Setback

It would be unrealistic to expect any treatment to progress over a long term without aberration. The human body is a complex organism, and reactions to drug treatments can vary according to how the body responds under ever-changing (however slightly) conditions.

While the Pfizer drug Sutent presents a number of well-documented side effects, their manifestation remains largely unpredictable beyond broad parameters. For example, there is skin soreness. During one cycle an internal blister-like skin sore presented on the side of my left thumb pad. After the treatment cycle, the soreness subsided and the “blister” solidified, sloughed off the surface, and was replaced by new skin with no trace of the problem. During another cycle the same thing happened but the site was side of the pad of my big toe on my left foot. The same sequence of healing occurred. These “blisters” appeared only these two times, however, over the course of several treatment cycles.

During the most recent cycle my right jaw became swollen and a similar growth arose in the corner of my mouth between my cheek and gum near my lower wisdom tooth. In this case it was necessary to delay the start of a new treatment cycle and wait for the jaw swelling to subside, because it had restricted the extent to which I could open my mouth and thus affected eating. I should point out that this area of my jaw was subjected to the intense radiation treatment, which was given as part of a larger treatment regimen for my entire lower jaw and neck area some twenty-two years ago. The eight-week radiation treatment was for a squamous-cell carcinoma that was detected in lymph nodes on the right side of my neck, under my jaw, with an unknown primary.

The jaw swelling was a new side effect; however, I have always felt some tension in that side of my jaw during each Sutent treatment cycle. The blister-like growth is currently subsiding, though differently, I suspect because it is always moist inside my mouth and so cannot resolve in quite the same way as on my thumb or toe.

Side effects that do not directly cause problems can reveal issues that otherwise might lie undiscovered, or they can exacerbate problems that were minor and now require attention. In this case the jaw side effects were sufficiently puzzling to send me to an ENT (ear-nose-throat) specialist, who ordered a sinus CT scan and found a nasal polyp. Another issue that presented itself was a perforated sinus, with a channel opening between my right sinus and an area of gum behind an upper molar. X-rays of the jaw showed no abnormality.

Future ENT and oral surgical appointments lie ahead to address these newly arisen issues. In the meantime I have started a new Sutent cycle that, I hope, does not reveal any new problems.

Side effects are to be expected. That’s a given. Individuals undergoing treatment of this type, however, also should be aware that the unexpected is not merely possible but likely. The aberrations are unpredictable and simply must be dealt with methodically, one by one, as they arise.