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femara, chemo and fingernails

muddy
- 9 posts
September 5, 2012 7:59:55 PM WATime

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Has anyone else had the same problem as I have with fingernails during Treatment? I've been on Femara for 3 years (after 5 years on Tamoxifen) and I have the worst fingernails known to man or beast. I have tried topical treatments and mineral (silica and calcium ) supplements for all that time but nothing works. The nails split, flake and break so that they catch on everything and often then tear down to the quick.

Muddy

67, mastectomy, chemo 8 1/2 years post surgery

67 YO diagnosed late 2003. Grade 3 ER+ 26 mm tumour. Mastectomy, chemo, 5 years tamoxifen, 3years (so far ) femara
Glenys
- Moderator
- 162 posts
September 7, 2012 8:58:13 PM WATime

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Hi muddy

Thanks for a very interesting question!! Very sorry to hear you have this ongoing problem with the fingernails! Very unpleasant & such a nuisance for you!!

I am not aware of a significant association between fingernail problems and Femara - nor with Tamoxifen. Therefore I have researched this extensively and below is a summary of my findings.

Some theoretical weakening of nails is feasible with further reduction in oestrogen in the body (the action of Femara). Many studies have been done & side-effects of Femara reviewed but there is little evidence or reporting of this. My conclusion is the nail damage may be associated with taking Femara, however is more likely related to other causes.

The most common cause of nail damage with breast cancer treatments is chemotherapy. Specifically the Taxane chemo drug group (Taxotere, Docetaxel, Taxol), and Doxyrubicin (Adriamycin), Epirubicin and 5-fluorouracil (5Fu) are well-known to potentially affect the nails - causing weak, flaky, brittle and splitting nails. Yellowish discolouration and ridges or lines in the nails are also common. For many people this will improve and resolve after chemotherapy is completed, however longer-term effects may persist.

Treatment includes careful nail care & protection, and possibly supplements to aid nail strength. Recommended practices include:
• Keep nails trimmed short & filed smooth
• Use a nail-strengthening moisturising cream regularly & prevent hands/nails drying out
• Wear protective gloves for cleaning, washing dishes & gardening
• Apply a nail-strengthening protective polish (e.g. Revitanail or similar – ask local pharmacist)

I know you’ve tried some supplements. A variety of preparations for skin, hair & nail strength are available from supermarkets, health stores & chemists (& on-line). Recommended supplements for strengthening nails are Biotin (see Biotin http://www.nlm.nih.gov/medlineplus/druginfo/natural/313.html ) and Silica or Orthosilicic Acid (I know you have tried this one!). Both these supplements are recommended by a Dermatologist from the Memorial Sloane-Kettering Cancer Centre in USA – a centre highly regarded world-wide for cancer treatment and research. A presentation by the Dermatologist (Dr Mario Lacouture) referring to chemo skin, hair & nail care during chemo (reference is made to lung cancer, however many of these chemo agents & side-effects are the same) is available to view at http://cancergrace.org/cancer-treatments/files/2011/09/dr-lacouture-on-skin-hair-nail-side-effects-of-treatment-transcript.pdf .

Other information & articles on the net you may be interested to look at:
Nail health | Breast Cancer Network Australia
http://www.bcna.org.au/new-diagnosis/treatment/chemotherapy/nail-changes
Fingernail Disorders During Breast Cancer Chemotherapy – Causes, Care, Prevention
http://breastcancer.about.com/od/lifeduringtreatment/tp/fingernail_disorders.htm

**Most importantly muddy - discussing with your GP and considering review by a Dermatologist would be advised to clarify the true nature and possible cause of this problem. It is possible of course that it may not be a result of Femara or chemotherapy. A specialist assessment and management may even help to resolve this for you.

I certainly hope some help is at hand (oh, sorry about the pun! … )
Love to hear how things go muddy,
Cheers Glenys xx

The Click Breast Care Nurse
muddy
- 9 posts
September 8, 2012 8:54:21 AM WATime

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Hi Glenys
Thank you so much for the work you put in on this question---I really appreciate it.As I'm already doing all the suggested remedies, except Biotin (which I'll get onto immediately) it seems that I'm just one of the unlucky ones. I didn't have Taxane but I did have Epirubicin. I had a lightbulb moment reading the reference on lung cancer chemo when athelete's foot was mentioned--- I have tinea about half the time! And I lost two toenails during my chemo and even now, 8 1/2 years later, the same two periodically turn black and fall off, most recently about 2 weeks ago.
Once again, thanks. Now I'm off to track down some Biotin!!

67 YO diagnosed late 2003. Grade 3 ER+ 26 mm tumour. Mastectomy, chemo, 5 years tamoxifen, 3years (so far ) femara
Glenys
- Moderator
- 162 posts
October 23, 2012 1:57:21 PM WATime

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Hi muddy. I have noticed lately that Biotin is an ingredient in most 'hair, skin & nail' preparations so you most likely have already tried it!
I'm wondering if specialist review by a Dermatologist may be the next best option (or have you also done this??).
Hoping an effective solution (or at least better management) comes your way soon muddy! Sending hugs and wishing you the very best! xx

The Click Breast Care Nurse
muddy
- 9 posts
October 31, 2012 11:23:08 AM WATime

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Hi Glenys
After your first post I went out and found some Biotin at my local Pharmacy. Th nice young pharmacist was very interested in my reasons for wanting it and asked me to let him know how it went--"you'll be my test case!' So I'm happy to persevere with it for a few months until the current nails grow out, and see how it goes. I'll keep you posted. Maybe it works better as an individual supplement rather than part of a Hair, nails and skin supplement.
Thanks for all you help with this problem
Muddy

67 YO diagnosed late 2003. Grade 3 ER+ 26 mm tumour. Mastectomy, chemo, 5 years tamoxifen, 3years (so far ) femara
Ness
- 81 posts
November 1, 2012 7:36:06 AM WATime

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Hi Muddy
That's great that you have such a proactive pharmacist - you will have to let us all know how you go too so if anyone else has the same issue they can follow your lead!
: )
Hope all else is well
Ness
x

The Click Project Coordinator

Daughter-in-law and niece of breast cancer "thrivers"!
muddy
- 9 posts
April 10, 2013 5:35:07 PM WATime

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Hi Glenys

It is now about 6 months since I first started taking Biotin. I've just finished the second bottle of 100----and it works !! My nails are not perfect ( they weren't before, but they have improved out of sight. The vertical splits have gone and they are not flaky anymore, except for two which are a little bit. So if anyone else has the same problem Biotin is certainly worth a go, probably combined with a silica gel.

Once again, thanks so much for your help with this.

Muddy

67 YO diagnosed late 2003. Grade 3 ER+ 26 mm tumour. Mastectomy, chemo, 5 years tamoxifen, 3years (so far ) femara
Glenys
- Moderator
- 162 posts
April 10, 2013 5:43:01 PM WATime

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Oh Muddy - I'm SO delighted to hear this!! WOW - that is great news!
Thanks so much to you for raising this - when we put our heads together hopefully we can find answers that really help! Wonderful!
xx

The Click Breast Care Nurse
MelRom
- 6 posts
May 30, 2013 9:20:25 PM WATime

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Dearest Muddy, Glenys and Ness!
Can't believe it's been so long since I've been in the Forum typing. Muddy I do hope you are all good now with your nail in tact. I found with mine they healed after a good 12 months but now they never went back to the "before". I used to have gorgeous toe nails and now well they need to be painted. My fingernails have also gone back to pre-cancer and for that I am ever so thankful. I would love to get some acrylics done but to be honest, I am not game to try. Not worth the risk. How are you now Muddy?

49 YO mother of 2, DX MAR 11, 2 tumours, 2 cancers and I'm a fighting to win!! I take Tamoxifen every day and hope this will keep the little cancer critters away!
JoBattersby1961
- 3 posts
November 2, 2013 11:17:24 AM WATime

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Thanks Glenys, for referring me here and Muddy for starting this quest. I have the same problem which I have been attributing to Tamoxifen so will give Biotin a try. I'll let you know how it goes.
muddy
- 9 posts
November 2, 2013 6:00:07 PM WATime

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Hi Jo and Mel,
Thanks for your replies. I hope this works for you ,Jo. I have found that the effect wears off after a while-- don't know if my body gets used to a certain level of supplement and then reverts to the poor nails. So I went off both the silica gel (which had been my first line of attack and which brought about some improvement for a while) and the Biotin. I have only just started on the Biotin again, so will see if the nails improve again in a few months. Good luck.
Muddy

67 YO diagnosed late 2003. Grade 3 ER+ 26 mm tumour. Mastectomy, chemo, 5 years tamoxifen, 3years (so far ) femara

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