Taxol side effects -legs weakness

I was devastated to find that at the conclusion of chemotherapy, side effects and debilitation actually increased markedly for a number of weeks, but please tell your friend not to be discouraged. It does subside in time. I was unable to continue working in an extremely physically demanding job during chemotherapy, but did succeed at returning full-time 7 months following the final cycle. Others have reported being able to take that trip to Europe within the same time line.

Try typing the word EYELASHES into the search box above to see whether a series of messages related to eyelashes and taxol & taxotere is still accessible. Apparently, there are 3 rows of eyelashes that come and go for quite a while for those of us who have received taxol or taxotere, causing tears and eye irritation. This, too, disappears in time.

Hugs,
Denise

I can empathize with all who have been through the Taxol course- I only had four treatments with Taxol and had leg weakness (esp. knees) and neuropathy in fingertips and feet. I still have neuropathy in my feet and the cold weather makes it seem worse. I found that gel insoles in my shoes help enormously. Also, I found it interesting to read your post DeeNY711, about the eyelashes. Since I've been off chemo (about 8 months since last round), I still notice my eyelashes coming and going. Strange...

Neuropathy, a problem that sometimes occurs with chemotherapy treatment. It's not all that rare, especially frequent in patients older than 65 years of age. It is damage to the nerves. It can occur from some chemotherapy drugs used in conventional cancer treatment.

There are three major goups of nerves in the human body, the peripheral nerves that carry information to and from the limbs, the nerves that supply the bowels and other internal organs, and the nerves of the head which connect to the ears, eyes, taste buds, etc. Nerves in any or all of these major groups can be affected by certain chemotherapy drugs.

Nerves are vulnerable to many kinds of damage. They can be damaged by certain cancers. This may be caused by the cancer cells producing a particular kind of biological agent that interferes with the function of the nerves. Sometimes, they can be damged by drugs used in chemotherapy treatment. The chemotherapy drugs that most likely cause nerve damage are the vinca alkaloids(vincristine, vindesine and vinblastine), platinum drugs(cisplatinum, carboplatinum) and the taxanes(taxol, taxotere). These drugs have the potential of interfering with nerve function.

You may notice symptoms in different areas of your body depending on which groups of nerves are affected. Symptoms in the hands and feet happen when peripheral nerve damage happens and are not rare with vinca alkaloids. The first sign of nerve damage is usually a feeling of tingling and numbness like what you experience when your foot goes to sleep after you've been sitting for a long time in an uncomfortable position. If the problem progresses further, it often produces weakness of the muscles, resulting in loss of strength at the wrist or the ankle. You will notice difficulty in doing up buttons and picking up coins. You may notice that you will tend to trip while walking up stairs or dragging your feet and tend to have a wide-based gait. In severe cases, the weakness may be so severe that you will need a wheelchair.

When the nerves in the bowel are affected, constipation is the earliest sign. In a few people, the abdomen becomes bloated with a distended bowel that is basically paralyzed. Some of the nerves in the head can also be affected. Platinum drugs can affect the auditory nerve and cause loss of hearing and tinnitus(ringing in the ears). Vision can very occasionally be affected.

A lot depends on how quickly your cancer treatment can be stopped. Sometimes the need for treatment is more urgent then the residual nerve damage. Sometimes, the balance between benefit from the drug and the side effect of nerve damage is more finely balanced.

Once treatment has been stopped, recovery is usually slow. It may take months to get even partial improvement and often there will be some residual impairment, either a motor weakness or a sensory numbness or both. Recovery is slower in the feet and legs than in the hands and arms.

There is no specific treatment that enhances nerve recovery. There are no drugs that will directly stimulate nerve regeneration or recovery. If you have severe and prolonged pain, then the pain may require narcotics often combined with antidepressants. In some cases, certain types of anticonvulsants would be helpful. Treatment options are subjects that you should discuss with your doctor, so you have accurate expectations of potential benefits and side effects.

Chemotherapy drugs that can cause neuropathy. NCI lists these as most likely to do so:
Cisplatinum (Platinol)
Carboplatin (Paraplatin)
Vincristine (Oncovin)
Vinblastine (Velban)
Etoposide/VP-16 (VePesid)
Cytarabine (Cytosar, Ara-C)
Hexamethylmelamine (Hexalen)
Suramin
Paclitaxel (Taxol) and Docetaxel (Taxotere)
Other medications reported to contribute to neuropathy include oxaliplatin (Eloxatin), gemcitibine (Gemzar) and thalidomide (Thalomid).

Taxol is given into a vein, but in order for the body to absorb the drug, it must first be dissolved in a solution. Taxol's history began fourty-three years ago. It was found to be virtually insoluble in water. It had the solubility of a brick. The compound wouldn't dissolve very much in any solution. Without a way to get it into a cancer patient, what good was it? It was discovered that something Taxol would dissove in the "might" work in a reasonably "safe" intravenous solution in humans. It was an elixir made of castor oil and marketed as Cremophor EL. It was the "only" answer (until synthetic compounds were introduced like Taxotere). However, this castor-oil carrier is suspected as the culprit behind the misery which includes nausea, vomiting, joint pain, appetite loss, brittle hair and tingling sensations in hands and feet (neuropathy).

The American Cancer Society, in its press release about a new breast cancer drug approved, mention that the solution can cause dangerous allergic reactions in many people, so patients "must" first take other drugs like steroids and antihistamines in "hopes" to prevent a bad reaction. The solution can also leach chemicals from regular plastic tubes used to deliver medication, so Taxol must be given through special tubing.

The new drug for breast cancer (Abraxane) is a new form of Taxol (Paclitaxel), which is also a widely used breast cancer drug. Taxol side effects can happen in any cancer. Abraxane does not need to be dissolved in the castor oil solution and does not require special equipment to be given to patients. However, more of the women on Abraxane had numbness and tingling in their hands and feet. And more suffered nausea and vomiting, diarrhea, muscle and joint pain and anemia.

Some taxane-induced side effects are so common, and in some instances so severe, that patients and their physicians may delay treatment, reduce the dose or discontinue therapy altogether. While medications designed to prevent or treat nausea, vomiting and decreased white blood cell counts are available, there are currently no treatments for other serious taxane-induced side effects, particularly nerve damage.

Now, Bionumerik, in boosting its new drug Tavocept, that is aimed at preventing or reducing common and serious side effects, particularly nerve and kidney damage, associated with taxane (Taxol) and platinum (Carboplatin) drugs, talks about in their literature that chemotherapy-induced toxicities are common and serious clinical problems that adversely impact both the quality of life of cancer patients and the ability of patients to continue treatment for their cancer. Very little has been accomplished to prevent or reduce chemotherapy-induced toxicities such as nerve damage (neurotoxicity), kidney damage (nephrotoxicity) and hearing impairment (ototoxicity). But now they have another new product.

Docetaxel is another widely used taxane drug (sold under the name Taxotere® by Aventis) that is used in the treatment of cancers of the lung, breast, ovary and other common cancers. Despite the broad antitumor activity of taxanes, their clinical usefulness has been limited by common side effects such as painful nerve damage (neurotoxicity), reduction of white blood cell counts, liver damage, allergic reactions, nausea and vomiting, and other toxicities. For example, it is estimated that over 50% of patients receiving paclitaxel experience some form of drug-induced nerve damage.