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Long Term Effects of Chemotherapy

gdpawel's picture
Posts: 525
Joined: May 2001

When a new drug or procedure comes out and the people writing the report or article then badmouth the previous drug or procedure in explaining it. However, when this happens, it is usually possible to get very interesting information on company's products from various company websites. They are competitors of course.

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 that "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 much ballyhooed drug was no panacea.

The American Cancer Society, in its recent press release about a new breast cancer drug approved, mentioned 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. 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.

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.

hummingbyrd's picture
Posts: 961
Joined: Sep 2002

What's the answer? Where does one find the solution? We take what they have because it's all "they" will offer. I nearly died in 2000 from chemotherapy, quit it for 2 months, then resumed treatment at a lower dosage. Now it's 2005 and I'm back on chemo after fighting w/ my doc for 3 years. I had bone mets in 2001, radiated and stabilized till 2004. CEA got up to 465 normal is less than 3 and CA27.29 got up to 249 normal Mets possibly in lungs, liver and kidney. Praise God all functions and levels are normal, alk phos 109, big deal. My point is what are you suggesting? I know what happened to your wife and understand where you are coming from, but what is the alternative? Diet, water, vitamins, faith in God (that for me is the big one!) got me this far. They can't argue w/ my survival rate I'm already 2 years past what "they" would have given me IF I had taken chemo sooner. However I felt at this point it was my only solution. Interested in knowing what you have to say.

Posts: 1
Joined: Feb 2005

I'm a 12 year surviver. I had hodgkins in my chest cavity. It has been a long road to here. I am having more troubles in the last 4-5 months. I have begun to loss my speach pattern. I start to stutter and then I can not think of the right word, or I skip over words, running them together. It happen this weekend, but this time I also lost feeling and movement of my right arm. It is so surreal. My family has a very hard time dealing with this. This makes me so sad
What if this keeps on happening. What if it is permanet. They make me feel like I not trying to speak right. My husband says it all my nerves. I say that is right. He says just calm down. Inside I'm screaming; help me, do not leave me here by myself. If anybody is having problems like this please email me. This weekend it took about 2 days to get my speach back, it took 3 and a half days for my arm and hand and fingers to feel better.

gdpawel's picture
Posts: 525
Joined: May 2001

Unfortunately, this is indeed quite normal. It is estimated that maybe one in five people who undergo chemotherapy will experience what many cancer survivors frequently refer to as "chemobrain" or "chemofog." Women and men who experience chemobrain typically say that they feel that they are not able to concentrate, have a hard time remembering things, have trouble finding the right word when speaking or writing, or can't multitask the way they used to.

This type of cognitive dysfunction is a problem that cancer survivors have been talking about for years. Only recently, though, have researchers begun studying the impact of chemotherapy on cognitive functioning. But it's not an easy area to study. Part of the problem is sorting out which problems are due to chemotherapy and which are due to having a serious illness like cancer that can result in physical debilitation, depression, sleep disruption, hormone shifts (not just sex hormones, but thyroid, melatonin, etc.), and fatigue--all of which can affect cognitive functioning.

For older women, the impact of chemotherapy may be compounded by the natural aging process, which, in and of itself, can be related to the development of cognitive problems. There is some evidence that verbal fluency and word recall changes for some women but not others as they age and their estrogen levels fall. So it is possible that the problems some women think are due to chemotherapy might just be what they'd be experiencing anyway at their age and stage of life. For younger women, the cognitive side effects related to chemotherapy may be compounded by the fact that chemotherapy can put them directly into menopause, which in and of itself causes hormonal changes that can affect cognitive functioning.

There are a number of theories as to why chemobrain may occur. One is that some types of chemotherapy can cross the blood/brain barrier. Another is that the cognitive problems are created by free radicals, the toxic elements that many types of chemotherapy produce. And yet another is that some people have a genetic background that makes them more susceptible to the effects of chemotherapy. Most likely it is not just one factor but many factors that combine to set the stage for chemobrain to occur. However, we still have a lot to learn before we will be able to explain why this problem affects some people and not others or why these problems persist after treatment stops.

As the search for the cause of chemobrain continues, researchers have begun looking at ways to alleviate its impact. Studies now underway are exploring whether Ritalin, which is used to improve fatigue, or Procrit, which increases red blood cell count to improve energy can improve cognitive functioning. This research is still very preliminary, however, and these drugs should only be used as part of a clinical trial.

You should definitely speak with your doctor about the problems you are experiencing to try to rule out other causes. Your doctor should review with you whether depression, the use of medications that are sedating, or sleep problems that are causing fatigue could be factors in the cognitive problems you are experiencing. Developing coping strategies such as making lists, using a tape recorder or Dictaphone, carrying a personal calendar or diary, or taking notes during conversations can also be helpful.

Doing puzzles to stimulate your mind may be helpful. So can reducing stress--which not only can result from such cognitive problems but can also cause them--may also be helpful. Support groups, meditation, and yoga may offer benefits as well.

Posts: 1
Joined: May 2005

I was diagnosed with Large B Cell Non-hodgkins isolated in my abdomen with multiple large sites. I took 6 cycles of CHOP Regimin which I completed on April 17, 2005. I look forward to going back to work as an RN, but I am still having some trouble with remembering some stuff. I still am easily fatigued and nauseated every day. My blood sugar has shot up to 170's for first check in the morning. Does chemo affect blood sugar? If so, how long? Also, how long til I get my strength back? I was cleared to return to work on June 1st, but I have trouble just walking around in my yard with out feeling like I'm going to puke. Help!!!

Posts: 1560
Joined: May 2006


You may want to consider contacting the American Cancer Society's National Cancer Information Center. Cancer Information Specialists can assist you with your questions. They can be reached 24 hours a day at 1-800-227-2345 or by clicking on the "Contact ACS' link at the top of this page.

Take care and be well,

CSN Dana

Posts: 1
Joined: Jun 2005

not a cancer survivor here. Don't want to seem like I'm selling anyone a bill of goods. I've been working with my roommate from grad school days for the past year or so. He has reformulated the platinum complex drugs, cisplatin, carboplatin and oxaliplatin by putting them into liposomes with a PEG coating (sometimes called stealth liposomes). This makes the liposome as well as the drug invisible to the body and the immune system, for the most part. Since we are very small, we've been focusing on cisplatin, (since it appears effective against a wide range of cancers) which is now about 1/2-3/4 way through phase III testing in Europe and is showing some extremely promising results. The liposomes keep the drug in the circulation for a much longer period of time meaning the drug isn't deposited in all the normal body tissues which is what causes the toxic side effects. The other effect is that the liposomes are preferentially deposited at the location of the tumors and metastases. This is because tumors cause new blood vessels to form and these new blood vessels are rather leaky with tiny holes. The liposomes are small enough to leak through these holes. The liposome composition is such that they tend to be absorbed by the tumor cells. This causes a relatively high concentration of drug in the tumor cells and a relatively low concentration everywhere else in the body. The efficacy appears to be equal to cisplatin with greatly reduced side effects.

So far, we have seen virtually no toxic side-effects such ototoxicity, kidney toxicity, hair loss, etc. We still see some neutropenia at a very low level and vomiting, although generally these effects are seens at higher dosages of the drug. We hope to be approved by the EU within a year. We expect to start phase III trials in the US this year with possible FDA approval in 2006/2007. Our company name is Regulon.

Just wanted to let you all know that good things are happening. Hopefully will have more good news in the near future.

tiggertoo's picture
Posts: 26
Joined: Mar 2003

I was treated 3 years ago for acute lymphoblastic leukemia. During treatment and in the years since I have struggled with memory problems, not remembering things done the day before, repeating (many times) the same thing to my husband...etc. I have what I consider to be very few memories of my past. My siblings will have to be the keepers of our history, as I don't have much. :( I had blood sugar problems when I was on chemo and large amounts of steriods. I would run 300 even tho I was on a nutropenic and sugar free hospital diet (can you say YUCK) not too tasty! I think by the end of treatment your body chemistry is so out of whack that it has a hard time metabolizing anything from food to drugs. If your oncologists have cleared you for work but you are unable to be on your feet for extended periods (I am 3 yrs out and still dont have the stamina) then go to your primary care and ask for help with your symptoms. Are you on Social Security Disability? States have different rules on the application process but whether you are or are not, primary care docs can be your alli in maintaining disability coverage and in helping you to manage your long-term effects. Blessings to you and I hope this helps! Love, tiggertoo

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