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Melinda

Swelling of feet, ankles, and legs (Peripheral edema)

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Hi, all--

Although we've JUST started treatment (Zometa last week and chemo and raidiation this week) my fiancee's mother is experiencing swelling in her feet, ankles, and legs (even though we're trying to get her to keep them up--she's a compulsive cleaner and her other son is... well, let's just say, he's not).

Is this a common side effect of lung cancer? I think I read something something about blood clots before being related to this--but found nothing on the web.

We are already monitoring her sodium intake...

My fiancee is already really worried about it (he's one big ball of terrified anxiety) -- so I sent him to bed and have done a bunch of research on the net to arm him and his dad with questions when they go to see the onc. tom morning.

Much of what I have seen on the web states that these symptoms are common signs of congestive heart failure, pericardical effusion, and plueral effusion. Also possibly mets to the liver (please, no!). I know he's going to see these terms and FREAK--but I figure it's better to have the onc. rule them out, right? It's such a fine line betwen trying to inform him and not scare him unecessarily.

Her recent CT scans and PET scans did not show any sign of mets to the liver...

Also something called Sarcoidosis--has anyone ever heard of that?

Any advice from those that have reseached this and/or lived it?

One a side note--I'm scared that if he is such a wreak this early in our LC odyssey--that's he's going to melt down when things get rougher... But that's an entirely different problem...

Thanks.

Melinda

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hi melinda,

i don't know too much about sarcoidosis, but here's a link with info: http://www.lungusa.org/diseases/lungsarcoido.html#about

as for the swelling, you may want your mother-in-law's oncologist to check it out. i believe that this can be directly caused by chemo, not necessarily from the cancer. my mom's oncologist constantly checks for swelling in the ankles/legs during routine visits.

as for your fiancee, just be supportive and listen to him when he feels like talking. as a caretaker, i know what an emotional rollercoaster this all is, and we all have our moments where we feel like we are losing it.

i will pray for you and your family, especially your mother-in-law and mother. i hope that you find the info above helpful.

take care and God bless,

mj

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My Dad's very first symptom of lung cancer was swelling of the feet and ankles. It was osteoarthropathy. My Dad also has some "clubbing" of his toes. (the end of his toes where the nail is has gotten flat and rounded) Does your loved one have this going on? In my Dad's case, the swelling was secondary to the clubbing, although you can have osteoarthropathy without the clubbing. It could also be caused by the chemo. I believe that is called neuropathy. Does she have any numbness or tingling in her feet? The good news for my Dad was that an anti-inflammatory, Bextra, and the chemo have greatly helped the swelling. Try not to panic right now. I know that's easier said than done......I'm the queen of panic! :roll: Wishing you and your family the best. Prayers from Alabama.

Angie

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Is the swelling in both legs or one? congestive heart failure according to the article below is most likely with both legs.

Make sure they check the Drs check for thrombosis, since it is pretty common. Lovenox or some other blood thinner may be given.

Abstract

Lower-extremity edema is often encountered in clinical practice and represents a manifestation of a variety of possible disease processes. Edema results from fluid accumulation in the interstitial compartment of the extravascular space. Clinical assessment relies on several diagnostic modalities including history, physical examination, noninvasive vascular duplex ultrasound, computerized tomography, and magnetic resonance imaging. Without intervention, the swollen extremity can progress, leading to further tissue damage and permanent impairment. Determination of the underlying cause is necessary to maximize and specifically guide the treatment. Peripheral edema should be classified as a unilateral or bilateral process. Causes of unilateral lower-extremity swelling include venous and arterial abnormalities, lymphedema, infection, trauma, and neoplasms. The possible sources of bilateral edema include congestive heart failure, systemic and metabolic abnormalities, endocrine dysfunction, lipedema, and pregnancy. This article reviews the clinical evaluation modalities and diagnostic standards for assessing lower-extremity edema, as well as potential causes and differential diagnoses.

[\quote]

Venous Abnormalities

Acute DVT often initially may appear with swelling with bluish-red discoloration, often accompanied by pain and the presence of prominent lower-extremity veins. The thrombosis often damages the valves with subsequent development of chronic venous insufficiency (Table 1). Fifty percent of patients with DVTs develop post-thrombotic syndrome, which may manifest up to 30 years later. The incompetent valves result in a long column of unrestrained blood that transmits pressures of over 100mm Hg to the venules and capillaries. This pressure promotes both fluid and protein loss into the interstitial tissues. The resultant edema contributes to chronic skin changes including pigmentation, dermatitis, nonbacterial stasis, cellulitis, and ulceration.[6]

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Hi Melinda,

From your post, it appears that you have known for about 2 weeks of your future MIL's LC. That is really no time at all for the shock of diagnosis to sink in. The past 7 months have been a rollercoaster for our family, but the first few weeks were the absolute worst. I know everyone is different, but I think that Geoff will adjust in the weeks to come. I think everyone just needs time to absorb all the information and that can take a while. He is so lucky to have you, supporting the family and doing research.

How did your mom's surgery go? Please let us know how Geoff's mom makes out today.

Did you learn any more of the walk at the end of April? I left a message for them yesterday.

Blessings,

Denise

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Swelling occurred with Lucie all during her chemo and radiation treatments. We had to keep her on Lasix, a diuretic. Even after the treatments were over, occasionally she would start to swell again, we would take Lasix again and bring it down. Right now, she is doing fine. Don

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Guest phyllisb

Hi, I don't mean to alarm you but my oncologists check for swelling in that area all of the time. They told me it was to check for liver mets and the swelling was not a good thing. It could be other stuff. Some chemo treatments do cause you to swell up and get bloated. Sorry, I hope I didn't upset you, but you seemed to want information. Good luck!

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My dad was dx in 12/03 and when we went for a second opinion, the MD noticed the swelling. My dad wasn't even aware of the swelling until the MD told him about it so he could have had it before (I don't think the first oncologist we saw ever did a full physical). Anyways, our oncologist said if the swelling didn't bother him, my dad didn't need any medicine. He took an x ray and that showed it was not congestive heart failure. The oncologist said that it is common in cancer pts to be in a "catabolic" state and cited that my dad's albumin (protein) level was low. He encouraged high protein foods like tofu, nuts, eggs, etc to try to raise the albumin level but he said this catabolic state was common and a side effect of it was swelling. A week later my dad had pain in the foot and then the MD ordered Lasix (a diurectic) to see if the swelling would go down. My dad didn't take the Lasix much since the swelling didn't really bother him. We haven't had his albumin level retested lately so we don't know if it's better or not - but the swelling seems to come and go. shirley

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Melinda,

My mom has also had swelling feet and legs. We really dont know if it is from the previous chemo's or the Iressa she is taking now. Or maybe something else?? I worry about it because she has numbness in her feet also. The doctor is aware of it and upped her lasix (sp) but didnt seem too concerned... Not much help but if I learn anything else, will pass it along...

Oh yes, I am taking mom to get a new wig on Saturday. What is really hard is finding the right color. You see my mom is 76 and still had very dark hair. Now people want to put grey wigs on her which look nothing like her!! Everyone thought she colored it but she didnt hahaha... Her mother was 86 when she died and STILL had dark hair!

Take care and keep reading the posts here, you learn so much from these wonderful people on here!!

Gayle

________________________________

10/03: 76 yr. Mom diagnosed squamous cell nsclc

11/04-1/04: 4 rounds of Taxol/Carbo

1/30/04: CT scan no change in growth/new spot 

2/4/04: Taxotere (1 hour intrav.)

2/8/04: Bad reaction, bedridden with Thrush/Diarrhea

2/26/04: Starts 15 days of Iressa

3/11: 30 more days of Iressa

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I have been experiencing swelling of my left leg from the calf down since Dec 2003. This is due to the chemo drug (taxotere) which lists fluid retention and swelling as a side effect. The chemo also caused DVTs in my left leg, also contributing to the swelling. Check on the internet or with the oncologist for side effects of the drugs she is taking. Remember, everyone's case is at least slightly different!

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Hi I cannot help you with the swelling, but I have/had sarcoidosis---it was found along with the cancer---the surgeon removed inflammatory tissue along with the cancer----

I never had any symptoms---however, it does cause me to have enlarged lymph nodes and really thows off my scans--as they light up-I have had many scares since my lobectomy , really enlarged nodes (larger than even my normal ) and nodules on my lungs , and they even went in via a mediantinscopy (sp)and bronchioscope, and all was negative for cancer---

It basically is an immune disorder, sort of like rhematoid arthritis--

I hope you fiance's mother gets some answers

also I think the shock will wear off and your finace is just going through the denial period--- ---it is a normal reaction and she was just recently diagnosed---I think many people go through that before the fight kicks in--

best wishes --

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