Need help on fluid retention!

Annie,

You really, really need to call the doc. AC can damage your kidneys/bladder if it sits in there too long!

Nico

Annie -- any update?  Hope your doctor helped you out and things are okay.

Annie, please let us know what your doctor said.   I did have fluid retention but never asked.  I attributed it mostly to the steroid/decadron I was using along with the chemo.  They do blood work so doctor should know about kidney function and the like.

Annie, you DROWNED that tumor!

Glad to hear things are flowing again, although I missed out on all the excitement this time.  I thought I understood enough pharmacology to wade through all this, but I guess not.  On my Taxotere/Cytoxan regimen, one of the reasons they use dexamethasone (Decadron) is to reduce the fluid retention that would otherwise occur from the Taxotere.  But, your fluid retention occurs because of the Decadron?  Who knew...  It was nice to hear a happy ending.

I'm sitting here grumbling because I'm trying to get my onco's office to schedule the DEXA scan my onco said I needed, and the poor, overworked scheduling gal just can't seem to get it accomplished.  She told me today that the reason she never called me back yesterday is because she needs my nurse to tell her what the "indications" are for the DEXA scan.  Like the fact that I've been menopausal for 5 years, and I'm about to embark on a 5-year adventure with Arimidex...  But my word isn't good enough, and she can't seem to find my nurse even though they work in the same office.  Sheesh.

Mushy (edematous) hugs, Annie!

otter 

Hi all:

Just adding two cents here...I am on CMF and this happened to me as well. 

It was from the decadron as well.  They cut the steroids to 1/4 of the dose and I have done fine thru the last 7 txts.  I do still retain a little bit but it's OK the next day.

I guess it's a side effect to watch out for. 

apparently, you can get a kidney "freeze" on this stuff, despite what they tell you about drinking water.  Not quite so much, and try to move around alot during IV treatment.

Good luck

Thanks for updating us Annie, and I'm sure your nurse won't give steroids again at this juncture! Great attitude, what's done is done, and one that keeps us moving forward in this.



I'm super happy to hear your report that the AC is doing its job, and most happy that you too may finally feel some sense of relief and hope that this is all doable. There's a post by a triple negative gal on "can AC be used twice" who also had medullary. I thought of you and wonder if you might not like to look at her post.



Sorry Otter that your in the testing twilight zone. It is nice Ann, that more and more our cancer centers are accommodating, reflecting the times we patients live in.



best to all,

Tender

Annie, I know you can't see me, but I am jumping up and down with delight that the AC has worked on your tumor (and nodes!).

Maybe the Taxotere/Avastin was just the set-up, and made the tumor even more vulnerable to the AC.  Or, maybe AC just works really, really well against your tumor.  That is such good news, though.  I was focused on the acute problem of your fluid retention, and your happiness about the tumor response kind of slipped by me.

I think you and your dh should have a little celebration, once you're out of the fog and feeling up to it.

More hugs,

otter 

OK, leaf, here's your test question:

Fluid retention is a known, and potentially life-threatening, SE of the taxanes.  That's why all the pharm sites and packaging materials say to give steroids (dex) in conjunction with administration of Taxol or Taxotere.  (Drum roll....)

Part A:  Through what mechanism does Taxotere cause fluid retention?

Part B:  Through what mechanism does dexamethasone reduce the fluid retention that would occur with Taxotere?

This is an open-book question.  You have as much time as you need.

otter

(Gee, Annie, doesn't that sound like a written prelim question?  And, leaf, you don't really have to answer it.  Some of it is theoretical anyway.) 

OK, I work the graveyard shift- we don't do chemos on that shift!



I am *** guessing**** they are not using decadron for fluid retention. I am guessing they are using decadron for nausea, vomiting, and/or potential hypersensitivity reactions. "Paclitaxel frequently causes hypersensitivity reactions which can be severe, and all patients receiving the drug hould be premedicated to prevent severe reactions." About 20% of the patients in the study had hypersensitivity reactions, and reactions occured in 41% of patients despite premedication. I know they commonly do give other drugs for hypersensitivity reactions. One onc at the hospital I work at insists on using cimetidine (Tagamet) IV instead of the famotidine (Pepcid) we carry. These should help somewhat with some histamine reactions. In other words, they can use different types of premeds. They often use Benadryl, tylenol, hydrocortisone, decadron, ativan, etc, as premeds for various things in our onc dept. I am not privy as to the chemo protocols as they only occur during the day shift.



The most common hypersensitivity reactions (according to this 2006 text) are mild, the most common being flushing, rash, hypotension, dyspnea, tachycardia, hypertension. Severe reactions can include...angioedema and generalized urticaria, and are probably histamine related. It says anaphylaxis or severe hypersensitivity reactions requiring therapeutic intervention and/or discontinuance of the paclitaxel infusion occurred in 2-4% of patients with breast, ovarian or lung cancer in the first, second, or third course of therapy despite premeds. Some patients tolerated subsequent paclitaxel doses.



My friend has gotten decadron with every chemo dose (gemcitabine) she has gotten, and gemcitabine is not particularly nauseating.



My 2006 book says in clinical breast and ovarian cancer trials, 21% of paclitaxel patients had edema. I don't know how true this is, or if they have changed their mind but it says "Edema in patients receiving paclitaxel commonly was focal and disease related; severity of edema did not increase with length of time spent in the study."


It is unusual for us to know exactly why an adverse reaction occurs (for drugs in general). Some drugs have more simple mechanisms of action than others. But often we just know an adverse reaction occurs, not why. Often, for people on complex regimens, it can be difficult to tell what drug caused an adverse reaction, or if certain symptoms are part of a disease process.

They don't know exactly how paclitaxel works as a chemo agent. One action probably is connected with its chemotherapy effect: it does promote *nonfunctional* microtubule assembly. (Microtubules are, among other things, the 'strings' that 'pull' the chromosomes apart - one set to each cell - when cells divide. They are also involved maintaining cell shape and motility. The cells get stuck in late G2 and M phase of the cell cycle.)

They don't say anything about why paclitaxel causes edema. I bet they don't know why.

Annie, I've tried twice to answer your question!  (First time was hours ago -- didn't realize it didn't "take"!)

I guess the failure of my posts is a representation of the lack of news!  I think this will be way too long a stint a limbo...

Annie, I'm new to this postings....18 months cancer free...I had Insavise Lobular.  I agree w/everyone....Yes you should tell your Oncologist...never thinking you are troblig your medical professionals.  During treatment I did not have swelling but after six different Serms/AIs, the swelling is terrible. 

anyone had issues post treatment?

i didnot have swelling but now afrter

bump