Chemo side effects.

[zoxxoz]

What is the name of your state? Utah

My mom recently died of lung failure due to the side effects of her chemo treatment for breast cancer. Even though she was in her early 70's she was prescribed a more aggressive approach due to her good health. No indications were found that the cancer had spread beyond the breast and a few lymp nodes.

She developed a reaction to one of the cancer drugs (cytoxan) which caused severe lung damage. The damage was irreversable, but she continued on with her treatments (no longer using cytoxan) despite being vey weak and on oxygen. A few days after taking her next treatment phase drug (taxol) she developed an infection due to her compromised lung and immune system. A week later she died.

Originally we were told she had a good chance to live ten years or more cancer free. The whole topic is still very painful for the family, but we are convinced that if a less aggressive approach was taken, the side effects would have been detected sooner and her treatment could have been modified. Continuing chemo despite being on oxygen and very weak seems (in retrospect) excessive. We also know that we were fighing to keep her from having the cancer spread and cause a painful death.

Could the drug manufacturer or doctor have any culpability, or is this just one more example of how challenging the fight against cancer is? None of the family wants to relieve the trauma over and over again, but we continue to question ourselves whether we did all we could do and if what was done was appropriate for her situation.

Any thoughts would be appreaciated.

 

[rmet4nzkx]

I'm sorry for your loss. As you know, cancer is an agressive disease with no sure outcomes from treatment. Eventhough your mother was in otherwise good health the fact that the cancer was spread to the lymph nodes shows that it had begun to spread and thus the agressive approach of medication and it is always a decision to weigh the difference between treatment and the outcome for sometimes the treatment is worse that the disease and some otherwise healthy people don't survive.

In this case you can make sure to report the adverse drug reaction and research that reaction with the FDA. If there are a number of adverse reactions, that may give grounds for suit or if there was not sufficient informed consent, so you might consult with a med/mal attorney, but more than likely as sad as it is, your mother's death may have been caused by the cancer.

 

[ellencee]

zoxxoz
The term, lung failure, may mean something different to you than it does to me, as an RN. In order for me to understand the event, I need to know what you mean by "lung failure". Cytoxan is not known to cause any type of lung injury, other than lung infection. Cytoxan is considered a safe medication and is given for a variety of conditions/diseases, not just for the treatment of cancer.

Taxol is a serious drug. I question its usage when there was no evidence of metastatic cancer, only a suggestion that the cancer may metastisize (lymph node involvement).

Most likely, the issue of lung failure and the usage of Taxol are not relevant when one considers whether or not product liability or medical malpractice exists. Cancer treatment with chemotherapy has the inherent risk of causing the patient to develop a fatal infection or to succumb to the force of the medications/treatments. A percentage of patients, and not a small percentage such as 1-2% either, die within the first few weeks of cancer treatment with chemotherapy.

Request her physician to submit to the FDA and to the drug-makers the information from her clinical records as it will be useful in determining the adverse effects of this regimen in this patient and will allow each to add this patient's response to the appropriate data base.



EC

 

[zoxxoz]

Chemotherapy induced lung injury follow-up.

Thank you for your comments. I have all the medical reports and they do cite, "biopsies revealed evidence of chemotherapy-induced lung injury. No evidence of malignancy was seen in washings, brushings or biopsy."

Several similar references are cited, such as "she saw xxx for her diffuse interstitial infiltrates on chest x-ray. A biopsy of the lung tissue by transbronchial method revealed no evidence of lymphangitic tumor spread, but did show a pattern consistent with acute lung injury from chemotherapy. Her Cytoxan was disontinued, and she was started on steroids at the time."

Other areas refer to hypersensitivity - also "started decadron for cytoxan -induced pneumonitis." She was given strong doses of steroids for quite a while to try to counteract the damage.

Seems like the best outcome would be to at least make sure her reaction to the drug is documented as suggested in such a way that it could help others also undergoing treatment. Hopefully it remains a very rare reaction and not something more common but under reported.

 

[ellencee]

zoxxoz
Thank you for the additional information. Cytoxan-induced pneumonia is a known side-effect and risk of treatment with Cytoxan. The information/terminology, "diffuse interstitial infiltrates", is the description of the physical changes in her lungs brought about by pneumonia.

The lung biopsy report addresses "no lymphangitic tumor spread". Most likely, this addresses the known risk of Cytoxan-induced spread of the malignancy and/or Cytoxan-induced development of a secondary tumor or type of cancer. The biopsy findings were negative for this evaluation.

Hypersensitivity is also a known risk of the treatment.

There is really no possible way to prevent Cytoxan-induced pneumonia, Cytoxan-induced spread of malignancy or develoment of a new type of cancer, or of acute and severe hypersensitivity reaction. Treatment is rendered in the manner documented in her records: stopping the Cytoxan, administering steroids, oxygen support, etc.

It is truly an unfortunate and sad series of events but based on the provided information, I do not see an area of medical malpractice or of product liability. Each of the untoward responses were properly managed.

Best wishes,
EC

 

[zoxxoz]

Thank you very much EC for your further comments. We feel better knowing that all of us likely did the best we could under the circumstances.

 

[CancerSurvivor]

I am sorry for your loss.

I know Cytoxin all to well. I am 33 and had bone cancer. I was on one of the most agressive treatment plans out there. I being young and healthy had a hard time with Cytoxin. My Dr. even made the comment that they do not give my dosage to elderly people because there is a high risk of them not making it through the Chemo. I was never told that there risks involved with the lungs. Did her Doctor advise here of the "problems" that could happen due to her age? I am truly sorry for your loss. Being a cancer survivor myself I have a speacial place for others with cancer.