Alimta and cellulitis - 1267331

tkirzhner
Posts:18

Hi
I am living with adeno stage IV for 15 months. I had 6 Cisplatin/ Alimta/ Avastin infusions followed by Alimta/ Avastin maintenance. All my tests showed stable since start of treatment. My blood work and metabolic panel were always great and I had very minimal side effects.
All was working great until I got cellulitis.
As one of my side effects my feet are swollen most of the time and a few weeks ago I noticed one of my ankles got red and hot to the touch. I went to the urgent care, got treated for 2 days in the hospital with IV antibiotics and then the course of 8 days oral antibiotics. My cellulitis cleared up but my doctor came to conclusion that Alimta and Avastin is over for me and I have to start new chemo.
I am surprised and upset. Is it feasible to change chemo that works to potentially more toxic concoction that may or may not work? Could I just contain the swollen legs with compression socks and lasix and stay on the same chemo regimen till progression?
Thank you very much in advance or your advice.

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Reply # - November 27, 2014, 10:34 AM

catdander
Posts:

Hi and welcome to Grace. I'm sorry your experiencing these problems. I don't know how likely it is your side effects can be managed. Perhaps Dr West will though it maybe a little slow today because of the US holiday Thanksgiving. I'll make sure someone comments today.

All best
Janine

Reply # - November 27, 2014, 12:11 PM

Dr West
Posts: 4735

I'm afraid that's the kind of question we can't answer. I have only had a very rare patient who has had similar symptoms on Alimta (pemetrexed) with or without Avastin (bevacizumab), and I am not sure the symptoms are clearly related to these agents. If you're doing well, it may be worth holding treatment for a few weeks to months to see whether the symptoms improve off of the treatment. If so, it argues in a compelling way that the chemo and/or Avastin is a direct cause of your symptoms. If the cellulitis persists long after the treatments are discontinued, it argues that these are independent issues -- and therefore it may be feasible to resume Alimta and/or Avastin.

The same argument could be made for just switching treatments. If the cellulitis resolves on a new treatment, it argues that the Alimta and/or Avastin was the culprit. If the switch in treatment makes no difference, you could conclude that returning to one or both of these agents is a reasonable idea.

Good luck.

-Dr. West

Reply # - November 27, 2014, 08:08 PM

tkirzhner
Posts: 18

Thank you for your response.
I have a few arguments i think proving that my cellulitis is not alimta induced.
1) It almost completely cleared up after 10 days of antibiotics.
2)when cellulitis started I have noticed a bleeding scratch at the back of my calf just where it was the worst
3) my feet are swollen even after 6 weeks off Alimta.
I hope my doc would accept these as a valid case to get back to proven treatment.
I just worry that he made up his mind and will not allow me back to it.
Hoppy thanksgiving!

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