Avastin and High Blood Pressure

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Hi all

Just wanted some advice…has anyone had their Avastin stopped/suspended due to a hypertensive crisis?

I’d been having 3/4 weeks Taxol + fortnightly Avastin - 3 cycles, which have totalled 9 Taxol _ 6 Avastin, of course. However, the last Avastin was cancelled because my BP taken at the hospital was too high.

So I ended up finishing that particularly course one Avastin light. There followed some scans which showed a small improvement on my liver mets and a decision by the head oncologist to continue/restart the Taxol + Avastin combo.

Despite a 6 week break between the last Avastin and today’s scheduled, but once again aborted dose, my BP has remained just about within acceptable limits (I’ve got proper BP monitors at home, so I KNOW). At the hospital today it was just below the 200 systolic that sets the alarms off and 40mmHg higher than it had been at home!

Result: a sedative, another BP pill and the usual anti-histamine, etc and so of course I fell asleep (was being given Taxol at the time). The next thing I remember is a more junior doctor walking in and saying ‘No more Avastin for you, ever’ and walking out (He had his charisma shot off in the war). I’d brought my own monitor with me and took a load of readings - all around 158/95, not good, but normal for me (I already take 160mg Valsartan every day) and these values were regarded as acceptable the last time I was given any Avastin (which is beginning to seem like a very long time ago now). But this time no-one was interested.

I went straight from the hospital to see my GP and he’s added ‘Lercanidipine’ to my BP medication and is going to speak to the hospital on my behalf.

I’d love to know if anyone has been on/off Avastin like this and what steps (if any) were taken to rectify the situation. The hospital seem very reluctant to change my BP medication on a permanent basis, but I feel that without beefing it up, I’ll lose the Avastin for good.

I have to say that until recently I had no strong feelings one or the other about the use of Avastin in a bc (as opposed to other cancers) context, as I was aware that it has mixed trial results.

However, when I embarked on this course of treatment, it was made very clear unto me by the very same charisma-less doctor mentioned above that the oncology team felt it was an essential part of the regime. Now, all of a sudden, it’s going out of the window, with no apparent effort to control the source of the problem, that is, my high blood pressure. (I’m nearly 53 and extreme hypertension runs in the family).

Secondly, and this is just a minor reason, there is a small amount of anecdotal evidence that Avastin benefits lymphoedema in some way not yet fully understood, so those of you who have read the lymphhoedema threads will understand even more fully why I am/was keen for it to continue.

So…sorry about the long-winded explanation, but if anyone has any similar experiences or suggestions, I’d be immensely grateful to hear of them. Need some ammo’ for my next appointment…

X to you all

S

Should have added that I don’t smoke, barely drink at all at the mo’ due to the SEs, am slap bang in the middle of the the normal weight for my height. I take plenty of exercise (mostly walking and swimming). I love fruit and veg and never add salt to my food. I do the best I can!

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Just giving this a hopeful ‘bump’.

X

S

3

Hi,
yes I and others on here have suffered high blood pressure due to avastin, I did stay on it but stopped August this year. I am having breathing problems which I think could be connected to avastin but there is no evidence other than my very acurate gut feeling in these matters.
Hope others can give you more help.
Love Debsxxx

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Oh meant to ask If you can make your avater vanish how about my tumours?
Love Debsxxx

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Hi Debs

Thanks for posting.

I do feel a bit alone on this one. The charmless onc is one of a team of three that cover the chemo at my hospital. The chief onc is fine - very approachable and I also get on well with the third member - a female onc. So I have a 2:3 chance of getting someone with some manners and a bit of empathy, but unfortunately I lucked out yesterday.

I took the first Lercanidipidine’ this morning and my BP has already fallen. Will take BP again in a minute - I’m taking it twice a day at the moment.

As for making things disappear, I’m your man. Pens, keys, shoes, any important document, you name it, I can magick it away. Sadly, this skill doesn’t seem to extend to tumours, or I’d be skipping through these forums sprinkling my disappearing dust all over you and everyone else, Debs. But I’ll keep working on it, just the same.

Hope you are feeling a bit better these days.

X

S

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Hi there bahons 2

Sadly high blood pressure is a known side effect of avastin, and one of the reasons why some doctors do not support routine use of the drug. In trials of avastin there have been deaths from high blood pressure.

Jane x

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jane i hope you don’t mind me asking a question, but are any of your recurrences on the opposite side to your bc.
i’m asking this because i have been following all the posts regarding regional recurrences and secondary bc because i see there is so much conflicting information about it all and it gets me confused. i had a local recurrence 18mths ago and now distant regional recurrence in opposite side.
thankyou for any information
thinking of you and always enjoy what you have to say.
reneexx

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sorry iv’e just jumped in with a different question hope you don’t mind.
reneexx

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Hi

Jane - nice to hear from you. I have an appt with an onc (hopefully one of the other two in the team) this Thursday and will try to get to the bottom of what happened a few days ago.

A lot of it is, I think, tied to my objection to having BP taken on my arms. I discussed this with head onc prior to the next round of treatment and he told me (and his staff) that he was happy for them to take BP measurements on my ankle. He also told me that he was, if not happy, prepared to live with my current BP (after applying the 10mmHg systolic correction). Unfortunately, one of his colleagues seems, I think to have taken umbrage at this and I got the full brunt of this a few days ago. Hey-ho, back in a few days for the next Taxol, so perhaps I’ll get to the bottom of things then.

Renee, no need to apologise! - you gave the thread a useful bump. Hope you get some answers soon.

X

S

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Renee:

most of my recurrence is on left side…same side as original bc. I have cancer in neck, supraclavicular nodes, chest wall, and skin mets on mastectomy scar. The only recurrence I have on right side is a 4cm tumour in my right axilla (armpit.)

Jane

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A little update:

Saw(approachable)onc last week and talked about Avastin.

I think he gave me a probably much needed reality check in that he pointed out that Avastin is ‘a’ drug, not ‘the’ drug.

However, he has advised me to keep monitoring and recording my BP, which is now within normal range, twice a day and he is going to discuss my situation with his colleagues over the next few days, to see whether they can reach a concensus on reinstating the Avastin (or not)some time in the future.

JaneRA - thinking of you.

X to all

S

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Due to the way the system works at the hospital, I was actually given my last chemo without seeing a doctor at all (he forgot me, I think. Nurses had already said my bloods were OK); he would have made time for me if I’d flagged it up to the nurses, but because it was the rather dogmatic onc, I said nothing and skedaddled out sharpish once I’d I’d been unplugged. Naughty, I know, but I’m about 90% on Taxol, which is great and I absolutely did not feel the need to hang around just to have an argument with him, which is what usually happens. And I live so close to the hospital that I can be there in next to no time if I do have any problems.

Which brings us to this week…And, good news…I think… approachable onc says have decided to reinstate the Avastin in a fortnight’s time now that my BP has come down to normal levels with the addition of a calcium channel blocker to my usual hypertension medication. He’s made it clear tho’, that if it starts to climb steeply and quickly again that will be the end of it forever.

X

S

13

Back to square one.

Grumpy onc says Avastin is definitely cancelled. End of. Unless of course appoachable is there next Friday when I have my chemo.

Despite approachable onc (who is, as far as I can gather, in charge) writing in my file that Avastin was to be restarted, grumpy onc says ‘no’.

I don’t where I stand. I don’t know who I will see next week. I don’t know what treatment I will be getting. All I know is that I’m fed up with being mucked about.

With apologies to those who are grappling with much greater problems than this. (I just wanted a moan).

X to all

S

14

Dear Bahons,

I don’t have any advice to give …sorry.
I have just start Avastin and like you struggling with blood pressure.
My GP is not concerned but my Oncologist made all sorts of fuss.
So I am now on tablets.
Both my parents and grandparents all had high BP so I think it would have caught up with me at some timeor another!!!

I hope you soon get it sorted out, your BP sorted and you can continue Avastin.

Best wishes

Tess.X

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Hi Tess

Thanks so much for the reply (lovely avatar, btw); I was beginning to think I had started a blog!

Like you, oncs very concerned about BP, GP less so. I think lifestyle changes must have a limited impact on what seems to be largely hereditary blood pressure such as yours and mine.

Are you managing to keep going with the Avastin or have you had to stop for a bit, too?

Anyhow, just back from hospital, full as an egg on Taxol + Avastin.

Yes, a result. The third onc, the woman in this unholy Trinity was on today and got the full saga from me. She’s a big fan of Avastin, was happy with BP (taken at ankle) and consequently threw her weight behind approachable onc and reinstated the Avastin.

I’d like to be a fly on the wall when grumpy onc finds out and fingers crossed he’s not on the next time I go or there could really be some fireworks.

All best wishes to you and hoping your BP behaves itself. Oh, have you noticed any changes in your lymphoedema whilst on Avastin, or do you think it is too early to tell?

X

S

16

Hi Bahons,

I think there have been problems with BP and Avastin however I saw my
Oncologist today and she was very pleased that my BP was lower and that was the end of that conversation.

I am so pleased you managed to get a sensible conversation out of someone and hope thats the end of that!!!

My Lymphoedema was due to a blood clot so I don’t have any problems now.

I have been on paxitaxol for 3 months and have significant reduction in tumors, only had 3 Avastin due to treatment for brain rads.

Best wishes
Tess.X

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Hi Tess

Glad to hear everyone is happy with your BP; that’s excellent news.

And that your lymphoedema was only caused by a blood clot.

Really pleased that the Taxol has worked so well for you.

I am monitoring ny BP twice a day and it’s still in the massive dip (123/53 tis am) caused by the Taxol immdediately after chemo, which I can feel, but I am expecting it to climb steadily as that particular effect wears off and that of the Avastin starts…

Like you, I’m light on the Avastin, only having had 6 out the intended 10 so far, due to BP problems and the differing opinions of the oncs.

All the best for now

X

S

18

Well,

I think I have developed the OTHER BP side effect of Avastin, namely hypotension, as my BP has not risen significantly at all and at its lowest a few days was 100/55.

I felt a bit light-headed (but often do after chemo anyway), but otherwise not too bad…anyone any experience of this - and what did you do about it? If anything.

Might start a separate thread…

X to all

S