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Docetaxel is another very effective chemotherapy agent we use across several tumor types and it’s in the same family as paclitaxel and the taxols. The thing about docetaxel is it really does drop your counts in your bone marrow, specifically your neutrophils that help you fight infection and maybe your platelets and blood counts, red blood cells as well. So we watch those every time we give it. The thing about docetaxel is the neuropathy, for one, isn’t as bad as it is in paclitaxel. The thing that is unique about docetaxel is it really causes significant fluid retention or has the potential to do so. For this reason to decrease the amount of that fluid retention, which can actually be what we call a pleural effusion on the outside of your lung, it can be actually in your abdominal cavity, which we call a [?], can be in your legs.
We give decadron at a pretty high dose, eight milligrams twice a day, before you receive your dose on the same day and afterwards. That can kind of reduce the amount of fluid retention you’ll have. One of the ways to kind of appreciate how much fluid you may be retaining from docetaxel is to weigh yourself every morning. And you might find a significant number of pounds different when you start getting docetaxel because of that fluid. And when you do notice that, you can talk to your doctor to do things to hopefully reduce it. For example, like compression stockings, and other things in addition to that decadron to reduce the amount of swelling during your course. In addition, docetaxel, like it has the big effect on your bone marrow. It could also cause really significant fatigue and just kind of feeling unwell. And these are things you want to gauge because if it’s to the point of reducing how much you’re eating and drinking, then you want to let your doctor know because sometimes we have to increase the medications at home, as well as even bringing you in for fluids. But remember that retention of fluids is something to watch closely. In addition, docetaxel is pretty notorious for causing what we call a maculopapular rash. It basically can be red and you see spots on your skin. This is something that’s not necessarily an allergic reaction, where we worry about you having a worse reaction in the future, but you should let your doctor know if this is the case. Docetaxel can cause what we call hand-foot syndrome, where you might get lesions that are painful or red on your hands and feet.
In addition to the lesions or in absence to those lesions, you just may notice that your hands are getting darker. The more chemotherapy you get, you’ll find that your tips of the fingers may darken over time. This does improve months after discontinuing the docetaxel. It also does cause hair loss and it’s one of the more notorious medications in causing hair loss at the bigger three week dose.
