Dry Eyes!!!

matsgirlie · June 2014

I've just been diagnosed with dry eyes and was told by my optholmogist that it can be caused by radiation!!! My eyes are killing me and every time I blink it feels like i have sand under my lid! Anyone else experience this and if so what helps??? Ugh!

Moderators · June 2014

Hi matsgirlie,

We're so sorry to hear about this side effect! Did your ophthalmologist recommend anything or prescribe you drops to help?

While you wait for some advice from the ever-helpful members here, there's some useful tips on the main Breastcancer.org site's side effect page on Vision and Eye Problems.

We hope this helps!

--The Mods

SpecialK · June 2014

matsgirlie - what did the doctor who diagnosed you recommend? Are you taking Tamoxifen? It can also cause dry eyes. It may also be coincidental timing. My 24 year old daughter was just diagnosed with severe dry eye - has not received any treatment or medications that would have caused it. Her ophthalmologist has her on lubricating eye drops 4xdaily. He recommended in a pinch to use Refresh drops.

matsgirlie · June 2014

SpecialK! the eye drops are worthless - but i think i figured it out - i have been taking xanax regularly and just read a major side effect can by dry eye syndrome - burning, itching, watery eyes. is your daughter by any chance taking it?

Monis · June 2014

If using artificial tears several times a day isn't helping your symptoms there are small plugs your ophthalmologist can insert into your punctum (tiny opening on the edge of your lid where your tears drain from your eye). They prevent your tears from draining away as quickly, thus keeping your eyes moister. There is also a medicated eye drop called Restasis that can help some dry eye situations.

SpecialK · June 2014

matsgirlie - no, she is not on any medications. Thanks for mentioning that as a possibility though.

yoga_girl · June 2014

RADIATION - SCATTER - BREAST CANCER

You will find very little to nothing published on this topic. Most reference links say it's a myth.

I asked other women in rads treatments with me, during our six weeks of sessions, they were all experiencing some form of scatter as described below. We were all told the same thing, you had it before, it is not a result of rads, it is from chemo, it is from thyroid issues, etc. Many of the women only had surgery and rads, no chemo. We all believed there was nothing we could do but endure it alone and reach out to each other for support on rads side effects that impact the issues identified below.

Yes; I was experiencing symptoms all through rads, but wasn't sure what it was. Can't blink, gets stuck, feels like sand, and is painful, eyes are crusty when waking up from sleep. Using same solution I was using while wearing contact lens, multipurpose solution that is sterile and buffered.

I did not receive IV chemo before or after surgery, only rads after surgery.

First time I reported it, Onc Rad Team said it was from chemo. I didn't have IV chemo. Oops had to go back and look at my chart to find easy answer to what what the cause. Then I was told I had these symptoms before cancer. I did not.

Next time I repoted it, Onc Rad Team said it was my thyroid (blood tests were done, it was not my thyroid, ranges were normal).

Next time I reported it, Onc Rad Team said it was my supplements that were causing it. Told to end all supplements for six weeks. Confirmed, supplements were not the cause.

I was diagnosed with dry eyes, mouth and throat by my dentist five minutes into my 1st exam within three weeks of completing all rads. Direct result of rads treatment 'scatter' per my dentist. I see this doctor every six months or more often and he knows my mouth and throat area better than anyone. Confirmed by my dentist, scatter from rads. Confirmed by my primary care doctor, scatter from rads. Confirmed by my integrative doctor, scatter from rads. I am still dealing with all the same symptoms 5 months post rads.

Until my dentist and two other doctors confirmed what I was experiencing I was getting no where with answers to resolve the situation from my Med Onc Rads Team.

Med Onc Team would not see me regarding these issues due to Med Onc Rads Team still overseeing my care post rads.

Med Onc Rads Team would not deal with issues, stated it was a palliative doctor who needed to take on the issues and find solution.

Primary care doctor, took it on, agreed with dentist.

Integrative doctor, took it on, agreed with dentist and primary care doctor.

Then the research began on my end. . .

Side effects are different for everyone, but these are mine so I wanted to share what I have been diagnosed with and what is helping to me to cope as best I can.

Talk to your primary care, and/or integrative medical doctor. They will listen, they know exactly what you are going through and will assist as best they can to get you some type of resolution for symptoms on the palliative side. Be your own advocate, find another advocate who has knowledge about these topics, discuss options. Keep pushing forward with healing and managing pain.

•Oral mucositis (inflamed mucous membranes in the mouth).

•Salivary gland problems (after 30 minutes in a face down position during a rehab deep tissue session we have to stop so I can drink water to unglue my mouth that has no saliva to enable me to swallow).

•Change in taste. Very few things I can taste unless it is a strong taste.

Smell: unless it is a strong smell or offensive to my system, I can't smell it.

Hot/cold: I can't determine what is to cold or hot until it burns the inside of my mouth and the damage is done. I have to be very careful to guess the temp of food before eating other than room temp.

•Pain.

I have dehydration and it becomes difficult to eat properly with bleeding gums and virtually no saliva to start digesting food.

Talking for long periods of time is difficult, due to very little saliva and I lose my voice. Then I sound like a man with a deep voice, water doesn't really help.

Cancer treatments can cause mouth and throat problems, read on. . .

*****

This publication states protocol is only for patients with head and neck radiation, but as a breast patient I have had many of the side effects. Left breast, prone treatment, tumor bed one (1) inch from my heart, 730pm position growing along rib cage bone (was missed in mammo, I found the tumor within 30 days after receiving the letter that said nothing was detected your annual exam, was fine).

I've extracted the 'published' points on this topic from the NIH, NCI web page and posted below. Not all possible side effects from 'scatter' when being treated for breast cancer were discussed, shared, or advised by my medical teams (two different hospitals) using rads until AFTER treatments have started and AFTER you start asking about why you are experiencing so many side effects and what from. Actually, NO discussion was shared from any Onc Team about scatter potential.

http://www.cancer.gov/cancertopics/pdq/supportivecare/oralcomplications/Patient/page1/AllPages/Print

National Cancer Institute at the National Institutes of Health

Patient Version

Last Modified: 04/24/2014

Complications are new medical problems that occur during or after a disease, procedure, or treatment and that make recovery harder. The complications may be side effects of the disease or treatment, or they may
have other causes. Oral complications affect the mouth.

Cancer patients have a high risk of oral complications for a number of reasons:

Chemotherapy and radiation therapy slow or stop the growth of new cells.

These cancer treatments slow or stop the growth of fast growing cells, such as cancer cells. Normal cells in the lining of the mouth also grow quickly, so anticancer treatment can stop them from growing, too.
This slows down the ability of oral tissue to repair itself by making new cells.

Radiation therapy may directly damage and break down oral tissue, salivary glands, and bone.

Chemotherapy and radiation therapy upset the healthy balance of bacteria in the mouth.

There are many different kinds of bacteria in the mouth.
Some are helpful and some are harmful. Chemotherapy and radiation therapy may cause changes in the lining of the mouth and the salivary glands, which make saliva. This can upset the healthy balance of bacteria. These changes may lead to mouth sores, infections, and tooth decay.

This summary is about oral complications caused by chemotherapy and radiation
therapy.

The goals of oral and dental care are different before, during, and after cancer treatment:

•Before cancer treatment, the goal is to prepare for cancer treatment by treating existing oral problems.

•During cancer treatment, the goals are to prevent oral complications and manage problems that occur.

•After cancer treatment, the goals are to keep teeth and gums healthy and manage any long-term side effects of cancer and its treatment.

The most common oral complications from cancer treatment include the following:

•Oral mucositis (inflamed mucous membranes in the mouth).

•Infection.

•Salivary gland problems.

•Change in taste.

•Pain.

These complications can lead to other problems such as dehydration and malnutrition.

Cancer treatment can cause mouth and throat problems.

Complications of chemotherapy: Oral complications caused by chemotherapy include the
following:

•Inflammation and ulcers of the mucous membranes in the
stomach or intestines.

•Easy bleeding in the mouth.

•Nerve damage.

Complications of radiation therapy: Oral complications caused by radiation therapy to the head and neck include the following:

•Fibrosis (growth of fibrous tissue) in the mucous
membrane in the mouth.

•Tooth decay and gum disease.

•Breakdown of tissue in the area that receives radiation.

•Breakdown of bone in the area that receives radiation.

•Fibrosis of muscle in the area that receives radiation.

Complications caused by either chemotherapy or radiation therapy

The most common oral complications may be caused by either chemotherapy or radiation therapy. These include the following:

•Inflamed mucous membranes in the mouth.

•Infections in the mouth or that travel through the bloodstream. These can reach and affect cells all over the body.

•Taste changes.

•Dry mouth.

•Pain.

•Changes in dental growth and development in children.

•Malnutrition (not getting enough of the nutrients the
body needs to be healthy) caused by being unable to eat.

•Dehydration (not getting the amount of water the body
needs to be healthy) caused by being unable to drink.

•Tooth decay and gum disease.

Oral complications may be caused by the treatment itself (directly) or by side effects of the treatment (indirectly).

Radiation therapy can directly damage oral tissue, salivary glands, and bone. Areas treated may scar or waste away. Total-body radiation can cause permanent damage to the salivary glands. This can change
the way foods taste and cause dry mouth.

Slow healing and infection are indirect complications of cancer treatment. Both chemotherapy and radiation therapy can stop cells from dividing and slow the healing process in the mouth. Chemotherapy may decrease the number of white blood cells and weaken the immune system (the organs and cells that fight infection and disease). This makes it easier to get an infection.

Complications may be acute (short-term) or chronic (long-lasting).

Acute complications are ones that occur during treatment and then go away. Chemotherapy usually causes acute complications that heal after treatment ends.

Chronic complications are ones that continue or appear months to years after treatment ends. Radiation can cause acute complications but may also cause permanent tissue damage that puts you at a lifelong risk of
oral complications. The following chronic complications may continue after radiation therapy to the head or neck has ended:

•Dry mouth.

•Tooth decay.

•Infections.

•Taste changes.

•Problems in the mouth and jaw caused by loss of tissue and bone.

•Problems in the mouth and jaw caused by the growth of benign tumors in the skin and muscle.

rosecal954 · June 2014

I finished radiation treatments in Jan. 2014 -- external, 60 gray total, no chemo When I went in for my annual vision exam my optometrist saw that I had mild cataracts, never having had them before. I have a strong prescription, very near-sighted, however always correctable to 20/20 until this last time. I received new glasses and could not see very clearly for near reading. They were re-done and still blurry for close vision. On the 3rd time they were corrected so I can see fairly sharp while reading. My optometrist told me he could not longer correct my vision to 20/20 because of the cataracts. I also had my retinas checked and they were fine. I was referred to an ophthalmologist and he agreed I have mild cataracts, I would most likely be a candidate for cataracts surgery in 7-8 years. When I asked him if they could have been caused by radiation treatments he said it's possible saying sometimes the eyes remain stable for several years or they can degrade quickly. My parents both had cataracts in their 80's. He said radiation speeds up the process of aging including the eyes. I have had dry eyes since Jan. and have been using Refresh or Oasis Tears, using them two times a day which has improved the dry eyes. For a few months my eyes were very itchy and painful. I am thankful my eyes are doing much better.

Scatter -- Wow, I thought I was the only one who experienced strange symptoms. Yoga girl, thank you for the info. I believe I have seen the same articles and have scoured the internet for hours trying to find some info on the subject. My "strange" side-effects during radiation were: intense burning sensations inside my chest during treatment days, burning feelings on my face and arms. It would move around, starting on the sides of the face, my eyelids, back of my neck. While in the car my face and arms would "burn" through the glass. A couple of red patches appeared on my arms. My hands felt hot and while I washed dishes or was in the shower. I did not tolerate the sun very well during treatment -- my arms and face felt hot. Toward the end of my treatment time, my arms tingled and felt numb. My face felt as if I had a peel, it was very soft and tender. I mentioned these symptoms to my radiation oncologist. She told me matter of fact these could not be caused by radiation treatments, that the beam is precisely targeted at my chest and breast. She thought perhaps the symptoms were from an immune disorder and referred me back to my primary physician. He ran a few blood tests and everything came out normal including thyroid except I was slightly dehydrated. I was in excellent health before rads.

Today, 5 months post-treatments my skin is doing much better. I can tolerate the sun although I put sunscreen on and wear a hat if I am outside. New symptoms are tingling on the top of my head than comes and goes and my chest feels tight when I take a deep breath. I am also noticing a slight ache under my breast along my rib cage. Went back to my primary doctor, ran some more blood tests, everything normal except a slightly lowered white blood count. Since the radiation did clip my lung the chest pressure is most likely caused by the radiation and my primary dr. said it could be permanent. It has been very frustrating with the oncologists when they say these type of symptoms are not side-effects of radiation. What else could it be? Thank you for sharing, listening and reading and I wish everyone well. We are not alone.

doxie · July 2014

My dry eye problems are SE of AIs. I was on anastrozole/arimidex and now exemsetane/aromasin. I have two separate issues that create serious dye eye problems. I didn't have these before chemo and AIs. Chemo caused my prescription to change somewhat though.

I have plepharitis caused by bacteria in my eye lids which are swollen. There are several other causes for this, allergies are one. To control it I am to scrub my eye lashes with baby shampoo twice a day. If this doesn't work, then I'll need a low dose of antibiotic eye drops. Then for clogged meibomian glands, I am to put very hot moist wash rags on my eyes for several minutes twice each day. My eyes make enough tears, but not the oil needed to keep the tears from evaporating. Or it is blocked in the glands. I also use eye drops up to six times a day if I remember.

You could try either of these rather simple treatments to see if they help, or try them together. Just the hot compresses on my eyes make a huge difference.

yoga_girl · February 2015

*Anxiety and Insomnia*

http://thiaminedeficiency.org/ - to read the entire article

Cancer patients treating with DCA (to shrink tumors and/or prevent cancer recurring) require additional supplementation of Thiamine/Vitamin B1. This is because the DCA utilizes thiamine stores in your body to shrink and expel the tumor cells – this increased utilization of thiamine can trigger thiamine deficiency without adequate supplementation. This Thiamine Deficiency has symptoms of the Nervous system disorder, known as “Dry BeriBeri (see below). To learn more about DCA visit pureDCA.com

Vitamin B1 is an essential vitamin known as aneurin, thiamin, and thiamine deficiency in this vitamin can be serious. Vitamin B1 is water soluble and must be taken daily to replenish our stores and prevent thiamine deficiency. Thiamin helps maintain a normal metabolism; process carbohydrates, fats, and proteins; burn carbohydrates for energy; and, aid in metabolism of amino acids. Every cell requires Vitamin B1 to fuel our body. Nerve cells require Vitamin B1/thiamine powder in order to function normally. Thiamine Deficiency has serious repurcussions to your health.

Thiamine Deficiency is reversible with supplementation.

Dichloroacetate has been used in recent human trials. These trials were done by a university and their results have been published for anyone to read about the dichloroacetate cancer connection.

Pure DCA Information
The main facts about sodium dichloroacetate, pure DCA.

Scientific Research Papers and Studies Done With Dicholoracetate
Various papers in the peer-reviewed scientific literature, for educational purposes only.

http://www.cancer.gov/

yoga_girl · February 2017

Opti-Free Pure Moist by Alcon

Comfort and moisture

Target sells the 2 fl oz purse size that clears TSA requirements

It's sterile, buffered and doesn't burn. Since rads dry eye is still the same.

ChiSandy · February 2017

It also depends on whether you had whole-breast or only partial-breast radiation (i.e., to the tumor bed), and if the latter, how close the radiation field is to the head. My dentist had told me I would need to use Biotene until I told him I was getting partial-breast radiation. I have had mildly dry-eyes for years. In the past couple of weeks, I have had the foreign-body sensation (similar to what I experienced during the first couple of weeks after cataract surgery) in my eyes—but so have my son and housekeeper, neither of whom had cancer or any radiation or endocrine treatments. Turns out it is already tree-pollen-allergy season, a month early. What we're feeling are actual grains of pollen. Ugh. So I now take a prescription antihistamine drop (stronger than the BID OTC stuff like Zatidor) at bedtime and Systane in the morning or whenever I feel I need it.

BTW, my cataracts showed up 12 years ago and began ripening faster even before bc treatment. (I had the surgeries last fall, at 65). DH had his first cataract surgery at 58 and his second at 67.

Mandycat · May 2018

I have also been diagnosed with dry eyes and new cataracts 6 months after radiation and no chemo. My vision started getting worse a couple of months ago. I had no idea this could happen. I figure it was normal aging.

Lula73 · May 2018

cataracts are likely normal aging...they’re caused by sun exposure and raw years to develop. Dry eyes can be caused by the anti-hormone treatment as well as rads. It can be exacerbated by pollen and ragweed as were coming into spring. Natural tears help tremendously. You can get them as drops or a liquigel. Liquigel is great for nighttime, drops are perfect for day. Using a very small amount of Vaseline under your eyes can help as well as it will keep the skin in eye area moisturized. Very small amount meaning when you put it on you can’t even see the shine of the Vaseline on the skin. You can use it under your makeup too. Hope you get relief soon!

yoga_girl · June 2018

Mandycat

https://www.cancercenter.com/discussions/blog/eye-related-side-effects-of-cancer-treatment/

Discuss treatment options with an ophthalmologist (eye doctor). In some cases, dry eye is caused by another disease or condition, like rheumatoid arthritis or systemic lupus erythematosus. If this is the case, the systemic disease should also be treated in order to relieve the dry eyes.

Severe Dry-Eye Syndrome

Patients develop a red, painful, scratchy eye (foreign-body sensation) and photophobia. The drying effects of wind are particularly bothersome. Severe problems may produce corneal epithelial breakdown, ulceration with bacterial infection, vascularization, opacification, or perforation. Some patients develop iritis in association with corneal ulceration. Symblepharon (scarring of the conjunctival tissue) or phthisis bulbi (shrinking of the globe) are observed occasionally.

Most patients who develop severe dry-eye syndrome become severely symptomatic within 1 month after completion of irradiation. Corneal opacification and vascularization are often pronounced within 9 to 10 months after therapy is completed.

Various treatments have been administered in an attempt to control symptoms of severe dry-eye syndrome, including artificial tears, lubricating ointments, bandage contact lens, conjunctival flaps, or tarsorrhaphy. Topical steroids are occasionally used for iritis.

Topical and/or systemic antibiotics are prescribed for treatment of corneal ulcers. Retrobulbar alcohol injections may be used in a uninfected painful eye. Many patients eventually require enucleation or evisceration because of endophthalmitis with pain and perforation of the globe.

Discuss treatment options with an ophthalmologist (eye doctor). In some cases, dry eye is caused by another disease or condition, like rheumatoid arthritis or systemic lupus erythematosus. If this is the case, the systemic disease should also be treated in order to relieve the dry eyes.

https://www.mayoclinic.org/diseases-conditions/dry-eyes/symptoms-causes/syc-20371863

https://en.wikipedia.org/wiki/Dry_eye_syndrome

gb2115 · June 2018

I believe radiation caused me to have dry eyes. I had dry patches on my corneas. Over a year ago my eye doctor had me start taking Retaine MGD eye drops, multiple times a day. It helped tremendously. I still use it one time a day, but my eyes feel pretty much normal otherwise.

Dry Eyes!!!

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