blurry vision and swelling and pain on the back side of head near neck - 1261476

hellowall
Posts:8

Hi

My mother(age 64) has NSCLC stage 4 with BRAIN metastases. She got WBR in july-2013 and started on Gefitinib. On progression on Gefitinib, she is on chemo (Gemicitabine and carboplatine) from october-2013.
After third cycle there was a chest scan and it shows shrinkage. On july 7, 2014, she finished 4th cycle (day1). she has two problem now

1. from the last 10 days and before 4th cycle of chemo, there is swelling and pain on the back side of head near neck.
2. After day 1 of 4th cycle of chemo, she is feeling blurry vision.

On the point one I consulted to my oncologist, he prescribed us pain killer and saying we will do brain scan after 6 cycle. My mother complained me today about blurry vision. Now I am worried.

Is this chemo side effect or something more? Please suggest me what to do.

Regards
Arvind

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Reply # - January 11, 2014, 11:07 AM

catdander
Posts:

I'm so sorry your mother is having so difficult a time. Head pain and blurry vision is my symptoms of brain than chemo. We aren't able to say what someone should do especially in an instance such as this. The best person to contact would be the oncology team or ER if you feel she may be in danger.

I hope she is feeling better soon,
Janine

Reply # - January 11, 2014, 05:10 PM

Dr West
Posts: 4735

Yes, I'm sorry we really can't say much beyond that these symptoms are not what would be expected from chemo, especially after it was tolerated without such side effects previously. I agree with Janine that it is worth contacting her oncologist or getting evaluated in an ER if she's having new, worrisome symptoms.

-Dr. West

Reply # - January 11, 2014, 07:35 PM

hellowall
Posts: 8

Thanks Janine and Dr, West for the reply.

My mother is already gone through WBRT in july 2013. If we need to fight with recurrent brain metastases, what options are left with us. She is EGFR mutation positive. But there was progression on gefitinib. We have not tried ERLOTINIB yet. Is cyber-knife possible after WBRT or ERLOTINIB can be an option to try?

Reply # - January 11, 2014, 08:46 PM

Dr West
Posts: 4735

Yes, it is most common to do focal radiation such as cyber-knife or gamma knife for one or a few brain metastases after WBRT. It is quite unlikely that Tarceva (erlotinib) would be significantly effective after prior Iressa (gefitinib).

In rare occasions, we also consider repeating WBRT, though that always causes anxiety. Here's a post about that situation:
http://cancergrace.org/radiation/2008/12/07/reirrad-brain-mets-zg/

Good luck.

-Dr. West

Reply # - January 19, 2014, 06:39 AM

hellowall
Posts: 8

As we complained blurry vision problem to mother's oncologist, he decided for brain MRI. Brain MRI shows better result in comparison to previous report (previous brain MRI was done in july 2013) then WBRT.

Her hemato oncologist decided to continue chemotherapy, as he said that there is no need of radiation right now. 4th cycle of chemotherapy is done.

Now I have two confusion for that I am taking appointment to her doctor but need suggestion from cancergrace also.

1. What is the cause of blurry vision and what should I do?
2. Not proposing radiation for one lesion is right approach by her hemato oncologist or should I contact to radiation oncologist?

Please suggest me what should I do to be on right path for mother's safe life journey.

Reply # - January 19, 2014, 10:04 AM

JimC
Posts: 2753

Hi Arvrai,

As Janine stated, we can't tell you what to do, nor is it possible for the GRACE faculty to determine the cause of your mother's blurry vision with the limited information available and no opportunity to examine her. It certainly can be a symptom of a brain met, but since the frontal lesion is shrinking and there is minimal swelling, her doctor may not feel it is the cause.

Blurry vision can have many different causes, including drug reactions. Aside from her chemo infusion, has she recently begun any new drugs, including pain meds?

It is never a bad idea to have a second expert review her situation, so I agree it would be a good idea to discuss that with her radiation oncologist, along with the question of whether to hold off on radiating the frontal lesion.

Good luck in finding and treating the cause of her blurry vision.

JimC
Forum moderator

Reply # - January 19, 2014, 02:47 PM

Dr West
Posts: 4735

I'm sorry we can't help here, but we specifically ask people to NOT post their reports for us to interpret (which constitutes an implied patient/doctor relationship), and to NOT ask for medical advice about what to do (both of these requests clearly listed in our forum guidelines). We are not allowed to give free second opinions, nor is that why we're here. We are happy to provide general information to help many people, but we simply can't interpret medical findings for people and give individualized medical advice.

-Dr. West

Reply # - January 19, 2014, 08:13 PM

bobradinsky
Posts: 144

Arvind

Sorry to hear your mom is having vision difficulties. My wife, Beth, was also 64 when she was diagnosed with stage 4 NSCLC with mets to brain, bones and liver. She was EGFR positive and took Tarceva. It wasn't long after she started taking it that she had visual disturbances including blurry vision. Her oncologist sent her to a vision specialist but nothing could be done. I believe we finally concluded that the visual problems were a side effect of the Tarceva and visual irritation and disturbances are listed as a possible side effect. I know your mom is taking or previously took Iressa which is different but similar. You should check with your oncologist to see if the blurry vision could be a possible side effect of the drug or some other drug she is taking.

Bob

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