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March 2006–May 2007
Published in Kate Hayward, From Oncology Nursing to Coping with Breast Cancer, 2021
Poor night again so didn’t get up till 11am. Tim’s secretary rang to change his appointment from the evening to the afternoon. Didn’t tell Phil but went on my own and felt much more relaxed without him, as I didn’t have to worry about what he was thinking, etc. Saw Eileen and arranged appointment to talk about surgery options. Tim explained about ductal carcinoma in situ (DCIS), which is a non-invasive precancerous condition that in some cases can become invasive cancer. The reason for a full mastectomy is that I’ve probably had that for ages and it doesn’t respond to chemotherapy. Told Tim about my eyes watering and he said it’s due to the Taxotere® and that they call it ‘tearing’ in the USA. I later found out the medical term is epiphora and can be corrected by inserting a silicone tube in the tear ducts which sounds a bit drastic.24 He also warned me about losing my nails, as they’re so sore and discoloured and lifting off the nail bed. Oh the joys of chemo!
Ophthalmological system (eyes)
Published in David Sales, Medical IELTS, 2020
Occasionally patients will present with epiphora (watering eye) and, especially in the elderly, they may have an ectropion (lid falling away from the eye) or entropion (lid turning inwards).
Watery Eyes
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Watery eyes, termed epiphora, may be the least of your worries on a Friday afternoon, but to the patient, epiphora can be disabling. Epiphora occurs when there is the slightest imbalance of tear production and absorption and can occur due to problems with any part of the lacrimal apparatus causing increased tear production.
The Association Between Taxane Use and Lacrimal Disorders
Published in Current Eye Research, 2023
Gerald McGwin, Tucker Contorno, Matthew G. Vicinanzo, Cynthia Owsley
Taxanes (docetaxel and paclitaxel) are antineoplastic agents used in the treatment of metastatic breast cancer, gastric cancer and non-small cell lung cancer. Their use is associated with a number of adverse effects.1 While bone marrow suppression, diarrhea, and alopecia are the common adverse effects of docetaxel, adverse lacrimal events, including canalicular duct stenosis, has also been frequently reported.1 Estimates of the incidence of tearing in patients receiving adjuvant docetaxel-based chemotherapy vary widely ranging from 7.9 to 86%.1–4 According to one study, epiphora only occurred in seven out of the eighty-nine patients (7.9%) who received docetaxel weekly.1 However, another study reported that a majority of patients receiving weekly docetaxel therapy (86%) developed excessive tearing.2 One explanation for the wide range of prevalence estimates are the disparate definitions of epiphora used across studies. Additionally, differences in dose and schedule likely play a role. While the cessation of therapy often resolves epiphora, many patients pursue surgical intervention for symptom management. In one study, thirty out of the seventy-one patients (42%) who received weekly docetaxel underwent surgery to correct epiphora, the majority of whom reported either an improvement of symptoms or complete resolution.3
A rare case of pemetrexed-induced diffuse punctal and canalicular stenosis: management by coronary balloon puncto-canaliculoplasty
Published in Orbit, 2022
Abhimanyu Sharma, Monalisa Pattnaik, Mohammad Javed Ali
Chemotherapy-induced epiphora is being increasingly recognized in patients with several malignancies. Chemotherapeutic agents known to cause epiphora include 5-fluorouracil, docetaxel, S-1, panitumumab, radioactive iodine, doxorubicin, capecitabine, imatinib, pentostatin, and mitomycin-C.1,2 The proposed mechanisms causing epiphora are ill-understood.1 Pemetrexed is a chemotherapeutic agent approved for pleural mesothelioma treatment and prolonged maintenance therapy in advanced cases of non-small cell lung carcinoma. It inhibits thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide formyltransferase, and hence interferes with the folate metabolism.2 Ocular adverse effects of pemetrexed previously described in literature include conjunctivitis3 and eyelid edema.4 Epiphora as a new ocular adverse effect was first reported by Jung et al.2 The patient was successfully treated with three snip punctoplasty (for punctal stenosis) followed by probing (for canalicular stenosis). The present case is the second report to the best of authors’ knowledge, but the first to document dacryoendoscopy findings and report balloon puncto-canaliculoplasty as a minimally-invasive treatment modality for pemetrexed induced punctal and canalicular stenosis.
Lacrimal gland botulinum toxin injection for epiphora management
Published in Orbit, 2022
Johnathan Jeffers, Katherine Lucarelli, Sruti Akella, Pete Setabutr, Ted H. Wojno, Vinay Aakalu
Our findings suggest that botulinum toxin injection represents a safe, minimally invasive, and effective treatment for the management of epiphora. Table 4 shows a summary of findings grouped by etiology. The injections can be utilized to treat both functional and non-functional cases of epiphora without changes in efficacy. Subjective improvement was reported in nearly all the studies involved, with values reported ranging from 67 to 100%. Both Wojno et al. and Singh et al. compared groups by etiology of epiphora.22,34 Singh et al. found no difference in median Munk score reduction between the functional and non-functional groups.34 Wojno et al. noted subjective improvement in all patients in both groups.22 Side effects between the two etiologies were also nearly equal, with 18% (n = 21) of patients in the functional group and 21% (n = 19) of patients in the non-functional group experiencing side effects. Thus, there appears to be little difference in overall efficacy and side effects in cases of both functional and non-functional epiphora treated with botulinum toxin A injections.