Taxol Treatment - Numbness and Pains in The Legs

Five months post taxol, noticed joint pain, weakness in left hand unable to write well,leg pain in knee joints, hip joints, recommended therapy is pool therapy.

I hate to tell you this but I had Taxotere (10) treatments and finished in August 2002. I developed neuropathy in the bottom of my feet sometimes it burns and other times it is just numb. I have gone to 5 neurologists and have been given different medications, and they do not help. So far August will be three years and I still have the same problems. My oncologist thought it would go away, but it still has not. Hope that you do not have the same effect on yours. Please let us know how you are doing. I would be interested. By the way I did try the B6 and it did not help either. Good luck.

I had taxol (4 treatments)for breast cancer in the summer of l999. To date, I'm having lots of pain in my legs and get tired quickly when walking. I never had this problem before the treatments. The drs tell me it is not from Taxol but I disagree with them. I've been on many different meds for it and none have really taken care of the pain. I regret doing that chemo. I had the a/c kind first.

I had my last chemo Aug 31, 2004 and still have some foot problems. I had taxol and carbo for 18 weeks for lung cancer. I am now cancer free and only have some numbness and pain in my feet. My onocologist says it may take a year for it to go away completely and then I may have pain forever. But at least there is a forever. A little foot pain is better than alot of cancer. Also I have alot of curly hair now and my energy level is almost normal. The chemo was worth it. An occasion Lortab at night takes care of the pain when it keeps me awake.

Hi Delia
It sounds to me like you are getting the same treatment that I was given, back in 1998-99. (I also received Cisplatin, I don't know any of the dosages) I guess the main thing to note here is that I am still here. They believed that they got most of my tumors (both ovarian and uterine) out at the time of surgery (complete hysterectomy at age 46) . I was luckier than some on an early dx. But I too went through the 6 months of chemo. The leg pain I experienced was awful, I would wake up int he middle of the night from dreams that I couldn't walk or was walking in deep sand carrying luggage, or some other off the wall thing. The chemo made me progressively weaker in my arms and legs (could barely throw a tennis ball for my dog). Got heavy into bird watching, since it was about the only activity that didn't hurt, though it was hard to hold up the binoculars for very long. (When I mentioned my leg pain to my oncologist after treatment then, his comment was "well you're not getting any younger". Could'a punched him in the nose! lol) Got to where going up and down stairs was a real chore. The good news is I slowly got stronger and less pain as soon as treatment stopped. (Painted the whole outside of my old two story house for therapy.) I do still suffer leg pain and sciatic nerve pain that I never had before treatment. Still can't walk up a flight of stairs quite right. So, I recently starting taking some enzymes (Vitazym) recommended by a friend and low and behold I haven't had any sciatic pain. Maybe you should give some a try earlier on, instead of waiting years like I have. These are some very strong chemicals being used in our therapy and I don't think anyone really knows the long-term side effects of this stuff (though a good one was that my hair grew back thicker than before) and yes I have aches and pains I never had before among other things, but most importantly I'm still here 7 years later. I wish you a long future of roses, with very little thorns! Cassiesue

Neuropathy is 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 groups 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 damaged 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).

12 months ago I took 3 rounds of Taxol and Carboplatin for Ovarian Cancer stage 2, which we hope has erradicated the Cancer. Since surgery (complete hysterectomy) and chemo, I have been feeling extremely old (I'm 51). I have achiness in my lower legs in particular, especially when I sit for extended periods of time. It seems to fit the description of "restless leg syndrome" that is see described in a TV commercial.

I am very, very slow in getting moving in the mornings. I do pretty well midday, but evenings start the "old" feelings again.

I have always loved walking and it is my preferred method of exercise. Now, I have to struggle to walk one mile, and really push to get a second mile. Instead of making me feel better and return to normal as I had hoped, I feel so drained afterwards, I just have to stop everything for a while.

I saw some hope that chemo long-term side effects will gradually disappear, but I'm starting to doubt that. For the last couple of months, I have been taking Glucosamine and Chondrotin at the recommendation of a friend, and it may be helping a little, but I'm certainly not back to normal. I had hoped that after the one-year mark, I would be back, but it just isn't happening.

I do appreciate this message board and reading what others are expericing. It does sound like we need to be firm with our doctors in convincing them that the after effects are real!

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).

Paclitaxel (frequently sold under the brand names Taxol and Onxol) is a widely used chemotherapeutic agent for cancers of the lung, breast, ovary, esophagus and other types of cancer and it has been a generic drug for the last three or so years. Paclitaxel is known as a taxane type of chemotherapy drug.

Docetaxel is another widely used taxane drug (sold under the name Taxotere) 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.

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. Platinum drugs, such as cisplatin and carboplatin can cause significant side effects, including nerve damage (neurotoxicity), nausea, vomiting, and bone marrow dysfunction.

Nerve damage has been reported for all doses and administration schedules of platinum drugs, but no effective therapies are available for the prevention or treatment of platinum drug-induced nerve damage. There is a drug, Tavocept, that is aimed at preventing or reducing common and serious side effects, particularly nerve and kidney damage, associated with taxane and platinum drugs.

My wife was inflicted with leukoencephalopathy (a form of diffuse white matter injury that can follow taxol chemotherapy), confirmed by an unenhanced/enhanced MRI. Leukoencephalopathy syndrome is a disorder that results from structural alterations of cerebral white matter, is characterized by cerebral edema, and can occur in patients of any age. A diagnosis must confirm exposure to a toxin and the presence of neurobehavioral deficits and neuroradiologic abnormalities.

Leukoencephalopathy is a structural alteration of cerebral white matter. You simply do not give another drug and it goes away. At best, cognitive rehabilitation on an outpatient level is about all one can hope for. For older women, the impact of chemotherapy may be compounded by the natural aging process (she was 65). At the time, we tried exploring with Ritalin. Another drug that can be explored is Procrit. However, after further complications happen (radiation necrosis), we were not able to find if Ritalin was effective.

Also, Cremophor is a toxic solvent used to deliver taxol. It causes severe allergic reactions, like nausea, vomiting, joint pain, appetite loss, brittle hair and tingling sensations in hands and feet. To avoid those reactions, patients are given steroids before receiving taxol, but steroids have their own side effects. Cremophor requires special intravenous tubes for delivering because it can leach the plastic off normal tubes.

There are a number of theories as to why this infliction happens. One is that some types of chemotherapy can cross the blood/brain barrier. Another is that the problem is created by free radicals, the toxic elements that many types of chemotherapy produce. And yet another is that some people have a genetic predisposition that makes them more susceptible to the effects of chemotherapy.

I was diagnosed with Stage IIIC Endometrial Cancer in August 2003 at age 41. After surgery, I endured 6 weeks of external radiation and only one internal radiation treatment. I had full pelvic radiation and radiation to my upper abdomen because cancer cells were found in the para-aortic lymph nodes. From the very first radiation treatment, I have suffered from chronic diarrhea - this condition is going on three years.


Following radiation, I went through 6 rounds of chemo. I was enrolled in a clinical trial and was assigned the arm that required I take Adriamycin and Cisplatin on one day and Taxol on the second day. This was repeated every 3 weeks.


I immediately had tingling in my feet after the first treatment, but my oncologist could not believe it was the chemo. Two weeks after the first treatment, I had a severe pain in my upper right abdomen that lasted a couple of hours. I went to the ER and tests did not reveal anything. The next day, I saw my oncologist who could not find a source for the pain. On the way home, the pain returned, and I thought I was dying. I called my doctor who told me to stop at the ER, and he would call in orders for a CT -which again revealed nothing. The pain stopped but returned 8 weeks later - on the morning of my 4th round of chemo. Since my oncologist could not find anything, he sent me to my PCP who ran tests for gallstones.


The ultrasound showed a bag full of gallstones. My surgeon wanted to wait until I finished all the chemo, but my oncologist insisted I have the surgery. After the surgery, the pain left.


The tingling and numbness in my feet began to worsen after the chemo was finished, and it began to spread to my legs. I also developed a severe case of vertigo fours days after my last chemo treatment.


By the time I was able to see a neurologist, the neurpathy was extremely painful. My ENT doctor had sent me to physical therapy for the vertigo.


To deal with the chronic diarrhea, and my oncologist sent me to a GI doctor. He has determined that the radiation has caused me to have radiation enteritis and radiation colitis - in his words "the radiation cooked your intestines."


My neurologist did a test on my legs that showed I have permanent nerve damage to the sensory nerves in my feet and legs - causing peripheral neuropathy. She has yet to find a medicine that I can tolerate. I went through 13 anedyne treatments this past winter which gave me some temporary relief. However, the numbness, pain, and tingling are as bad as ever. I recently had a neuroma removed from my right foot which helped with some of the pain, but I know my feet and legs are always going to be numb and painful.


Six months after my chemo ended, I had returned to work and was in the middle of teaching my U.S. History class when the terrible abdominal pain returned. That was November 8, 2004. For the next 18 months(24 hours a day/7days a week), I have been in pain, and none of the 11 doctors I have seen knows what to do. Ten out of the 11 say it has to do with the radiation and/or chemo, but the oncologist says "no way."


I have had every GI test available and the results do not show anything that could cause the pain. I have seen a pain specialist who has tried several nerve blocks - a celiac plexus diagnostic block, an epidural steriod injection, and an intercostal nerve block - and they only make the pain worse. I have even tried Durgesic patches who no relief. My GI doc thought it could be scar tissue and talked his personal surgeon into doing exploratory surgery. He found a couple of adhesions on my liver but said they could not have caused the pain. The surgeon said he thought it was neurological. An MRI showed a herniated disc at T8/T9 so my neurosurgeon offered surgery but could not guarantee it would help the pain - which it did not.


For the past two months, my doctors have had me in a "let's wait and see if it gets better" mode before they try something else. Of course, it is not better.


Between the neuropathy, the chronic diarrhea, and the chronic upper abdominal pain, it has become impossible to work. I had 4 surgeries this past school year and have been on sick leave since March. I can only eat one meal a day if I want to get anything accomplished.


Every time I see a doctor, they all assure me that this pain is not from a cancer recurrence. To be honest, I have been in pain for so long that I would welcome a cancer recurrence - at least I would know what I am dealing with and would have a treatment course to follow.


I feel like my doctors do not take me seriously. If one of their family members presented with my symptons, I am sure they would move heaven and earth to find help for them. I have told them that I feel like a hypochondriac, but they assure me that they believe I am in pain. The only thing is - no one wants to take the lead on this, and they keep passing me back and forth to each other.


Although my doctors are not sure what is causing the pain or how to treat it, I am very positive that the pain is an "after-effect" of the radiation and chemotherapy. I also have ocular migraines where flashes of light go across my eyes and I cannot see for about 30-45 minutes (try dealing with that while teaching high school students). The vertigo returns every six months or so. I have constant ringing in my ears and have trouble hearing what people say more and more. I get very little sleep because of all these problems.


I always said if I ever had cancer that I would not go through radiation and chemo, but at the time of my diagnosis, my doctor insisted that I was too young not to do this. Had I known about all the after effects, I might have passed and just took my chances. I believe quality of life far outweighs quantity of life.


At 44, I cannot imagine enduring this abdominal/thoracic pain, the neuropathy, the digestive problems, and everything else for 20 years, for 10 years, or for 5 more years. I have not had a pain-free day in over 4 years.


Next week, my 2-month moratorium is up, and I see my neurosurgeon to determine what, if anything, can be done to help me. Pain pills have not helped (and the ones I could tolerate at first have recently caused allergic reactions).


If I were Barbaro, they would have shot me right there on the track.

Hi Margo
I know exactly how you feel;I have been,going crazy with extreme aches and pains in the legs and feet,Now I have the feeling of wet feet,and cold legs below the knees.I had agressive chemo for breast cancer that was in four out of 12 lymph nodes.I received agressive chemo and radiation.The worst of the chemo was the last rounds with taxotere it seemed to affect my kidneys to.I can't drink anything after 6pm at night,or I will be up to the washroom at least 4 times.I also have chemo brain I really have a hard time getting my thoughts together. and remembering how to spell.It will be 4 years august 14th that I had my breast removed and it will be 4 years february since I finished treatments.I'am also on a drug called arimidex,a hormone treatment drug.I put on 44 pounds when I was on taxotere because of the steroids they give you before and during treatment.I use to get extreme pain in the back of my ankles, when I walked.it would almost bring me to my knees,not so bad now.everyday seems to be something knew. good luck with your walking Its the only thing that is keeping me sane.