Chemo side effects and countermeasures Paper by Ludwick P

I wanted to post this paper of Ludwicks from the old HRPCA site which is closed and it is copied from some htlm files I have , see if it works


Tx: Taxotere - eliminated from body –excreted – in first 3 days – residual in the cells


Allergic reactions hypersensitivity reaction,

especially during the first

and second infusions

Hypersensitivity reactions

may be signaled by very

rapid onset of itching/

flushing, redness / rash of

facial skin, palms of hands

and/or reddening and

itching of whites of eyes


Blood pressure may fall

rapidly (hypotension)

and/or you may feel

bronchospasm (inability

to breath).

According to the

manufacturer, this allergic

reaction occurred in 2.2%

of 92 patients

premedicated with 3-day


*** stop

Nausea Vomiting * Zofran (constipating)

* Marijuana pills

Infection Symptoms



WBC low neutrophils Temp oral over 100.4 F

Temp EAR over 100.4 F ?

(RR 2 to 7.5)

* Emergency Dept

* Antibiotics

* NO dental work

* Neulasta (Neulasta caused paralytic pain 2nd

cycle - Percocet helped the 3rd cycle)

Granulocytopenia * G-CSF Neupogen (Filgrastim)

Bruising Bleeding Low Platelets PLTS <20 (RR 380)

Easy bleeding

* Numega (Oprelvekin)

* Transfusion

Anemia Low HGB below 120 * Aranesp, Procrit, Epogen

(Erythropoietins alpha & beta)

Fatigue Chemo build up with


* Rest more

Diarrhea * Immodin-AD, Lomotil

* Low fibre food & avoid gas

* Not longer than 24 hrs – action required

Constipation * Colace & Senekot

* Citrucel better than Metamucil (gas)

*Up fibre & fluid & exercise

* Not longer than 3 days – action required

Embolism & DVT Postive D-DIMER test * Action needed

Heartburn * Antacids


Tx: Taxotere - eliminated from body –excreted – in first 3 days – residual in the cells

Bowel inflammation * Low acid foods

* Bentyl for the stomach discomfort caused by

the decadron

Mouth sores

/ throat irritation

tumor acts as a

‘glutamine trap’

depleting the host of

glutamine and resulting

in cachexia (weight


body’s need for glutamine

can increase dramatically

following injury, infection,

or the progression of

cancer and in these cases,

the need for glutamine can

exceed the ability of the

body to supply it;

glutamine is one of the

major energy sources

needed for the

gastrointestinal tract cells

to recover from


* Rinse salt/baking soda mixture

* Avoid metals

* Antiviral Herpes labalis breakoout

* Ice in mouth during infusion

* Glutamine rinse mouthwash 2 X/day

* Oral glutamine (as a mouthwash)

glutamine seems to prevent gut and oral toxic

side-effects, and may increase the effectiveness

of some chemotherapy

* 10 g X 4/day during any chemotherapy


* Glutamine heaping teaspoon full twice a day,

except the day of chemotherapy

(Glutamine is a white powder that doesn't

dissolve well. Stir well and use a cold to warm to

hot liquid when mixing it. The decomposition

temperature of glutamine is 185ºC)

* infusion of ethyol with each chemotherapy -

No problems with my

fingers -- only toes.

Muscle pain Joint pain

Hair loss * Rub head with contents of 4 to 6 Vit E pills -

(w olive oil) - night before, night of and night

after chemo - just before bed and cover head in

tee shirt to control messing sheets

* 2 x 200cc carrot juice, 2 x 300 cc cabbage

juice + turmeric - didn't loose hair with juicing.

Edema / swelling DVT???

Hand / feet ?

Dry skin

Skin irritations - Rash

* Vit E

* Aquaphore for feet and hands (dry skin)

Eye tearing * Eye drops four times a day for dry eyes

* night before, night of and night after chemo -

few vit E pills rub over eye lids - to protect tear


* any glaucoma, prednisone may increase your

intraocular pressure

Nail changes * Ice on finger nails during infusion

* Vit E pills rub onto fingers and toes - to protect

nails - night before, night of and night after

chemo - repeat for a couple or three nights

again mid-cycle, around day 10.

Nose bleeds * bioflavinoids to reduce nose bleeds


Tx: Taxotere - eliminated from body –excreted – in first 3 days – residual in the cells

Tingling ?

Tremors ?

Sleep Problems * Melatonin

Weakness Anemia?


Emotional Low E2 ? * Estradiol patches or gel

Photosensitivity ?

Odd sensations ?

TAXOTERE 75 mg/m2 every 3 weeks

+ prednisone 5 mg twice daily

Number of men in trial = 332

Side effect

Anemia Low hemoglobin (red cell) count. If severe may cause fatigue. Can be treated with Procrit®,

Aranesp®, or blood transfusion.

Neutropenia - low neutrophil (white blood cell) count. Makes you more vulnerable to infection. May lead to

treatment interruption until counts recover. Can be treated with Neupogen® or Neulasta®.

Thrombocytopenia - low platelets (the cells that form blood clots that stop bleeding). May cause purple

blotches on skin especially at site of injections. Chemo will be interrupted (delayed) if platelets fall below a

certain level. Severe drop (not common in this trial) may bring on a medical emergency (bleeding) requiring

hospitalization and platelet transfusion.

Febrile neutropenia - fever and a significant reduction in white blood cells. Any temperature over 100.5 F

(Fahrenheit) or 37.5 C (Celsius) should be reported to the medical oncologist without delay and you should go

to the ER (Urgent Care) for work up and antibiotics.


Epistaxis (nosebleed)

Allergic Reactions, Hypersensitivity reactions see below

Fluid Retention*

Peripheral Edema*- Fluid retention and swelling in feet, ankles, legs or arms

Weight Gain*

Neuropathy Sensory- Nerve damage causing tingling or pain, usually in feet or hands


Tx: Taxotere - eliminated from body –excreted – in first 3 days – residual in the cells

Neuropathy Motor - Weakness but no tingling, pain or numbness. Cramps or muscle twitching may be


Rash/ Flaking skin

Alopecia - Hair loss

Nail Damage -- keeping finger tips and toes in ice water during the chemo may help. See "Frozen Glove

Reduces Skin and Nail Damage from Docetaxel Chemotherapy" (NCI)



Stomatitis/Pharyngitis - mouth sores

Taste Disturbance may be a metallic taste


Anorexia - weight loss from lack of interest in food


Dyspnea shortness of breath

Impaired cardiac left ventricular function


Arthralgia joint pain

Myalgia aches and pains, muscle pain

Irritated, teary eyes

use artificial tears during and after each treatment to flush the Taxotere from the surface of the eye to prevent

this problem.

If it persists, tearing can be relieved by a tiny silicone tube inserted in the irritated tear ducts. If you are taking

Taxotere and your eyes tear too much, tell your cancer doctor and get checked by an eye doctor who has

experience placing these tubes.

8 Replies

  • Good Lord! I start my second month on chemo next Wednesday, and so far have felt zero side effects even without any counter-SE drugs. Every function and perception I can think of is normal, with zero need for nausea drugs, no taste effects, no observable changes but two, and they are not new:

    • A LITTLE lower leg edema, not normal but nor is it new to chemo.

    • Two non-painful ulcerated-looking spots on my throat, both of which disappeared spontaneously in a couple of days.

    By FAR ... heck, infinitely ... the main impact has been the 100 hours per week I spend juggling 18 confusing new meds, dealing with pharmacies and insurers and government red tape (for the thalidomide), getting endless scans and tests to tweak my meds by the week and month, and many-times-a-day emails to and from my oncology nurses and staff managing all the above. (One example: I cut my out-of-pocket costs for my thalidomide from >$20,000 to $20 for a 90-day supply. That's worth a hundred-hour week.)

    Now you've got me waiting for the other shoe(s) to drop! :)

    I fully expect the fatigue (just the ADT should do that), but that is based largely on our red blood count which takes several weeks to drop from chemo, and serious whole-body exercise should also mitigate it.

    OTOH, a bud who just began chemo is the poster boy for almost every SE you list. He isn't sure he can keep going. I can think of two explanations for the difference in reactions:

    1. The bell curve.

    2. Leibowitz's more frequent but lower doses.

    I will be advising him to ask his oncologist to begin #2. She has administered it with incredible success to other patients who were ready to quit chemo, but like almost all medical oncologists, seems stuck on this 75-mg taxotere torture plan until patients demand relief. I've been told that there is no basis for the 75 mg dosage, that it was plucked out of the air (or some darker place) decades ago and has never been scientifically compared to lesser doses.

  • Its great to hear you are not having the side effects, if you have not had then by now not likely you will, some Men have a hard time, fortunately you do not. I just posted these to link an older generations research to the present group.And to make Ludwicks research more permanent in an open group.

  • Oh, I fully support your post; no explanation needed. MOST PubMed studies deliberately hide SEs, because they impact drug approval and sales. Heck, many of our oncologists hide them, don't know them, or flat lie about them. The victims? The public, right down to the individuals like Joe Kam who get so upset when SEs are mentioned. Can you imagine not being informed that, or even being lied to about, some treatment is almost guaranteed to give you drastic, maybe even life-threatening, SEs for very little benefit?

    As for my escaping SEs, several chemo SEs take many weeks to appear (the mechanisms and delays are well understood), and some don't appear until long after the chemo is over. I'm making no assumptions, and plan to keep on keeping on as usual, watching very closely for the worst, most common, most irreversible SEs such as cognitive impairment, neuropathy and breast pain. Neuropathy, for example, can often be averted and mostly reversed IF caught before it reaches mid-foot, saving us from a wheelchair. But how many patients and doctors know this and act in time to prevent it? I check my fingers and toes every morning for signs of nerve damage.

  • Interesting. I was told it goes by weight and bmi and stays the same through treatment. I asked if it was a one size fits all approach and the answer was no. Was I misinformed. Good luck with chemo. 2 down. Yes for my dad it git harder in the end but I've spoken to guys in here who had do few side effects. I would use All preventative measures to protect the nails, tear ducts, hands and so on most of all the liver and kidneys. My dad refused to do any of this. Be grateful rt now that you aren't suffering and know that should symptoms worsen you will prob. Be close to done. It seems every guy has one cycle that is the big ouch but you have a long life ahead and this is but 18 weeks of it. Do I'm sending god thoughts and live lieb. Approach. Your knowledge Alone has you well protected and ready to stroll through this. Best regards, Erica

  • Erica, Thank You for the kind words. Chemo is as you say it goes by the weight and BMI, in fact when I gained 8 lbs between second and third , I had a slightly higher dose.I am thankful every day for all I have been given.


  • I am happy to be in a group with so many people who advocate so well for themselves , like you and many others come to mind.

  • Ty very helpful wish I had this info about that ducts. My dads 6 cycles are over but his eyes continue to tear. Any suggestions or he than wetting drops. I assume the ducts were burned by chemo in the cells? Does this effect stay?

  • I am not sure if it does or does not, I have never had, but will remain aware of the possibility. I will search some other groups to find more information

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