1. < Head & Neck Cancer

Chemo with bad kidneys?

Posted by earless @earless, 3 days ago

Hello, I have had two separate surgeries within the last 2 years to remove large SCC tumors. One was on the one side and involved removal of my ear. The other was on the other side by my eye. I had full radiation treatment both time, Plus I have had radiation over the years in two other locations. Now the Doctors think I should have chemotherapy even though the tumor was completely removed with good margins, this is because the last tumor showed nerve invasion.
I also have very bad CKD with GFR< 20.
To those who have done chemotherapy have you found decline in your Kidney functions numbers?
I have been through but I will not go on dialysis. And maybe it would be less agonizing and painful to just pass from Kidney Failure rather that wait for cancer to take me.

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Moderator
Colleen Young, Connect Director | @colleenyoung | 3 days ago

Welcome, @earless. I'm tagging @gingerw on this discussion. While she has a different type of cancer (myeloma), she is familiar with dealing with chemotherapy and kidney disease.

See these two related discussions:
- Chemotherapy and Dialysis: Looking for others who have had both https://connect.mayoclinic.org/discussion/chemotherapy-and-dialysis/
- Kidney function and medications https://connect.mayoclinic.org/discussion/kidney-function-and-medications/

@earless, some chemotherapy drugs are more taxing on the kidneys than others. Is your oncologist working with your nephrologist to find a chemo combo that would work best for you?

REPLY
1 reply
Mentor
Ginger, Volunteer Mentor | @gingerw | 2 days ago
In reply to @colleenyoung "Welcome, @earless. I'm tagging @gingerw on this discussion. While she has a different type of cancer..." + (show)
@colleenyoung

Welcome, @earless. I'm tagging @gingerw on this discussion. While she has a different type of cancer (myeloma), she is familiar with dealing with chemotherapy and kidney disease.

See these two related discussions:
- Chemotherapy and Dialysis: Looking for others who have had both https://connect.mayoclinic.org/discussion/chemotherapy-and-dialysis/
- Kidney function and medications https://connect.mayoclinic.org/discussion/kidney-function-and-medications/

@earless, some chemotherapy drugs are more taxing on the kidneys than others. Is your oncologist working with your nephrologist to find a chemo combo that would work best for you?

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@colleenyoung, thank you for tagging me!

@earless This is a good discussion, and the conversations mentioned were started by me in the time before I started chemotherapy and dialysis. Chemo started Aug 2021, I had my fistula placed for dialysis Dec 2021, PD catheter placed Aug 2022, and started PD dialysis Sept 2022.

I sincerely hope your cancer management team and nephrologist are in communication with each other. If they are not, insist on it! That was a critical factor for me. Both my oncologist and nephrologist talk to each other, even now, and it helped figure out the best course of action to pick medications that would not affect my kidneys so bad. We all know at some point dialysis was going to happen. We chose to go "low and slow" with the chemo just for that reason.

There certainly should be no opposition to you getting a second opinion for adding in chemotherapy. If the surgeries were in the last 2 years, why are they only now suggesting the chemo? What changed their minds that is wasn't brought up at the time of surgery?

I commend you for thinking of the big picture! I know you have posted in the kidney and bladder group about contrast procedures with low eGFR.
Ginger

REPLY
1 reply
earless | @earless | 2 days ago
In reply to @gingerw "@colleenyoung, thank you for tagging me! @earless This is a good discussion, and the conversations mentioned..." + (show)
@gingerw

@colleenyoung, thank you for tagging me!

@earless This is a good discussion, and the conversations mentioned were started by me in the time before I started chemotherapy and dialysis. Chemo started Aug 2021, I had my fistula placed for dialysis Dec 2021, PD catheter placed Aug 2022, and started PD dialysis Sept 2022.

I sincerely hope your cancer management team and nephrologist are in communication with each other. If they are not, insist on it! That was a critical factor for me. Both my oncologist and nephrologist talk to each other, even now, and it helped figure out the best course of action to pick medications that would not affect my kidneys so bad. We all know at some point dialysis was going to happen. We chose to go "low and slow" with the chemo just for that reason.

There certainly should be no opposition to you getting a second opinion for adding in chemotherapy. If the surgeries were in the last 2 years, why are they only now suggesting the chemo? What changed their minds that is wasn't brought up at the time of surgery?

I commend you for thinking of the big picture! I know you have posted in the kidney and bladder group about contrast procedures with low eGFR.
Ginger

Jump to this post

Ginger, Sorry I didn’t make it clear but I had three surgeries. the first two were followed up with radiation, Then 1 1/2 years later I they found a new and more aggressive tumor in the same general area as my first surgery which was performed just a few weeks ago and all cancer was removed with at least 2mm margins. Will only have 20 sessions of radiation because the area has been radiated before. I will have my radiation simulation tomorrow and I am to meet with anther doctor about chemo next week. All of my medical is done at Mayo so there is pretty good communication between departments but I get frustrated because there is so much going on and so many different doctors that it’s hard to keep it all straight in my head. Anyway what I am now doing is trying to find out just how much harm the chemo will cause my kidneys because if there is good chance that it would put me on dialysis I will refuse the chemo and just take my chances.
Good for you for being able to handle everything at once it just seems impossible to me.

REPLY
1 reply
Mentor
Sue, Volunteer Mentor | @sepdvm | 1 day ago
In reply to @earless "Ginger, Sorry I didn’t make it clear but I had three surgeries. the first two were..." + (show)
@earless

Ginger, Sorry I didn’t make it clear but I had three surgeries. the first two were followed up with radiation, Then 1 1/2 years later I they found a new and more aggressive tumor in the same general area as my first surgery which was performed just a few weeks ago and all cancer was removed with at least 2mm margins. Will only have 20 sessions of radiation because the area has been radiated before. I will have my radiation simulation tomorrow and I am to meet with anther doctor about chemo next week. All of my medical is done at Mayo so there is pretty good communication between departments but I get frustrated because there is so much going on and so many different doctors that it’s hard to keep it all straight in my head. Anyway what I am now doing is trying to find out just how much harm the chemo will cause my kidneys because if there is good chance that it would put me on dialysis I will refuse the chemo and just take my chances.
Good for you for being able to handle everything at once it just seems impossible to me.

Jump to this post

Hello @earless, your nephrologist and oncologist should be working together to find the best alternative for you. You certainly don't want to be thrown into dialysis by your chemo. I have metastatic SCC also..... for 13 years now. My most recent metastasis was treated with a newer immunotherapy and it has cleared the tumor in my kidney and surrounding lymph nodes. Has anyone mentioned an immunotherapy to you instead of chemo? It might be worth a question to your oncologist. Mayo does a great job of having the specialties working together so if they are not, then start to question your teams why not?

REPLY
1 reply
earless | @earless | 1 day ago
In reply to @sepdvm "Hello @earless, your nephrologist and oncologist should be working together to find the best alternative for..." + (show)
@sepdvm

Hello @earless, your nephrologist and oncologist should be working together to find the best alternative for you. You certainly don't want to be thrown into dialysis by your chemo. I have metastatic SCC also..... for 13 years now. My most recent metastasis was treated with a newer immunotherapy and it has cleared the tumor in my kidney and surrounding lymph nodes. Has anyone mentioned an immunotherapy to you instead of chemo? It might be worth a question to your oncologist. Mayo does a great job of having the specialties working together so if they are not, then start to question your teams why not?

Jump to this post

Thank you for the information. I will be meeting with a Oncologist next week and will certainly mention it.

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