Understanding Allergic Reactions to Chemotherapy

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Allergic Reactions.
Exactly what a cancer patient wants to deal with.

Unfortunately, allergic reactions during chemotherapy are somewhat common—though some of us seem determined to raise that bar. Take Taxol, for example. About 30% of patients experience an allergic reaction, usually within the first 15 minutes. Taxol is a very common chemotherapy drug, used to treat breast, ovarian, lung, and Kaposi sarcoma cancers. More than one million patients have received Taxol as part of their treatment.

So, by my math, roughly 700,000 people didn’t have a reaction. That’s a nice number!

Apparently, I’ve been walking under ladders nonstop lately, because everything I touch turns to… well, definitely not gold. I didn’t just land in that 30%—I slashed the “15 minutes” down to four. No, no prize necessary, thank you very much. After that little excitement, my doctors switched me to Taxol’s cooler cousin: Paclitaxel.

Each chemotherapy infusion begins with a cocktail of pre-medications administered by the nurses: Pepcid, steroids, and Benadryl. This pre-med regimen exists for an important reason—to reduce side effects and prevent reactions—and the nurses are vigilant throughout the infusion. They monitor patients closely and are fully prepared to intervene immediately if a reaction occurs, which provides an enormous amount of reassurance when things go sideways.

The steroids, while known for weight gain (for some of us, excessive weight gain), are the MVPs of the pre-med lineup. They block nausea triggers, calm the immune system like a mom handling a misbehaving child— “Dex-ametha-sone, don’t make me come over there or so help me!!”— reduce inflammation and flip on the appetite switch. Pro tip: have your favorite cancer-friendly foods ready, because once you sleep off the Benadryl, it might get real.

Benadryl helps prevent allergic reactions. Pepcid prevents heartburn—or at least downgrades it from a full inferno to a “mild salsa.” It’s still there, but you don’t feel like you’re melting from the inside out.

As of today, I’ve completed 10 of 12 Paclitaxel infusions. Aside from the initial and lovely reaction, I’ve had three additional mini reactions after the drug was already fully in my system. This has baffled my new nurse friends—but not in the fun, “Oh hey, that’s interesting” way. More like I’m the overachiever or the difficult customer uncovering glitches the manufacturers didn’t even know existed.

Or maybe my immune system is the Gordon Ramsay of immune systems, sending the drug back to the kitchen screaming,
“What the @#!&, it’s RAW!!”*

On the days I don’t have a reaction, those are genuinely good days. I wish—and I’m pretty sure the nurses wish too—that we knew the common denominator on the rashy days.

I can still see the look on my nurse’s face as she watches red bumps and a rash creep down my neck to my chest, the redness at my knuckles spreading across the backs of my hands and up my forearms. All the while, I’m wearing a slightly tortured expression as I fight the overwhelming urge to itch. Be strong!!

Then there’s the look on Mark’s mom’s face. The chemo machine alerts that it is finished, only for the red tint on my skin to grow more pronounced. She quietly puts her belongings back down in utter defeat. We have 45 more minutes to go now.

That’s when we start talking about the next chemo drugs I’ll begin next month—eight weeks, every other week. Mark’s mom is with me as we ask about pre-meds for AC chemo.

“Well, usually we just administer steroids.”

“No Benadryl?”

“No, not usually… but with Renae—”

Touché, Nurse Tanya. Touché.

So, I press on and continue to fight the fight—red bumps, itchy rashes, and all.