Chemotherapy Effects on the Feet

Cancer is a difficult thing to deal with.  Once you are diagnosed, there are so many decisions to make regarding your treatment options.  And if chemotherapy is in your treatment plan, your oncologist will describe the side effects and complications as well as the benefits.  But so often, you don't hear about what happens to the feet and legs from chemotherapy treatments.  What you will read below does not affect everyone undergoing chemo, but will help you understand what's happening if it does.

1.  Tinea pedis or athlete's foot
A couple of my patients have described this as "wicked athlete's foot".  It often presents as multiple small red blisters that can be filled with a clear fluid and itches like mad.  As your immune system is lowered by the therapy, your ability to fight off fungal infections is reduced. This type of blistering athlete's foot can also be very painful.  And the open areas can become infected. The best option is to use an antifungal gel instead of cream to dry the areas and kill the fungus.  We will attempt topical therapy unless the infection is so bad that pills are necessary.  Often a short course of oral antifungals is all it takes, usually less than 2 weeks.

2.  Paronychia or infection around the toenails
The skin around our toenails is full of bacteria which naturally occur on the skin.  In a patient with a lowered immune system, this bacteria can overgrow and cause redness and swelling around the nail borders and cuticle area.  The more swollen the skin gets the more likely an ingrown nail can occur.  Wash your feet and toes daily with soap and water and don't forget to get between your toes.  If you are noticing redness around the nails, topical and oral antibiotics are your best option preventing serious infections.

3.  Nail discoloration and loss
Increased stress on the body can often be seen on our toenails, just like the rings on a tree.  After significant events like major surgery and chemotherapy, the nails can become brittle, yellow, crumbly and actually just fall off.  Sometimes the color of the nails can be quite intense like blue or purple or red.  Don't worry to much if your nails change or fall off.  Often within 1-2 years after you have finished your treatments, the nails regrow.  But beware, they may look a little funny.

4. Edema
Excess swelling of the legs (and arms) can occur with cancer treatments and should be addressed by your oncologist as soon as it is discovered.The more swelling you have the more painful your extremity can be, thus making you feel worse than you already do. Oral medications can help with the swelling as well as compression garments.   It is very important to bring this swelling to your doctors attention as it could be caused from a DVT, deep vein thrombosis, or clot in your leg.  These can be serious and need immediate attention.

5.  Ulcers
Increased pressure to the heels from sitting or laying in one position too long can cause a sore or ulcer. Certain cancer treatments like radiation can also cause sores. And if you are diabetic or have neuropathy or poor circulation, you are at high risk of ulceration. While undergoing any type of treatment for cancer, if you develop a sore on your skin, it needs to be addressed right away.  This can become infected quickly and just putting neosporin or vaseline on it isn't going to help. Wound care from a wound care specialist is your best option at preventing severe infections and complications.  The team at FAANT are experts in lower extremity wound care.

If you are reading this and you or a loved one have cancer, we wish you a speedy recovery.  And we are here for all your foot and ankle needs to help you through this process.