Edema with Advanced stage 4

[Sipj]

Edema. Should we worry? My husband has gained about ten pounds on his 174 lb frame in the last few days. Legs, ankles and buttocks are swollen, tight, and sometimes painful. He is trying to stay active but every time he does anything on his feet this kicks in. I have a message in to his doctor but being the weekend I’m sure he won’t respond. His last docetaxal infusion we mentioned swelling in his one ankle and MO said it was fine…

Wondering if anyone has thoughts on what is causing this and how concerned should we be?

HX: finished sixth docetaxal infusion December 2. Lupron injections every 3 months, next one due this week. Advanced prostate cancer Gleason 7-8, Mets to bones throughout from skull to bilateral femurs. Scans last week showed no progression to soft tissue/organs and “sclerosis” around his bone Mets (says due to scarring-healing) PSA 1.7 (down from original 350). Palliative radiation to bilateral hips 10 times finished October 19. Currently taking Oxycodone and Fentanyl patch for extreme bone pain Original PC diagnosis 2/20/21- already had spread to all bones

Thank you as always for any advice.

[Tall_Allen]

Glad the chemo has set back his mets. Edema is a known side effect of docetaxel. Hopefully, it will diminish over time. I'm sure the doctor told him to keep his legs elevated and wear compression stockings.

[Javelin18]

In my opinion you should go to the ER , and not wait for your doctor to respond. It sounds serious enough that you need a doctor to examine him right away. Rapid weight gain and swelling of the lower body can be a symptom of congestive heart failure.

mayoclinic.org/diseases-con...

[Sipj in reply to Javelin18]

We talked to doctor on call via phone. He said if he is in pain to my to ER. He is just uncomfortable. I was worried about CHF too…he has no shortness of breath or breathing issues but I’m still worried. Swelling has gone down but not all the way and still comes and gos. Doctor talked about diuretic but pharmacies are closed until tomorrow.

[CAMPSOUPS in reply to Sipj]

I assume he was taking prednisone thru out chemo and probably dexamethasone the day before, day of, and day after each infusion.

Is he still taking prednisone?

Did he stop prednisone abruptly?

Or did his dr. consult as to incrementally reducing and eventually eliminating the dosing of prednisone?

As was said chemo itself can cause edema and my pea brain assumes a abrupt stop of prednisone if it occurred might exacerbate the edema.

[Sipj in reply to CAMPSOUPS]

He has never taken prednisone. Dexamethasone yes.

[CAMPSOUPS in reply to Sipj]

Well was he taking it daily and when he stopped did he stop abruptly ?Might be something to discuss with the dr.

[Sipj in reply to CAMPSOUPS]

Dexamethasone only three days during chemo.

[CAMPSOUPS in reply to Sipj]

Thanks. Nevermind I guess lol.

You never know.

I do hope you can see the Dr. soon and find some relief.

[Sipj in reply to CAMPSOUPS]

Thank you though!

[12Leo in reply to CAMPSOUPS]

The same thing happened to me. Unfortunately it was my kidneys that were shutting down. Have been on dialysis for 3 years now. Peritoneal dialysis is the only way to go. Hemodialysis will kill him as it almost killed me the 3 months i was on it

[Sipj in reply to 12Leo]

I am so sorry. We lucked out, apparently it was the effects from docetaxal....prayers for you and I hope you are having some relief.

[Javelin18 in reply to Sipj]

Glad you were able to talk to the doctor.

[Boywonder56]

Im on lasix...plus my my bp med has diuretic...i you pee alot but that how you reduce it...

[London441]

If he is ‘trying to stay active’ but can’t be on his feet, then can he swim, or use a rower or recumbent bike? Stretching, light calisthenics, anything helps.

Not moving at all is unsustainable, especially paired with opiate use. The constipation alone can be brutal. At the very least, on Lupron his muscles will rapidly deteriorate to the point he won’t be able to move even he wants to, and you definitely don’t want that.

[Sipj in reply to London441]

He is the type of guy that staying active is hunting, fishing and doing things for the house. He is trying to do that. But it is sounding like he may need to be doing something in addition to keep his muscles going. This ADT thing is another beast. His fatigue is pretty extreme already. It takes everything for him to walk up the stairs sometimes.

[London441 in reply to Sipj]

It is common for men on ADT to default to doing nothing if they become unable to exercise in their preferred, habituated manner. This is tantamount to being suicidal. Time is running out, and he definitely needs to do something.

This is obviously not easy to do, and I’m sympathetic to his situation. However, the consequences of totally giving into the fatigue at this point are hideous and should be avoided no matter what.

[jersy]

Very sorry for what you are both going through. Have they considered Zytiga for your husband? I was also Stage 4 when diagnosed with Mets throughout skeleton, and Zytiga knocked it back to undetectable PSA and mild side effects, going on 3 years. Good luck and kind thoughts for you both.

[Sipj in reply to jersy]

No that has not been added yet. It may be the next step? He just finished docetaxal and is still castrate naive. I will put that on my question list for appointment next month.

[CAMPSOUPS in reply to Sipj]

jersy has a good point. I was thinking about the edema and not his treatment of PC.

I assume your Dr. is aware of the recently completed PEACE-1 trial that shows benefit of Zytiga with or soon after Dox chemo. You could mention this to his doc.

[Sipj in reply to CAMPSOUPS]

Good to know not has been a week and a half post chemo and we have an appointment in January. Definitely will bring that up.

[HopingForTheBest1]

There are specially trained and certified physical therapists that treat lymphadema; covered by health insurance. I have lymphadema due to removal of multiple lymph nodes as part of my prostate surgery. It definitely helps to control the swelling.

I was also provided a pump from Tactile Medical that massages my legs and thighs, which I use at home for an hour each day. Covered by insurance too.

[Hidden]

After my sixth round of Docetaxel, I had bad edema. It is known to happen. I took lasik and kept feet elevated as much as possible. It dissipated after a few weeks.

[Sipj in reply to Hidden]

Thank you. That’s good to know there may be an end. MO did not want to add lasix as it lowers BP and his is already very low. Hoping it will clear up soon.

[MastersApprentice]

I recently am getting over edema from my 1st Lupron shot given 1 day before Thanksgiving. I have had edema, muscle aches, and muscle loss. I will not take another 3 month Lupron, but will take 30 days at a time.

What is happening to cause edema is that your kidneys cannot process all the poison and are backed up along with your liver according to Traditional Chinese Medicine (TCM). When water cannot be processed through the kidneys your legs act as an overflow reservoir. This causes your skin to stretch and cause pain. The cure for me, aside from almost wishing I never took the 3 month dose, was to be acupunctured for the kidneys 2X a week, In 1 week swelling went down.

The muscle pains according to TCM is from liver fatigue as your body processes the medicine out of your body. You need to supplement the liver too.,

To me I am healing so I have to look at the benefits and realize these side effects are part of the game. But the acupuncurist and my supplement associate are key to my team with my Urologist and oncologist.

Just my take.