelling and peeling of skin by late January.  I had my first flare of measureable lymphedema swelling in my left hand and forearm area by the first week of Feb during my 3rd 21 day cycle of Taxotere.

I believe that the combined inflammation of recent surgery, extensive nodal removal and hand/foot syndrome all were contributing factors to my development of lymphedema.  Due to the severe nature of my hand/foot symptoms, my onc effectively lowered my Xeloda dosage by putting me on a 1 week on / 1 week off schedule which allowed more recovery time between the dose weeks and helped reduce my symptom severity.  Of course, Taxotere chemo is also a contributor towards inflammation and swelling so it really boils down to our individual lymphatic system's capacity to withstand the increased demands created by active phase cancer treatments.

Knowing what I know now, I would have already been wearing compression garments or daily wrapping, and getting regular MLD to help support my lymphatic system during the onslaught of treatment.  As it was, I started wearing a non-custom sleeve and gauntlet once LE swelling appeared, but should have had a full glove instead.  After I started radiation treatments in May 2006, my professional MLD sessions were halted (a practice which is less likely to be recommended today) and my degree of hand and forearm fibrosis rapidly progressed during this period.

I would certainly follow all precautions as Binney has suggested, watching for signs of infection and wrapping to help support your lymphatic system.  Be alert to increased swelling or involvement in your hand or arm.  If you don't already have a LE therapist, I would strongly recommend finding one who can help keep your lymphatic system in good shape during your treatment regimen by doing regular professional MLD.  If your hand/foot symptoms progress, be sure to speak with your onc about ways to allow that syndrome to resolve without completely stopping the Xeloda.

Many, many women tolerate treatment side effects without developing lymphedema and I do hope that will be the case for you.  It never hurts though, to be proactive in your approach and do whatever is possible to try to keep the odds in your favor during this particularly inflammatory phase of treatment.  

Best of luck and good wishes for you!

Linda