Chemo affecting kidneys

[Unfortunate45]

Hi there,

My mum had her first round of chemo (cisplatin and pemetrexed) two weeks ago for her stage IV NSCLC and has since been hospitalised (with complications of her cancer - pleural effusion and blood clots) rather than the chemo and she is going home in a day or two.

All the doctors had said the complications shouldn’t affect her next round of chemo until yesterday when a respiratory doctor said that apparently the chemo ‘nearly killed’ mums kidneys and as a result she won’t be able to have any more of that type and her treatment options will likely be ‘very limited’ but then qualified this by saying she isn’t an oncologist and it would be up to the oncologist to decide but we aren’t seeing them for a week.

I guess my question is whether anyone has had experience of this? Mum’s kidneys were strong and healthy going into chemo, she is in her 50s and was very fit prediagnosis - surely there will be a type of chemo that is not so harsh on the kidneys? Surely they can’t give up on treating her? I don’t know how we are supposed to wait a week to find out what options she has

Thank you

[Jenniferroseolson]

Call and talk to the oncologist’s nurse. You likely won’t get a definite answer until they see a new round of bloodwork, but it could give you a better understanding.

[danielleGO2 Partner Administrator]

We are so sorry to hear that she is going through this. Has your mom had all of the genomic profiling to look for possible mutations that have a corresponding targeted therapy?

[Unfortunate45 in reply to danielleGO2]

Hi yes she has, she is only 5% matched for one of the immunotherapy options but that was the most I think

[danielleGO2 Partner Administrator in reply to Unfortunate45]

OK, so no EGFR, ALK, ROS1, BRAF, NTRK or MET? If not, I would talk to her doctor about switching chemo regime if possible

[Unfortunate45 in reply to danielleGO2]

No unfortunately not but yes just praying that there will be other options. Thank you for your replies

[scifiknitter Blogger]

Kidney damage from chemo is real and both of the chemo drugs she took can damage the kidneys. My kidneys were permanently damaged from carboplatin/pemetrexed/Avastin. They have slowly healed some, but my options have been shinking and we've been unable to control growth.

This is something you can monitor. Ask for her blood test results and look carefully at her creatinine levels and (e)GFR. Creatinine normally does not exceed 1.3. It's a logorithmic scale, so an increase from 1 to 2 signifies more damage than an increase from 2 to 3. A normal e(GFR) is 60+.

I didn't understand this when I started chemo, and I allowed myself to have chemo when my creatine was 1.59. Bad mistake!

Be aware: kidney damage can lead to persistent anemia.

Your mom needs a discussion with her doctor.

[anrean]

The respiratory doc spoke out of turn. Call the oncologist and get your information from the horse's mouth. I had liver ca years before chemo and they modified the chemo so that the liver could tolerate it!

[Denzie Moderator Volunteer]

I agree the respiratory doc spoke out of turn. I’ve been following scifiknitter and her experience for a long time and I would follow the guidelines she suggested. There’s a reason they do blood test before each weekly treatment -they want to monitor kidney function.

Sending hope that she recovers swiftly.

[judg69]

Yes, chemo is hard on the body, period. I had 2-3 months chemo with the cisplatin and taxidere combination and while tolerable , it was also quite nasty. I then had 2 YEARS of alimta and avastin combination ( with neulasta added to somewhat keep my white blood cell counts at an acceptable level) . In my case, I found the alimta, avastin and neulasta combination much easier to tolerate. You need a long detailed chat with your mother’s oncologist , and it might be advisable to secure a second opinion. All the Best, judg69