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Shingles After First Chemo Treatment

Posted by denip @denip, Oct 13, 2023

Hello,
My husband received his first chemo treatment (3 drug protocol) on October 5. He felt pretty good until about 3 days after treatment when he started to feel really nauseous, couldn’t sleep and developed side effects from all of the meds that are supposed to help with the nausea (constipation, sleep disturbance). He has been mostly in bed and has not left the house much. Then, today, he developed shingles. It came on quickly and he was prescribed medication for it. My question is, has this happened to anyone else? After just one treatment? He goes back next Thursday for his next round of chemo. I am so worried about how this is affecting him. I am thinking he may need an adjustment to his dosage or the drugs that comprise his treatment. If anyone else has had similar experience, would love to hear about how you handled things. Thank you!

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Mentor
Lori, Volunteer Mentor | @loribmt | Oct 14, 2023

Good morning, @denip. Shingles is an opportunist. It tends to emerge from dormancy when the body’s immune system has weakened or is compromised. In the case of your husband he has cancer and undergoing chemotherapy. It’s not at all uncommon for cancer patients to develop shingles.

When I was going through all my cancer treatments and bone marrow transplant I was taking an antiviral med for several years until I could get the Shingrix vaccine. So your husband may not need to adjust his treatment plan because of this.

I’m so sorry your husband is having to deal with this on top of everything else. The antiviral should get him through the worst of it.

There is a discussion in the forum with other members who have also gone through this same scenario while on chemotherapy.

Anyone gotten shingles while undergoing chemo?
https://connect.mayoclinic.org/discussion/shingles-7/

The side effects from the chemo can be the most disruptive. You mentioned he’s experiencing constipation from the anti-nausea meds. One thing that helped me the most is daily, I’d eat a cup of Activia yogurt with a spoonful of ground flax seeds mixed in. I know he may not feel like eating but this helped keep my stomach/intestines soothed, the gut biome happy and ‘things moving’. It’s also very important for him to drink a lot of water during the day. Room temperature water worked the best for me in terms of being able to drink 8 ounces at a time. It’s easier on the body.

Does he still have an appetite?

REPLY
1 reply
ncteacher | @ncteacher | Oct 14, 2023

I can't speak to the shingles dilemma. I had shingles as a teenager, way back when, but haven't since, even during chemo. I can speak to the dosage question, though. Which regimen is your husband on? I did eight rounds of Folfirinox, and cycles 9 and 10 were Folforinox without the oxaliplatin. For round 1, my MD originally was going to give me a dosage that was 100% of typical, until he realized my age (I am now 71) and reduced it to 80%. He said the reason was because the original, full dose was tested on people much younger than me. Good thing he cut it back--even at 80%, it was a rough cycle. I was still sick two weeks later when I went back for cycle no. 2, with nausea and diarrhea for nearly the entire cycle. For cycle no. 2, the MD reduced my dosage level to 60% of typical, and it's been there ever since. I have gradually adapted and gotten stronger with each cycle, and my appetite has definitely improved. All of this is to say that it's OK to ask your MD about a reduced dose; it may not be the answer to your husband's issues, but it's worth inquiring.

Appetite, nutrition and hydration can be tricky. I decided calories were the primary goal and allowed myself to eat whatever sounded good at the time. I went on food jags (the same thing for lunch day after day, for example), and I tended toward starchy and sweet foods. I also drove my poor husband bonkers as he tried to keep up with getting me things that sounded good at the time. This has also improved as my strength has improved. I am back to eating more fruits and veggies, and my food cravings are somewhat more logical. Hydration can be difficult on chemo, because it dehydrates you. Also, I prefer ice-cold water, and that's tough to drink when the oxali-related cold neuropathy hits. I have a standing order from my MD for fluids at any time I request, and the nurses always ask when I come for chemo, when I return to remove the FU pump, and when I come for my Udenyca injection. In recent months, I haven't needed the fluids, but I appreciate having them available. You might want to ask your MD about that as well. Your husband can always decline them if he doesn't need them.

REPLY
1 reply
denip | @denip | Oct 14, 2023
In reply to @loribmt "Good morning, @denip. Shingles is an opportunist. It tends to emerge from dormancy when the body’s..." + (show)
@loribmt

Good morning, @denip. Shingles is an opportunist. It tends to emerge from dormancy when the body’s immune system has weakened or is compromised. In the case of your husband he has cancer and undergoing chemotherapy. It’s not at all uncommon for cancer patients to develop shingles.

When I was going through all my cancer treatments and bone marrow transplant I was taking an antiviral med for several years until I could get the Shingrix vaccine. So your husband may not need to adjust his treatment plan because of this.

I’m so sorry your husband is having to deal with this on top of everything else. The antiviral should get him through the worst of it.

There is a discussion in the forum with other members who have also gone through this same scenario while on chemotherapy.

Anyone gotten shingles while undergoing chemo?
https://connect.mayoclinic.org/discussion/shingles-7/

The side effects from the chemo can be the most disruptive. You mentioned he’s experiencing constipation from the anti-nausea meds. One thing that helped me the most is daily, I’d eat a cup of Activia yogurt with a spoonful of ground flax seeds mixed in. I know he may not feel like eating but this helped keep my stomach/intestines soothed, the gut biome happy and ‘things moving’. It’s also very important for him to drink a lot of water during the day. Room temperature water worked the best for me in terms of being able to drink 8 ounces at a time. It’s easier on the body.

Does he still have an appetite?

Jump to this post

Hi, thanks so much for your reply. Yes, he was just starting to feel better after his first treatment on October 5, then the shingles hit. Thanks for the yogurt with flax tip! He has been eating non-dairy yogurt and loves it with berries. The addition of flax is a great way to add more fiber!

Surprisingly, he still does have an appetite. It is not as strong as it normally is and he has lost some weight, but he is still eating a fair amount, which is great. I have also been making a veggie broth from about a dozen different veggies and root veggies. It is delicious and he loves it, so that helps too.

REPLY
denip | @denip | Oct 14, 2023
In reply to @ncteacher "I can't speak to the shingles dilemma. I had shingles as a teenager, way back when,..." + (show)
@ncteacher

I can't speak to the shingles dilemma. I had shingles as a teenager, way back when, but haven't since, even during chemo. I can speak to the dosage question, though. Which regimen is your husband on? I did eight rounds of Folfirinox, and cycles 9 and 10 were Folforinox without the oxaliplatin. For round 1, my MD originally was going to give me a dosage that was 100% of typical, until he realized my age (I am now 71) and reduced it to 80%. He said the reason was because the original, full dose was tested on people much younger than me. Good thing he cut it back--even at 80%, it was a rough cycle. I was still sick two weeks later when I went back for cycle no. 2, with nausea and diarrhea for nearly the entire cycle. For cycle no. 2, the MD reduced my dosage level to 60% of typical, and it's been there ever since. I have gradually adapted and gotten stronger with each cycle, and my appetite has definitely improved. All of this is to say that it's OK to ask your MD about a reduced dose; it may not be the answer to your husband's issues, but it's worth inquiring.

Appetite, nutrition and hydration can be tricky. I decided calories were the primary goal and allowed myself to eat whatever sounded good at the time. I went on food jags (the same thing for lunch day after day, for example), and I tended toward starchy and sweet foods. I also drove my poor husband bonkers as he tried to keep up with getting me things that sounded good at the time. This has also improved as my strength has improved. I am back to eating more fruits and veggies, and my food cravings are somewhat more logical. Hydration can be difficult on chemo, because it dehydrates you. Also, I prefer ice-cold water, and that's tough to drink when the oxali-related cold neuropathy hits. I have a standing order from my MD for fluids at any time I request, and the nurses always ask when I come for chemo, when I return to remove the FU pump, and when I come for my Udenyca injection. In recent months, I haven't needed the fluids, but I appreciate having them available. You might want to ask your MD about that as well. Your husband can always decline them if he doesn't need them.

Jump to this post

Hi, thanks so much for your response! My husband is working with a nutritionist in addition to all the docs. She recommended he fast the day before, during and after chemo. Or, at the very least on the day of chemo. She believes it will assist in making the drugs more effective. Luckily he still has appetite and is drinking a fair amount of fluids. He did have a difficult time with cold fluids for a few days after oxali, but that has improved. His chemo drugs are currently:
aprepitant (CINVANTI)
atropine
fluorouracil
ondansetron (ZOFRAN)
oxaliplatin
Plus all of the drugs for nausea that include dexomethasone

REPLY
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