Is phenol matricectomy a "more" permanent solution to severe toenails infection

Home Forums Cancer Treatments / Symptom Management (old) General Treatments / Symptom Mgmt. Questions Is phenol matricectomy a "more" permanent solution to severe toenails infection

This topic contains 9 replies, has 4 voices, and was last updated by  certain spring 1 year, 11 months ago.

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May 8, 2012 at 11:33 pm  #2185    

My wife's advocate

It seem like my wife’s adverse side effects from Tarceva are coming in waves. Since Dec 2011 for the past 4 1/2 months, severe sinus infections, diarrhea, conjunctivitis and now terrible toenails infections (that resemble the worse of ingrown toenails on two big toes and a third on her left foot) has caused her doctor to tell her to stop taking Tarceva for four separate occasions for 7 to 8 days each just to provide for a temporary relief for the healing.

Her podiatrist suggested the possible procedure above. Would our dear esteemed faculties please comment if this is a common practice?


Wife,Asian non-smoker, left upper lobectomy 10/19/10; Diag: mod. diff. adenocarinoma, focal squamous diff. with one AP node involvement. Stage IIIB (?) Brain MRI, body CAT & PET clear in 12/2010. 4 cycle cisplatin doublets done 3/21/11. MRI on 7/26/11 shows one 1.3 cm lesion with a 2.6 cm cystic component in rt. occipital region. Neuro excision done 8/8/11, confirmed sol. mets from lung. EGFR +. SR irradiation on excision site 9/9/11, started Tarceva 9/26/11. Very difficult side effects. Tolerable after dose reduction to 100mg.NED for 2 yr & 3 months Clear on all brain MRI’s and body CAT scans. Now dealing with unusual side effects or possibly toxicity of SRS of brain from 2011.

May 9, 2012 at 12:24 am  #2186    

certain spring

I would be interested to know what this procedure entails, as I have the same problem as your wife. Having looked it up, I’m not totally sure how it differs from regular surgery.
I have had infected toes for six months. We’ve tried hot soaks, antibiotics and steroid tape. When I finally got to a podiatrist last month, he pronounced that there were nail spikes in both toes and that these needed to come out, otherwise antibiotics would not work. He removed the spikes there and then, without anaesthetic. It was very painful – so painful that I cried. But I gather that injecting the toe with anaesthetic can be pretty painful too.
Interestingly, the podiatrist had not heard of Tarceva but sees ingrowing or embedded toenails a lot with cancer patients who’ve had chemotherapy (what is that about??) Best wishes to your wife – please tell her how much I sympathise! – and I hope the doctors can shed some light on this procedure.


49-year-old non-smoker, dx stage IV NSCLC May 2010 (squamous tumour of the left lung with multiple brain metastases). Radiotherapy to chest and brain; progressed through two cycles carbo/gemcitabine. Repeated lung collapses; pneumonia in collapsed lung, Nov 2010; bronchial stent placed, Dec 2010. Declined second-line Taxotere. Mutation testing Feb 2011, surprise EGFR exon deletion 19. Started Tarceva (150mg), Feb 2011. Progression in liver and elsewhere, May 2013.

May 9, 2012 at 8:21 am  #2188    

catdander forum moderator

I had to look that up and got a quite overview of the procedure here. http://www.abimelec.com/dermatologist/phenolization.html

I sounds like a solution is used and at least part of the nail is taken off (such as an ingrown nail). Doing a search with my new and much improved safari browser got no results from the Grace site. My husband ended up loosing most if not all the nails on one of his feet.

I wonder if the dermatologist that has become most acquainted with tarceva issues has any insight on this. I can’t think of his name though.

Best of luck to you and your wife,

May 9, 2012 at 8:35 am  #2189    

catdander forum moderator

The dermatologist is Dr. Lacouture. Dr. West has interviewed him for Grace recently. I wonder if Dr. West could ask him his thoughts on this.

Also here is the discussion Dr. West had with Dr.Lacouture http://cancergrace.org/cancer-treatments/files/2011/09/qa-dr-lacouture-on-skin-hair-nail-side-effects-of-treatment-transcript.pdf

May 9, 2012 at 7:13 pm  #2190    

Dr West

I’ll try to see what I can find out.

-Dr. West


Howard (Jack) West, MD
Medical Oncologist

Views expressed here represent my opinion, not those of GRACE or Swedish Cancer Institute. This information does not constitute medical advice and is intended to supplement and not replace medical information provided by your doctor.

May 23, 2012 at 6:33 am  #2211    

certain spring

Mywife’sadvocate, did your wife end up having the procedure? I suspect it is a fancy name for what I am about to undergo, ie taking off part of the nail and treating the remainder with phenol to induce a chemical burn that stops it re-growing.
I am far from overjoyed because a) I am afraid of the pain (when the podiatrist gouged out the embedded nails spikes, it was more painful than anything I have experienced for a long time; b) he tells me I won’t be able to swim for six weeks. I enjoy swimming and feel it keeps my lungs in order :(
I wondered also how your wife was getting on with the eye problems. I now have recurrent styes/eye infections, presumably from the same staph bacterium that is affecting the feet. Grr…


49-year-old non-smoker, dx stage IV NSCLC May 2010 (squamous tumour of the left lung with multiple brain metastases). Radiotherapy to chest and brain; progressed through two cycles carbo/gemcitabine. Repeated lung collapses; pneumonia in collapsed lung, Nov 2010; bronchial stent placed, Dec 2010. Declined second-line Taxotere. Mutation testing Feb 2011, surprise EGFR exon deletion 19. Started Tarceva (150mg), Feb 2011. Progression in liver and elsewhere, May 2013.

May 23, 2012 at 10:17 am  #2212    

My wife's advocate

Certain Spring,

Not yet. She is having a hard time recovering from three weeks ago when they removed the infected nails (a procedure very much similar to treatment of ingrown toe nails). Indeed what was proposed to her is exactly what you described. The suggestion was to return after about two to three month or when the ingrown toenail situation recurred to apply the phenol and hopefully rendered a more permeanant solution. But no guarantee though. Why they cannot apply the phenol the first time around three weeks ago was not explained.

By the way, do insist that your podiatrist inject lidocaine very very slowly then the rest would be more tolerable. She had the spikes removed twice in the past three months. The first podiatrist did it fast and carelessly but the second podiatrist a lot slower and gentle and that made a world of difference.

Best wishes for your procedures!


Wife,Asian non-smoker, left upper lobectomy 10/19/10; Diag: mod. diff. adenocarinoma, focal squamous diff. with one AP node involvement. Stage IIIB (?) Brain MRI, body CAT & PET clear in 12/2010. 4 cycle cisplatin doublets done 3/21/11. MRI on 7/26/11 shows one 1.3 cm lesion with a 2.6 cm cystic component in rt. occipital region. Neuro excision done 8/8/11, confirmed sol. mets from lung. EGFR +. SR irradiation on excision site 9/9/11, started Tarceva 9/26/11. Very difficult side effects. Tolerable after dose reduction to 100mg.NED for 2 yr & 3 months Clear on all brain MRI’s and body CAT scans. Now dealing with unusual side effects or possibly toxicity of SRS of brain from 2011.

May 23, 2012 at 10:51 am  #2213    

certain spring

I appreciate the tip. He did warn me that the injection would be the worst part.
And your wife’s eye problems – I hope they have improved? Mine are intermittent but annoying.
May I also ask – you mentioned at the beginning of the thread that your wife came off the Tarceva for a week or so to help with the side-effects. Did it help?
Thank you for sharing these tales of woe! My best to you and your wife.


49-year-old non-smoker, dx stage IV NSCLC May 2010 (squamous tumour of the left lung with multiple brain metastases). Radiotherapy to chest and brain; progressed through two cycles carbo/gemcitabine. Repeated lung collapses; pneumonia in collapsed lung, Nov 2010; bronchial stent placed, Dec 2010. Declined second-line Taxotere. Mutation testing Feb 2011, surprise EGFR exon deletion 19. Started Tarceva (150mg), Feb 2011. Progression in liver and elsewhere, May 2013.

May 23, 2012 at 12:56 pm  #2214    

My wife's advocate

She have had excessive side effect with scalp lesions, diarrhea, facial skin lesions, cracks on her corners of her mouth and dry eyes … Etc. after a little more than a month, the oncologist agreed to reduce her Tarceva to 100 mg. She has been on 100 since late oct 2011. Even at 100 mg she had to be off Tarceva for 3 times each around 7 to 10 days, all to relief compounded symptoms and worsen side effect of Tarceva and sinus infection, conjunctivitis and severe toe nails infection that different course of antibiotics were required.

Withholding the Tarceva while she was on antibiotics surely helped on each of the three occasions. Its just that we are a bit concern if stopping Tarceva whenever she needed to be on antibiotics is a bad idea. But judging the terrible compounded side effects, we pretty had not much choice.


Wife,Asian non-smoker, left upper lobectomy 10/19/10; Diag: mod. diff. adenocarinoma, focal squamous diff. with one AP node involvement. Stage IIIB (?) Brain MRI, body CAT & PET clear in 12/2010. 4 cycle cisplatin doublets done 3/21/11. MRI on 7/26/11 shows one 1.3 cm lesion with a 2.6 cm cystic component in rt. occipital region. Neuro excision done 8/8/11, confirmed sol. mets from lung. EGFR +. SR irradiation on excision site 9/9/11, started Tarceva 9/26/11. Very difficult side effects. Tolerable after dose reduction to 100mg.NED for 2 yr & 3 months Clear on all brain MRI’s and body CAT scans. Now dealing with unusual side effects or possibly toxicity of SRS of brain from 2011.

May 23, 2012 at 3:36 pm  #2216    

certain spring

I am really sorry to hear about the difficult time she has been having.


49-year-old non-smoker, dx stage IV NSCLC May 2010 (squamous tumour of the left lung with multiple brain metastases). Radiotherapy to chest and brain; progressed through two cycles carbo/gemcitabine. Repeated lung collapses; pneumonia in collapsed lung, Nov 2010; bronchial stent placed, Dec 2010. Declined second-line Taxotere. Mutation testing Feb 2011, surprise EGFR exon deletion 19. Started Tarceva (150mg), Feb 2011. Progression in liver and elsewhere, May 2013.

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