New Side Effects

For readers who follow this blog, I mentioned in the previous post (“Attitude,” December 10) that I have switched to the targeted therapy drug Afinitor, or Everolimus. I’m now closing in on four weeks on this regimen. As I said in that earlier post, the side effects have been fairly minimal, which is good because unlike taking Sutent, with Afinitor there’s no “rest” week between cycles.

Google side effects and you can find various lists. From those lists, here’s what I’ve experienced so far:

More common

•   abdominal or stomach pain, usually minor

•   change in taste, slightly less aware of sugar or salt

•   dry skin, but I had that before, especially in the winter

•   pain in the arms or legs, read joint and muscle pain, particularly joint, as if the drug intensifies arthritic pain somewhat

•   unable to sleep, which given that I struggle with insomnia has been one of the more annoying side effects

Less common

•   back pain, especially lower back

•   bumps on the skin, read pimples (do I really need to revisit my teen years?)

•   passing gas, always a treat as one ages anyway, it seems

Among the “not noted” is dizziness, which I can only attribute to the Afinitor, though who knows, really? I woke up one recent morning feeling like a drunken sailor and proceeded to reel about the house for a couple of hours until that sensation passed away. It only happened once—so far.

This morning there was a new side effect, which wasn’t entirely attributable to Afinitor. About 1:00 a.m. I awoke to the sensation that my upper lip was swollen on the right side. I’d bitten my inner lip during dinner the previous evening, and so I initially thought it was possibly a reaction to that, exacerbated by the Indian food we ate. I iced the lip only to find that the swelling then spread across my entire upper lip. (People pay good money for collagen treatments that have this effect!)

By 7:00 with no resolution in sight I was sufficiently concerned to go to the hospital emergency room. The doctors concluded that the swelling was a side effect of one of my blood-pressure drugs, Lisinopril. Apparently this effect is well-documented and can occur even after taking this drug, as I have done, for a number of years. However, taking Afinitor is known to increase the probability that this side effect will occur. Two hours later I emerged from the ER, having been given Benadryl and Prednisone and a new blood-pressure prescription (Losartan). Over the course of the day the swelling substantially subsided and by bedtime my upper lip was pretty well back to normal.

Again, for the most part the side effects I’ve experienced with Afinitor have been fairly mild. On the plus side, I have been able to decrease the amount of narcotic painkiller I need to take, which I regard as a signal that the Afinitor is having the desired effect on the cancer tumors.