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Sore feet a chemo side effect?


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On the fifth day after my second infusion of taxol/carboplatin/avastin (followed by neulasta after 24 hours), just as I was starting to recover from the body aches and fatigue I've come to expect, something new cropped up. My searches haven't identified this new symptom as a side effect of these drugs, but I'll try to describe it in the hope someone else has experienced it and can offer some advice.

But first, I should say that for over 10 years I've had some loss of feeling or numbness in the skin of both feet and ankles, though no tingling or pain. The chemo regimen which I started at the beginning of October has not changed this. Second, I generally have some rough skin areas on the feet which admittedly I haven't cared for very well over the years, and occasionally a crack or minor scrape (bare feet is the norm unless I'm going "formal") requires attention with some antibiotic ointment and a Band-Aid. Again, the chemo hasn't made this condition any worse as far as I can tell.

Here's the new part. In a smooth area on the sole of one foot, just behind the arch, an area of swelling about 1/2 inch across has developed under the surface. The skin is not red, and there is no evidence of a bite or puncture. Manipulating the area with a finger, I get the impression there is a pocket of fluid under the skin. It's painful only when pressed or walked on. A second area may be developing on the ball of the same foot, just behind the second toe.

Has anyone experienced something like this as a side-effect of chemo or one of the targeted therapies? I'll be calling my oncologist's office a bit later, but would appreciate any inputs this knowledgeable group can offer!

Thanks and aloha,

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Sort of sounds like you're getting blisters? If it's not something easy like a pair of new shoes, there is something called hand-foot syndrome that can happen with chemotherapy drugs. I don't see the drugs you mention in the following information, but I know that taxol can have extremity effects like peripheral neuropathy and restless leg syndrome so I guess I wouldn't rule the following out as a potential to discuss with your oncologist.

From http://patient.cancerconsultants.com/su ... d=23169#a3

Hand-foot syndrome is a side effect of some chemotherapy drugs that results when a small amount of drug leaks out of the smallest blood vessels in the palms of the hands and soles of the feet. The amount of drug in the capillaries of the hands and feet increases due to the friction and subsequent heat that is generated in those extremities. As a result, more drug may leak out of capillaries in these areas. Once out of the blood vessels, the chemotherapy drug damages surrounding tissues.

Symptoms of hand-foot syndrome include:

Tingling or burning




Small blisters

Small sores on the palms of the hands or soles of the feet

The chemotherapy drugs that have been reported to cause hand-foot syndrome in some patients include:

Capecitabine (Xeloda®)

Cytarabine (Cytosar-U®)

Floxuridine (FUDR®)

Fluorouracil (5-FU)

Idarubicin (Idamycin®)

Liposomal doxorubicin (Doxil®)

Changes to your normal, daily activities after receiving intravenous (through a vein) chemotherapy or during treatment with oral chemotherapy can reduce your chances of developing hand-foot syndrome.

Reduce exposure of hands and feet to friction and heat by avoiding the following:

Hot water (washing dishes, long showers, hot baths)

Impact on your feet (jogging, aerobics, walking, jumping)

Using tools that require you to squeeze your hand on a hard surface (garden tools, household tools, kitchen knives)

Rubbing (applying lotion, massaging)

Hand-foot syndrome is first treated by reducing the dose or stopping treatment with the chemotherapy drug that is causing it. Other approaches to managing hand-foot syndrome include:

Corticosteroids: Steroids work by reducing inflammation. Your doctor may recommend a systemic corticosteroid (administered in a pill) to help relieve the symptoms of hand-foot syndrome.

Dimethyl-sulfoxide (DMSO): Topical treatment with DMSO has shown activity in treating leakage of chemotherapy drugs into tissues.

Vitamin B6 (pyridoxine): A small clinical trial has shown that treatment with vitamin B6 can reduce the symptoms of hand-foot syndrome.

For relief of symptoms associated with hand-foot syndrome, try the following:

Cool with ice packs for 15-20 minutes at a time

Elevate hands and feet

Apply antibiotic ointment on open sores

Apply moisturizers sparingly

Avoid constrictive clothing

Hope this helps,


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Linda: Glad you're getting to the bottom of it with your onc.

Brilliant play on words -- love it!

Since I knew I'd need to do some walking later this morning, which I found quite painful yesterday, I fashioned (jury rigged) a temporary measure last night which I've just got to share...

Assemble these materials: a can of Bag Balm (if you've never heard of it, check it out -- something like Mane 'n Tail Hoofmaker might work too); various assorted bandages, sterile pads, and tape from your closet; scissors; clean fluffy socks.

Apply the Bag Balm liberally to the foot, especially to the rough, cracked, irritated areas, and work in well. Cut soft non-stick pad segments to cover the most painful areas and secure with long strips of tape. Carefully pull the sock over the whole mess to keep everything in place and to hide your handiwork from critical eyes. Then go to bed.

This morning, I can move around the house in relative comfort -- what a difference! Future enhancements might include preformed segments from the Dr. Shoals counter to replace some of the tape and pads, and tabi socks to make it easier to wear my $2.95 rubber slippers outside the house. I'm sure my onc will be impressed, and he might even have some ideas of his own. Will let you know!



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You're talking to a farm girl here, Ned -- very familiar with Bag Balm (a wonder ointment) and Mane n' Tail products; was pleased to see that I could get Mane n' Tail cheaper at my local people stores than the tack stores too! :roll: . I wouldn't swear by Hoofmaker for your feet though.....it doesn't even work well on my horses.

Curious to see what your onc. says about this -- sure sounds like extra sensitive tootsies from something, and if it's not hand-foot, then what? Rough feet, in general (I've got those too -- cracked heels and all -- no time for pedicures in my reality :shock: ), don't normally do what you're going through.

Glad you're getting some relief from your impromptu remedy there though. Ummm....those rubber slippers of yours....been wearing those long? Rubber doesn't breathe that well if you're walking around alot in it, has no support, and could be the source of the foot friction that's giving you blisters if you're wearing those a bunch. 'Fess up and take a look at the footwear you've been using recently -- this could be a really simple, non-medical problem you've got.


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Oncologist didn't have a definitive answer on the section of sole with fluid under the skin. Said it's not hand-foot syndrome and not a known reaction to any of the drugs I'm on. Could be caused by something else that's been allowed to develop because of the chemo-related sensitive skin and lowered resistance, and I should see my dermatologist if it doesn't improve or if it gets worse. Actually, he was more concerned with a small nick on the back of the heel which I've been treating (not very successfully) with Neosporin and Band-Aids and is starting to get infected -- put me on oral antibiotics.

I was happy to see that I wasn't taken to task for using a product originally intended for cows' udders without asking first. The onc's office seems well aware of the benefits of Bag Balm, though I don't ever recall seeing it officially promoted for human use. The word has apparently spread in the 107 years it's been in production. Our local drug store has a good supply since a number of soldiers deployed to Iraq have been asking relatives here to send a few cans.

Linda, you may have something there about the rubber slippers. I might break loose a couple more dollars and look for something more upscale. Would save me from buying tabi socks, and I might even come out ahead financially!



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I never even opened your post because I didn't have any answers for your question from reading just the title but did open it today! Boy, glad I did because I have been wondering about you and could not remember your screen name!

Sorry to hear about foot problems but it sounds as if you are doing a tad better :)

It's really nice to see you and please keep us posted on how you are doing.

Small suggestion but if you wear socks...100% cotton is the way to go. They absorb moisture better than a blend with poly, etc.


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Libby and Linda:

The left foot cleared up completely a couple of days after my last post (10/31), then the right foot decided it wanted some attention too. It also wanted to be different, and came up with an itchy, burning rash along the side instead of the large blister effect on the bottom. I treated that with a Longs Drugs version of Neosporin Plus and a custom-made bandage. It bothered me for a day and a half, then cleared up as fast as it started. That same night, as I was getting ready to shower, I noticed that my 2-month-old thoracotomy incision -- which had been pinkish and a bit touchy for a few days -- was back to a more normal color and feel. That gave me one of those "ah ha" moments when seemingly unrelated events reveal themselves as part of a larger pattern, in this case sensitive skin probably brought on by one of the chemo drugs. In retrospect, I also recalled that about that time the skin on my face and forehead had been unusually tender and I needed to take it easy with the washcloth.

I'll be watching for these symptoms on my next chemo cycle. Of course next time something else will probably flare up just to keep things interesting.



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