In a case report recently published, researchers from China showed that Botox (botulinum toxin type A) can be used in a safe and effective manner to treat Raynaud’s phenomenon (RP) associated with lung cancer.
The study, “A case report of the beneficial effects of botulinum toxin type A on Raynaud phenomenon in a patient with lung cancer,” was published in the scientific journal Medicine.
The existing pharmacologic and cirurgic therapies for Raynaud’s are not always efficient. In fact, patients with RP caused by cancer do not benefit from traditional treatments for Raynaud’s syndrome.
Researchers reported the case of a 63-year-old man with an 18-month history of pain and discoloration of his fingers when they were exposed to cold. The patient was initially diagnosed with RP and was treated with 15 mg of Adalat (nifedipine) daily and a low dose of aspirin. But the patient didn’t respond to the therapeutic regimen and there was no clinical improvement in his condition.
Eight months later, the patient developed severe chest pain, and more detailed clinical tests revealed he had stage 2B lung cancer, according to the American Joint Committee on Cancer (AJCC) staging manual.
After the new diagnosis the patient started 21-day cycles of chemotherapy based on Taxotere (docetaxel) and Paraplatin (carboplatin). This therapy allowed a partial recovery of the Raynaud’s symptoms after the first and second chemotherapy cycles. Still, the researchers could still observe bluish discoloration of the fingers and diagnosed the patient with paraneoplastic Raynaud’s phenomenon, a rare complication of different malignancies (in his case, lung cancer).
To treat the Raynaud’s symptoms, the team decided to give the patient nine injections of Botox scattered in the palm of each hand. Two months after the Botox treatment, the patient reported a relief of pain and numbness, as well as an improvement of stiffness and cold sensation, almost to normal levels.
The beneficial effects of Botox for the treatment of Raynaud’s phenomenon symptoms in this patient were observed for at least six months after the injections. The researchers proposed that Botox might be allowing the blood vessels to distend, increasing the blood flow and improving the overall symptoms of RP.
“BTX-A [Botox] may be an effective treatment for paraneoplastic RP that is not associated with significant complications,” the team wrote in their report.
The researchers also reported that no significant side effects were observed in the patient. Nevertheless, “additional investigations are needed to understand the mechanism of action and appropriate [Botox] dose and dose frequency,” the authors wrote.
RP is a syndrome that affects the blood vessels, reducing the blood flow mainly in the fingers and toes. It is characterized by stiffness, numbness and cold sensation of the affected areas. In more severe states, RP can lead to the development of ulcers and even loss of function.