New to Doxil… any one have heart issues?

[Bettybuckets]

Hi Ladies- maybe you can help? In just two days, I am due for my 3rd infusion of Doxil… which started out hard but last month was fine. The problem now is that my Apple Watch keeps alarming… well by that I mean it alarms and notifies me each time my heart rate dips below 40 beats per min for 10 solid minutes. It is sometimes just 32 BPM… normal for me is usually 55-60 bpm. This is Mostly at night when I am sleeping but also during my the day . It just happened again-Even just before I wrote this! Since I started on Doxil it has been doing this quite a lot… in the last month 350 times!

My smart medical writer husband has been reading lots of the studies with this class of drug and this seems to happen more often to those of us who had doxirubicin years ago like me. There is a suggested life time dose limitation and I am not near it…and the newer formulation with thr lipid layer called Doxil is purported to be less cardiotoxic than the older Dox but I am worried.

I spoke with my onc and he asked to go get EKG… that showed issues so they sent me to get a 24 hr holter monitor.. this will give a readout of all the Heart rates etc within 24 hrs BUT it won’t be read in time for my next dose of Doxil!

My dilemma is that Doxil appears to be working… or at least makes my tummy and bones etc feel better… I hate to blow past this therapy and onto something less well tolerated.. I feel like by just sounding the alarm and getting this checked out means that they will Discontinue treatment and push me onto 5th line rather than figure out if this is real or imagined by me. And You know how hard getting IVchemo appts are to set up… even so do you think I should ask to postpone doxil until we know if this may be starting to cause CHF( congestive heart failure).

I could just take the Doxil IV and then if I get worse that will prove it is cardiotxic for me… and then stop it and switch for next month… or just ask to postpone until cardiologist can read the 24 hr holter monitor. I hate to do anything that makes me feel like a Diva… and put people out. Problem is I don’t want to be left with damaged heart and shortness of breath as I love my swimming and biking.

My question is what would you do?

[MaryCos]

I would ask my oncologist what their recommendation is. But, I think if it were ME? I'd probably put off the chemo infusion until someone could assure me it is safe. My hope is that they can give you something else to counter this (med-wise), instead of you potentially needing to move on to another line--perhaps prematurely. xo

[daniellebrooks13]

hi Betty, my thought would be to wait with the next infusion if the oncologist thinks that would be ok!

[13plus]

Hi! I always love seeing your pics Well that’s quite a low HR! I believe, as frustrating as it is, I’d be asking to hold off the next infusion until you get the feedback from the cardiologist.

The downside of forging ahead with infusion is not knowing, if the Doxil is the issue, how badly it could affect your heart with another dose. Is it worth that risk?

[1711JPD]

I’d postpone the infusion. Best wishes.

[bikebabe]

me too - I’d go for postponing or ask for an urgent cardio oncology referral - maybe phone consult. There’ll be a work around for cardiac side effects eg pacemaker/ implantable ICD but it’s balancing the risk of permanent cardio toxicity offset by pacemaker versus different onco treatment and alas I think you need that expert advice. There’s two cardio onco units in uk (Bart’s and Liverpool) - not sure where they are for you but web search might throw them up although your onco should be checking. Some research papers might throw up names/institutions.