Dr. Arshad Hussain Shah
Medical oncology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
Four years back, I was diagnosed with alveolar soft part sarcoma with multiple lung nodules. The primary tumor is located in my right thigh. I started taking tablet Sunitinib 25 mg at the beginning, which got raised to 37.5 mg after one year. The dose of 37.5 mg improved the situation. However, most of the nodules have decreased in size and stayed stable. Two years back, I had computed tomography scans that showed some increase in the size of the nodules, and my oncologist decided to raise the dose of the tablet to 50 mg. I have been taking the new dose of 50 mg for 11 days now but not feeling any side effects that I used to have with the lower dose, such as diarrhea, foot and hand syndrome, mouth ulcers, and others.
I wanted to ask, is it normal not to face any side effects in the higher dose? I am concerned that not having side effects means no effects of the higher dose on the tumor. So please answer if side effects mean a better response or if there is no relationship.
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
It looks like you are suffering from metastatic alveolar soft part sarcoma with lung nodules. You have responded well to the treatment for three years. Before initiating the new dose of 50 mg, you should undergo a cardiac assessment two-dimensional echo, Pulmonary Function Test (PFT), and all basic lab tests such as liver function test and complete blood count. As you have been taking this medicine for a long and have tolerated it very well, hopefully, you will handle it well.
As 11 days is not much time since you started the new dose, we have to wait, watch its side effects, and monitor them closely. Some side effects may come in the coming weeks but will be manageable. Till then, avoid eating grapes, wear loose cotton dresses, hydrate yourself well, and use moisturizers or coconut oil for hands and feet daily. These things will prevent side effects to a large extent.
In alveolar soft tissue sarcoma, no proven study proves any relation between side effects and tumor response. Also, i suggest repeating thyroid funtion test (TFT) every six months
Patient's Query
Thank you for the reply doctor,
I usually do complete blood work, especially to monitor my liver enzymes by the end of each course of treatment. As a side effect of long-term treatment with Sutent, I am taking tablet Thyroxine 200 ug to treat hypothyroidism. In addition, normal results of the heart ecocardiogram were found to check the Q-interval.
Hello,
Welcome back to icliniq.com.
I suggest you continue the same dose and protocol as advised by your treating physician.
Mandatorily keep monitoring the heart, thyroid, liver, and skin regularly. The medicine will work again with the new dose regimen. In case of any side effects, report immediately.
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Medical oncology
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