Scott --

If your Dad is going to take amifostine, be advised (as Joanna warns) that it can be difficult to tolerate. It is imperative that your father folow the Medimmune guidelines *exactly* -- especially as regards pre-inoculation hydration (20-24 oz. water) and a serious anti-nausea drug (Barry used Zofran) taken 90 minutes before the injection (Compazine did NOT work!). Also, careful coordination with the radiation team so that the radiation is given in the 30-45 minutes window after the drug is injected. The nurse will watch for severe blood pressure drops and also, any sign of a generalized rash. Our nurse applied hydrocortisone cream to the two injection sites immediately afterwards. Nausea (often severe) seems to be the biggest issue, and they did not give Barry amifostine on the days he received chemotherapy for this reason. Our RO said that most of his patients can only tolerate amifostine for about 3-4 weeks (out of 6-7) due to persistent nausea and in a few cases, generalized rashes, but that even this seemed to help preserve salivary function.

Barry came through with what he estimates to be about 65-70% and now has about 80-85% function, but he also takes Evoxac and finds chewing Xylityol gum to really help as well.

He is glad he took the amifostine but would never want to go through it again. It was, he says, the worst part of the treatment.

Gail