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Hi All, now being treated at MD Anderson for stage 1-2 oropharyngeal CA. Getting proton and Erbitux. Got really sick after the loading dose of Erbitux and ended up in the ER. Got stabilized and put on dexamethasone for 3 days to get rid of the mega headache. Now the rash is coming on strong only 6 days post dose. I've been moisturizing, drinking tons of water, clindamycin lotion and just started doxycyclin. Does anyone have any tips to reduce the rash or make it less itchy, noticeable or anything to make it more tolerable? Thanks for your help.


T1 N0 oropharyx SCC HPV-
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Im sorry I havent had Erbitux. Hopefully someone who went thru it will check in soon.

From what I understand about Erbitux, the more of a rash the patient gets the better its working. It sounds very uncomfortable to me. Would benedryl work to help control the itching? Be careful, you dont want to get too dried out from using it so check with your doc. Stay in air conditioning so you arent outside in the heat, sweating would probably make it worse.

Good luck!!!


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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I had Erbitux in 2012, along with Taxotere, which wasn't fun, but was doable, although my skin rash wasn't that bad, some of the other side effects were. Other than reducing the dosage or stopping treatment, a few things were suggested or prescribed pretty much what you're already doing, but instead had Minocycline for the rash, and decadron infusions for the Taxotere, so maybe it helped with the Erbitux. I was also given benadryl infusions with each weekly dose of Erbitux, Tylenol to help with fever. Seems those areas more exposed to the sun are effected worse by the rash, so using sunscreen at least 30 UPF, wearing loose fitting, long sleeve pants, shirt. Avoiding hot showers, walking barefoot, moisturizing at night with creams being better than lotions, which may have more relief if refrigerated, putting creams on hands/feet and wearing gloves and socks over that. For nail cracks and finger fissures, regular band aids on finger tips, Liquid band aid, crazy glue, gloves. Washed with mild liquid bath soap like dove for sensitive skin, Aveeno, head and shoulders shampoo for dry scalp, although an oatmeal bath I heard helps. A topical antihistamine to help prevent itching, hydrocortisone, and moisturizing cream like aquaphor, Cetaphil, Eucerin, Aveeno, pain meds, extra hydration infusions, mucocitis care by spraying mouth out with saline at radiation center. I was hospitalized for dehydration, and needed a blood transfusion due to low hemoglobin, and later had conjunctivitis, probably from dry eyes from blocked tear gland, and slept most of the time when I stayed at Hope Lodge alone, which wasn't optimal.

Pretty much side effects cease when treatment ends, but some may take several weeks to resolve like the postures, itching, at least for me.

I hope this helps.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






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Thank you so much! My next infusion is tomorrow and I'm going to insist on the Decadron or dexamethasone. I had a reaction to the bender iv so I'm hoping there's something else they can give me to dampen down the histamine response. All of your tips are very helpful. I can't thank you enough.


T1 N0 oropharyx SCC HPV-
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[quote=Throat CA 704]My next infusion is tomorrow and I'm going to insist on the Decadron or dexamethasone.[/quote]
Decadron and dexamethasone are the same thing. smile When I was on cetuximab, I took 20 mg the night before each infusion, 20 mg with breakfast the next morning, and then 20 mg IV as a pre-med.

One thing that worked great for me, which was also mentioned above, was Head & Shoulders shampoo. My scalp really itched after my first infusion but I had almost instantaneous relief with the H&S shampoo. After that, I would always spread the lather over my chest, arms, shoulders and back.

My doctor also prescribed 2.5% hydrocortisone cream. You can get the 1% over the counter but it doesn't work as well.

One week I saw a different oncologist, who for some reason prescribed hydroxyzine pamoate for itching I no longer had. Since I didn't need it, I never took any so I can't tell you if it works or not but it's something you could ask you doctor about.

Incidentally, the antibiotics are strictly preventative, to hopefully keep the rash from getting infected. They won't do anything to help you feel better.

And yes, the rash does go away a few months after treatment is over.


Andrew
4x survivor
1998 - SCC of larynx
...laryngectomy, tracheotomy, radiation, caries, HBO, teeth extr, TEP
2002 - lung cancer, wedge resection
2014 - SCC of BOT, pharynx, oropharynx, HPV-, stage IV, T2N0MX, invasive, poorly differentiated
...chemo (carboplatin, taxol), dc'd due to neuropathy
2015 - SCC of palate
...Feb-April IMRT (46 x 70 Gy)
...Jan 2015 - May 2016 cetuximab 500 mg q week x 55wks
2016 - metastases to mediastinum, lungs, spleen, pancreas
...Aug-? pembrolizumab q 3 wks
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There are meta-analyses showing prophylaxis antibiotics reducing the severity of skin toxicities; rashes, itching, onset, duration from EGFR inhibitors, like Erbitux.

http://www.ncbi.nlm.nih.gov/m/pubmed/27214209/


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






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Hi,
It's encouraging that you have a first-cycle rash - but the itching must be wretched. In addition to the previous suggestions, please make sure you your clothing and bedding are laundered in an fragrance-free detergent, and don't use dryer sheets. Probably won't make much difference but no need to add potential allergens to the mix.
Maria
PS - my husband found the Eucerin products soothing.


CG to husband - SCC Tonsil T1N2M0 HPV+ Never Smoker
First symptoms 7/2010, DX 12/2010
TX 40 IRMT (1.8 gy) + 10 Cetuximab
PET Scans 6/2011 + 3/2012 clear, 5 year physical exam clear; chest CT's clear of cancer. On thyroid pills. Life is good.

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