Swollen legs and hips - any advice?

[Charlotte]

Hi all,

My Mum's just started a two week break after her first round of GemCap treatment - she has an extra week off as my brother is getting married on 21st May, so we're hoping she'll feel well enough to be able to enjoy the day. The symptom that is bothering her the most at the moment is swelling/oedema - mostly in her legs and hips, but also her arms and abdomen. It's really getting her down, especially since the palliative care nurse from the hospice visited and told her that it was probably more a result of the cancer itself than the chemo. Does anyone have any suggestions as to how to alleviate it? the district nurse had suggested a special kind of massage, but the nurse from the hospice didn't think that was appropriate at the moment as it would just shift the swelling elsewhere. The skin on her legs is also red and sore as though it were sunburnt, which I think is a side effect of the chemo.

Any advice gratefully received.

Charlotte x

[PCUK Nurse Jeni]

Hi Charlotte.

Sorry to hear that your mum is experiencing some problems. The red and sore ("sunburnt") skin on her legs should not be a side effect of chemo. It sounds like it could possibly be an infection of the skin (cellulitis), and for this she would need antibiotics. If this is the case, it certainly would contribute to swelling of the legs. Has this been seen by the oncologist or nurse specialist? If not, then perhaps she should visit the chemo unit and have them check her legs over.

The swelling may benefit from massage, but only if the problem is with the lymphatic drainage. There is a type of gentle, superficial massage which helps to drain lymphatic fluid from around the body, but this should be carried out by a trained Lymphoedema nurse. If it is not this, it may be fluid retention -Gemcitabine can cause mild fluid retention. Maybe a small dose of diuretic would be helpful? This could be prescribed by the GP or oncology team, especially if it is bothering your mum. She should always have her feet up when resting -very slightly raised above the heart level to assist drainage.

Regarding the temperature (other post), is she on the vaccine arm of Telovac? If so, it is well known that the vaccine can cause flu like illness and high temperature on the day/evening that it is given. Worth looking in to, then she won't have to keep coming into hospital (but only if it is vaccine related!)

Hope this helps,

Jeni.