Hair, skin, and nail problems with Taxotere and Taxol
I've finished my 4 treatments of Taxotere & Cytoxan, and I experienced some of the hair, skin, and nail SE's that are common with that regimen. Taxotere (and possibly Taxol) can cause skin rashes, folliculitis, hand-foot syndrome, nail dystrophy, etc.
I had heard about some of those SE's, but I didn't know what they would look like until I developed them myself. Also, some of the SE's only lasted for a few days, so I took photos to show my onco at my next visit.
Some of you might want to see what those SE's actually look like. They're kind of gross, so fair warning! The pics will be in the following post(s). Please add your own pics, or post descriptions of the problems you had with hair, skin, and nails from your chemo. We might be able to help each other identify problems and figure out solutions.
otter
Comments
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Here are pics of some of the skin and nail problems I had with my 4 treatments of Taxotere/Cytoxan (at 3-wk intervals).
Folliculitis:
Besides losing nearly all my hair, I also developed a rash on my scalp during my 2nd Taxotere/Cytoxan cycle. Here's what the rash looked like around day 13 of cycle #2. Note that the red bumps had developed into "pustules" by then. My onco looked at this pic and said it was folliculitis.
Hand-foot syndrome (probably):
Midway through round #3 of my TC regimen, my feet became very red and sore. The redness looked like a burn. My onco's nurse (over the phone) said it was probably hand-foot syndrome (HFS), although the "burns" were not right on the soles--they were at the sides of my soles. Also, I had no lesions like this on my hands. This pic is from day 12 or so of cycle #3. The redness was gone by day 21 (next tx), but I developed new "burn" areas during cycle #4. Even though the redness disappeared, the areas peeled extensively during and after cycle #4.
Beau's Lines (nail dystrophy):
The taxanes can cause discoloration and loss of fingernails and toenails. I didn't lose mine, but my fingernails developed "Beau's Lines," as shown in the pic below. Beau's lines occur when nail growth is interrupted because of illness, trauma, or in our case, toxic drugs. The white lines are actually ridges in the nails.
I don't think y'all need to see my bald head to know that chemo can take our hair. My onco said I would lose "all" my hair with Taxotere & Cytoxan, and she was right.
otter
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Hey Otter
I am starting Taxotere Aug 6th so I am so glad you showed these pics. Now, I will know what is happening if anything like this happens. Was this the worst of the worst??? I am hearing so many things about this stuff and it is making me nervous.
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A couple of the women at my gym (I'm in a fitness study at the hospital) said that they soaked their feet in epsom salts or something for that issue. I wonder if anyone else has had luck with any kind of soaking to relieve their feet? I'm anxious about keeping up with my running schedule, so I hope it's not terribly painful if/when it happens to me. I start the taxotere on Aug 7.
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StaceyR,
I had posted somewhere else a link that stated [about half of those taking docetaxel experience a side effect known as hand-foot syndrome]
Just a word of WARNING! You might want to reconsider your running schedule. Given the odds 50/50 that you may get it, I wouldn't do anything to increase my changes. Running puts extra pressure on the feet, thus greatly increasing the odds that you'll get it. Not to scare you but yes it is painful. Let's put it this way, if you do get it you won't want to walk let alone run. Here are 2 links to give you more info on HFS.
http://www.chemocare.com/managing/handfoot_syndrome.asp
http://www.caring4cancer.com/go/cancer/effects/lesscommon/handfoot-syndrome.htm
The second link does recommend soaking feet in Epson salts.
Ask your Onc about taking 150 mg of B6 daily and start taking now before treatment starts to help ward it off.
Enjoy the day, Karin
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Otter,
I had the nail problem and lost one thumbnail and big toenail. Last year, I stubbed my toe and lost the same toenail. Basically my toenails never recovered. The onc sent me to a dermatologist when my toenails were still "funky" three years post chemo. Dermatologist confirmed that it wasn't a fungus. Chemo had "done a job" on my nails.
Taxotere also left me with blocked tear ducts. (Another story.)
My feet and ankles swelled as did my hand and wrist. I am convinced that there is link between taxotere and lymphedema as are a few other people on the boards.
All I can say is hang in there.
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Ny nails looked exactly like yours, Otter - except I had six white ridges (TACx6). I had only very mild hand/foot syndrome, but had pronounced edema (my toes looked like vienna sausages!) for weeks after stopping treatment and the neuropathy still lingers a year later.
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Wow, that was some scary pictures. I had 6 taxotere treatments along with Carboplatin and Herceptin. I did of course lose my hair, but I personally had no skin or nail problems of any kind. I was very sick and had a lot of nausea and diarrhea from taxotere, but that was it. No swelling, no nerve problems, and as it is 2-1/2 weeks since my final treament, I feel great. I'm not tired at all and very much looking forward to a long life as a cancer survivor. I'm sorry you have so many lingering problems. I guess I'm just lucky and I thank God for that. Mary
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Otter, I have the Beau's Lines, too. I thought they looked kind of cute...striped nails! And I didn't pay a fortune to have them done. (Kind of like the free Brazillian, LOL.) Considering they could have turned black and fallen off, it's not an awful s/e.
As they've grown out, have you noticed any change in the integrity of your nails as the different areas of the stripes reach your tips?
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Otter, I had the nail thing like that after "only" A/C. The yellowish part of the nails eventually peeled away as the length was growing out. Only the thumbs were really gross and had to be covered with bandaids for a few weeks. A year later, all is well, though, so you should be fine. Your nails don't really look too bad.
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Otter,
My nails have turned black and have Beau's Lines!!! I keep polish on them because they are hideous!! The bottom of my feet feel dry and scaly, but shea butter has been wonderful. My skin has never been smoother. Go figure.
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Otter, I also had the nail dystrophy. I had 6 round TAC between April and July, 2007. I didn't experience the neuropathy on the bottom of my feet until after the last tx. I experienced runny eyes and nose and edema of ankles and feet. I guess that was just about it for me. I still am experiencing the neuropathy and runny eyes. Hang in there, this too shall pass.
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Update:
My hair is growing back--it's very light "peach fuzz" at this point, but I'm seeing something that wasn't there a week ago.
My feet have healed completely. The red areas all peeled, but it didn't hurt because the skin under the peeling areas was normal by then.
The lines in my nails (4 lines in all) are slowly growing out. I don't know what will happen when the lines reach the cut edge, because the first line is still just a little over halfway there. So far, though, my nails seem as tough as ever. I know things could have been much worse, and probably would have been if I'd had more than 4 Taxotere/Cytoxan treatments.
otter
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I am currently on taxol, have completed 8 infusions so far, and am just starting to have "foot issues". I found soaking my feet made them feel worse but lotion and a massage made them feel so-o-o-o much better.
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BUMP
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OK, I don't sell this stuff, and I own no stock in the company, but...
To help with the red, sore areas on my feet, my oncologist recommended applying a soothing emollient--she suggested Udder Cream, "Bag Balm," or something similar. I did some on-line searching, and found quite a few recommendations for "Udderly Smooth Udder Cream" to treat hand-foot syndrome.
My skin is really sensitive to perfumes, so I couldn't use the Udder Cream formulations that had fragrance added, even though it was mild. My favorite was "Udderly Smooth Extra Care Moisturizing Cream." It's fragrance-free and it contains 10% urea.
I also used Curel hand lotion on my feet (again, the fragrance-free version).
otter
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Hi,
I just finished 12 weeks of Taxol (weekly), and 4 A/C treatments over 2 months. Glad that's over!
My nails did strange things after the Beau's lines developed. My fingers starter to hurt, then each nail kind of "buckled up" in the middle. Under the nail beds it had areas of dark purple. Soon, the nails started lifting off the nail bed. They are all lifted about half way up now, and sore when I try to pick up something.
I believe I've kept from getting a fungus by soaking my nails in diluted hydrogen peroxide, and keeping them really clean. I also cut them as short as I could without exposing the nail bed.
Now I'm wondering what to expect. Will they crack and split up to the good part of the nail? Or will the lifted part come off? I know SE are sure different, but it does help to know what possibilities to maybe expect.
I have a little tingling in both my hands and feet, but.....the really painful thing is in my muscles whenever I stretch, walk up stairs, etc. It burns and cramps. Anyone else have that? Any suggestions to minimize it?
Take care
catemarie
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I've just completed taxtol infusion #11 and am having some serious issues with my finger nails especially my thumb nails. No beau lines but funky purple areas on the nail beds. Thumb nails are starting to lift and painful. I'm too the point that I wish the blasted things would just fall off ..... but I also know I should be careful what I wish for .... has anyone lost their nails? Is it painful? Did the grow back?
Rover
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I a having Taxotere once I have finished 2 more rounds of FEC. I am in Australia and at the place I go to your hands are placed in ice gloves during the taxotere infusion. Do you girls have this too? It is supposed to help with the nail issues.
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Hey Ima! I'm in Tasmania. The frozen mittens are a laugh..takes a while to turn the pages of the trashy mags! I am finding the Taxotere SO MUCH EASIER than the FEC. I actually cannot believe the difference. I guess I am only 3 days post 1st Tax, but hey! I'm pretty pleased thus far! Walking is everything..it's been nice to have some sunshine to walk in. Sitting around is OUT.
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We have the ice gloves here in Ottawa, Canada, too. I just wish someone had reminded me to suck on ice chips, too, 'cause my mouth was useless for a week afterwards. And Kerry, you are SO LUCKY that it is so smooth for you. I was in hell for over a week after treatment. It was rough.
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Hey Stacey. I'm sorry to hear that. With the FECmy legs, my face, especially my eyes would swell up, I'd get 'nappy rash' (I kid you not) and had to take extra drugs for stomach acid. With the taxanes I've had real dehydration (which has abated today..day 4 after chemo) and sleep deprivation from the dex. as well as quite surprising bone pain, particularly in the legs. But I'm good with pain..it's general 'toxicity' I'm not good with, and I haven't had any of that yet. The mouth thing is weird, isn't it? Mine is kind of numbish, but they gave me good toothpaste and some other gear in a toiletries bag. The chemo nurses said it was my reward for turning up every time
I could do the ice chips thing..but I'd rather have the large chai!Where are you at with your treatment? Take much care.
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Wow, that sounds like an odd reaction to the FEC. I mostly just had a lot of nausea with it (never threw up, just felt like I was going to all the time). I did 3 rounds of FEC and 1 taxotere so far - 2 more to go. The taxotere has been brutal on my bones (a lot of pain in my spine), it ripped up my stomach, and I had the aforementioned mouth issues. Also, the dosage of decadron they told me to take feels awfully high for little old me. 16 milligrams the day before, the day of, and the day after treatment - I thought my heart was going to explode!
I thought I was handling chemo pretty well until this round - now I find I'm pretty angry about it (residual "roid rage"?). I work part-time and couldn't even make it in last week, so that was not ideal. It's good to hear that some people have an easier time of it, though. I'm hoping my oncologist is open to lowering my dosage so I might not suffer so much next time.
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Hey Stacey.
Today ( 5 days after my first Tax) my back is broken, as are my legs and my stomach is shredded and on fire. When does this go away? I'm also crabby enough to kill someone
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OMG!!! I thought it was supposed to be easier than FEC...
I am so sorry that you girls are feeling crappy, I hope you improve soon. Just imagine what it isdoing to those wayward little cancer cells.
Kerry, I love your sig lol
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Kerry, I started getting better on day 8. I had to drag my sorry self to the drugstore for anti-diarrhea medicine, but that seemed to make a world of difference (as did eating real meals again). The bone pain faded ever-so-slowly. I resisted taking prescription pain meds last time, but I'm already planning to dive into them next time, since regular ibuprofen and acetominophen didn't do much for me. I hope you're not in too much agony.
Imam: I also thought it was supposed to be better than FEC. I was angry to discover it was not.
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Hi, all. Sorry to hear some are having a hard time with chemo, but eventually you get through and one day it's all behind you. Well, maybe a few side effects. I also had Taxol/Herceptin over 3 years ago and am still having problems with my hands, although not as bad as during treatment. At that time I had 6-7 layers of skin peel from my fingers on a regular basis; now it's 2 or 3. (Feet affected too, but I don't have to look at them!). My fingernails continue to die back, but never all the way, and then they regrow. Still have some neuropathy in fingers and toes, which causes difficulty at times, but you learn to cope. (My dr. suggested Neurontin, which occasionally helps.) At times my fingers are so bandaged up that I look like a poor imitation of Michael Jackson. I must try the hyd. peroxide solution mentioned earlier for the nails - maybe this is just some type of fungus.
My hands do trouble me, but I've learned to work around them. Painful, but certainly worth the price of admission. Good luck to you all, and God Bless!
Agie
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Hi everybody, Seems like the S/E's don't want to end but change from one thing to another. I was on 4 AC and am now just had my 8th of 12 Taxol tx. My right large toenail came off about 4 weeks ago. The left large toenail will probably be off in about 2 weeks. Only a few of my finger nails have the "Beau's Lines" so far. AT the cancer center where I go for tx. they suggested vitamin e oil or tea tree oil for your nails. I keep saying I am going to try one but haven't yet.
LOL
Sandy
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Hi everyone,
I have had 3 FEC and just had my first Taxol a week ago and the side effects were awful - dry mouth, insomnia, no appetite, moody, aches and pains all over my body. Started to feel better yesterday and then I woke up with "burnt feet" so sore it hurts to walk. Have tried ice and massage with cream and would be really grateful for any other suggestions.
Good luck to all you amazing women out there - I admire you all for your courage.
LOL Fran B
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Fran, if that burning feeling in your feet is due to hand/foot syndrome (HFS), which can be caused by Taxol, you don't want to be massaging your feet.
Here's a website that provides a good explanation of HFS and what to do about it. This site does not mention Taxol as a possible cause, but I've seen other sites and articles that implicate both the taxanes (Taxol and Taxotere) in HFS: http://www.chemocare.com/managing/handfoot_syndrome.asp
Generally, what you might try, to reduce the chance of developing HFS and to minimize the pain and tissue damage when it does occur, is keep your feet cool (a bag of frozen peas works well for this); keep your feet elevated (good excuse to lounge in that recliner); don't do anything that increases blood flow to your feet (rubbing, deep massage, and even walking can be a problem); and apply a soothing, cooling, emollient-type cream (gently).
For a soothing lotion, some of us have liked "Udderly Smooth Udder Cream". My favorite version of that product was "Udderly Smooth Extra Care Cream--Unscented, with Urea." It's available at some pharmacies, or on-line at http://www.uddercream.com/ONCOLOGY.HTML).
Hugs...
otter
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Hello To All:
I came in looking for info on how long the bone and nail pain would last after my first Taxotere treatment and wow there are a few of you that sound like you have been right where I am now. It is day 10 after my first dose and I feel quite a bit better today but man have I had muscle and bone pain. The Cancer Centre told me that Taxotere would be much better than FEC but I don't know who they thought I would be better for! I had three rounds of FEC at a three week intervals on Fridays. The first was the worst I spent the weekend in bed vomitting. The second I was nausiated but only spent Friday and Saturday in bed. The third I spent Saturday at the mall! I lost all the hair on my head on days 16 & 17 after my first treatment. I have 4 children from 12 through 17 and they told me that other than being bald it was just like I had become a stay home Mom. I was baking all the time, cooking, cleaning, laundry, running them to soccer, school, curling and all the other "kid" stuff. I was the "best case" we had ever heard of. Then the doctors and nurses told me Taxotore will be "easier" on you than the FEC.
I got my first round and went directly out for lunch. Saturday we went shopping and running around. Sunday we spent a family day around the house and attended soccer games. Monday morning I woke up and felt like every bone in my body was being crushed and I had been in dream olympics as every muscle felt like it was pulled. How the heck do muscles in your face hurt??? I would love to rip my nails off as they are so painful, no more opening jars, cleaning or scratching my own body as it hurts too much. I am hoping that this will be like the FEC in each treatment there where less side effects but I don't thing I'll hold my breath.
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