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#121732 09-14-2010 05:22 AM
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klo Offline OP
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I have just been reading an old post about dealing with phlegm caused by radiation and noticed that every single responder (with the possible exception of Ezjim who doesn't mention it in his signature) had received concurrent chemo. Is it a fact or an assumption that it is radiation that causes the phlegm rather than chemo (or cetuximab)? I ask this because my Alex has been suffering with phlegm for the entire 6 months of his treatment which started in March with induction chemo including cisplatin. And he didn't start radiation till July...
Hmmm
Karen


Karen
Love of Life to Alex T4N2M0 SCC Tonsil, BOT, R lymph nodes
Dx March 2010 51yrs. Unresectable. HPV+ve
Tx Chemo x 3+1 cycles(cisplatin,docetaxel,5FU)- complete May 31
Chemoradiation (IMRTx35 + weekly cisplatin)
Finish Aug 27
Return to work 2 years on
3 years out Aug 27 2013 NED smile
Still underweight
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I have no idea what caused this stuff but I still have it and have to watch when I cough. It seomtimes sneaks out without warning and looks like a giant slug that somehow got into my throat. It can be embarassing. I wish Alex well and hope it lets up one day soon. I think maybe the neck dissection has something to do with it. It has been my constant companion for over 3 years .


Since posting this. UPMC, Pittsburgh, Oct 2011 until Jan. I averaged about 2 to 3 surgeries a week there. w Can't have jaw made as bone is deteroriating steaily that is left in jaw. Mersa is to blame. Feeding tube . Had trach for 4mos. Got it out April.
--- Passed away 5/14/14, will be greatly missed by everyone here
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klo Offline OP
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smile we don't have handkerchiefs anymore, we have handtowels


Karen
Love of Life to Alex T4N2M0 SCC Tonsil, BOT, R lymph nodes
Dx March 2010 51yrs. Unresectable. HPV+ve
Tx Chemo x 3+1 cycles(cisplatin,docetaxel,5FU)- complete May 31
Chemoradiation (IMRTx35 + weekly cisplatin)
Finish Aug 27
Return to work 2 years on
3 years out Aug 27 2013 NED smile
Still underweight
Joined: Jun 2009
Posts: 875
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Hello Karen:
It's been almost 3 years since my treatments (chemo and radiation) and I have been fighting this CONSTANT phlegm (mucus) crap and have been told it is from the radiation, but have read chemo does it too. During and right after my treatments this crap wasn't as bad as it is now, so I wonder. After I get up in the a.m., what starts with me now is a constant foamy white gunk coming up into my mouth. Mine has the most putrid sweet taste that it makes me sick to my stomach. This type started about 6 months or so ago, and I started investigating other reasons for it. I go to an ENT and have sinus scans; 24-hr. monitoring acid tests which I wore tubes in my nose for 24 hours; endoscopies that did show acid reflux, but I take two Nexium/day so the gastro dr. attributes the gunk to radiation. I've been to Mayo in Jacksonville,FL, to no avail. Does Alex have the sticky mucus stuff in his mouth too? That's another thing - food sticks to my teeth, jaws, and gums. Heck, it's a never ending battle. Others on this forum get over the phlegm/mucus several months after treatment, but still have the constant dry mouth. I guess time will tell as to what Alex will have to deal with. My chemo dr. said it was the radiation, and my radiation dr.said it was both, so no answer. If all of this info serves any purpose, it'll be to let Alex know he's not alone.
julieann


Julieann
Nov 2007 SCC on right tonsil following tonsillectomy. Was smoker, QUIT. (Stage IV T2 N2b) 7 weeks radiation one day/wk chemo (carboplatin and 5-FU). Allergic to Taxol; PEG in, lost 30 lbs. TX completed January 2008. PEG out mid- 2008. PET/CT 1/17/2011;2/3/12 NEGATIVE for cancer smile
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Well guys, I had NO chemo, only XRT radiation and had awful phlegm starting about the 4th week of treatment. I guess it is possible that chemo may make it worse, but it would be hard to imagine.

I was on Salagen during treatment and took Guiafenex (sp) to help loosen the phlegm. All I remember is gagging on the stuff and standing over the sink pulling huge ropes of it out of my throat. It's been too many years for me to remember when it subsided, but I'll guess a couple of months after treatment.

Take care,
Eileen


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
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My aunt had only radiation and had the horrible phlegm also. Her MDs told her the rads would cause this.


Aunt diag. 2/4/10 with SCC Stage I/II on left side of tongue. Surgery 2/19/10 part. gloss./neck diss. on left side/free flap from chest muscle. TI/II,NO,MO. Clear margins with perineural invasion. Started rads 4/8/10 - 35 treatments, finished 5/26/10.
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I had the stuff after treatment Eileen mentions but it stopped in about 2 months. I now have constant coughing and never know when the goo comes with the cough but it is small amounts with black and green globules embedded within. It is very salty. I feel like I need to cough up more but the coughs are usually dry. I drink about a gallon of water a day and if I get too dry, the goo gets more voluminous.

Eileen:

You may remember my old song sung to the tune of Crystal Gale's "Don't it Make Your Brown Eyes Blue" but it was more of a "Don't it Make Your Brown Goo Clear". Once it turns clear after treatment, you have officially weathered the huge ropes as you so accurately describe! smile

Ed


SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
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Posts: 638
klo Offline OP
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thanks everyone - I am now more confused than ever. I am beginning to think there are two mechanisms at play here. The reasons for the questions are twofold - one I am a nosey parker and need to know the why for everything, and secondly, I am trying to think through what medications might work by considering the mechanism of the body's response and pair it with how each drug works. Without knowing exactly how this "phlegm" (and I am thinking it is not actually phlegm) is generated and where it is coming from, my attempts at a logical approach are thwarted. It is starting to sound like the problem is that the mucous that IS produced, is the wrong consistency which is what causes the feeling of too much, hard to clear, choking, frothing etc. I think I need a pharmacologist rather than the oncologists who seem to remain clueless.

Sitting here with normal saliva and mucous, I realise that I am constantly swallowing at an unconcious level and maybe this becomes conscious and problematic when the mucous is too thick and stringy. My Alex also complains that it "sticks" to his teeth (all 8 of them).

Has anyone ever tried a mucolytic?
This is a cough medicine available over the counter and it is usually recommended to help a dry cough. The idea is that the product thins mucous which collects in the lungs and makes it easier to cough up. As the product works all over the body, I wonder if it might improve the consistency of whatever this "phlegm" is. The name of the product in Australia is called Bisolvon but others might know it as Mucosolvon. Its generic name is bromhexine hydrochloride

Karen


Karen
Love of Life to Alex T4N2M0 SCC Tonsil, BOT, R lymph nodes
Dx March 2010 51yrs. Unresectable. HPV+ve
Tx Chemo x 3+1 cycles(cisplatin,docetaxel,5FU)- complete May 31
Chemoradiation (IMRTx35 + weekly cisplatin)
Finish Aug 27
Return to work 2 years on
3 years out Aug 27 2013 NED smile
Still underweight
Joined: Apr 2010
Posts: 201
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Hi Karen you may want to ask the dr's about a patch? While my sister was on a week break from radiation in the hospital they gave her some kind of patch behind her ear that made the mucos go away. I can ask the dr's what it is on Monday. I have also hears of people using the musinex which is what it is called her for the mucus also. As with anything ask the dr's and double check with your pharmacist if it can be used with your husbands current medications.


CG to Sister (42). Smoker quit @ diagnosis Dx 4/20/10 SCC T2N0M0, Rside of tongue Hemigloss R neck dis, all nodes removed 6/2/10, Trach and NG in, home 6/8/10,8/18/2010 start erbitux x6, 30 IMRT end 10/11/10 with only 3x erbitux due to reaction and one week off of rads
1/10/2011 Clear PET!!!
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klo Offline OP
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thanks Susan

would be grateful if you could check with your doctor about the patch. Also, do you know the chemical name of Musinex? The drugs we have in Oz are often named something else although the generic (chemical) name is often the same or similar enough for me to figure out what it is.

And yes, checking with the medics goes without saying - (although I probably SHOULD to say it everytime smile )

thanks again
Karen


Karen
Love of Life to Alex T4N2M0 SCC Tonsil, BOT, R lymph nodes
Dx March 2010 51yrs. Unresectable. HPV+ve
Tx Chemo x 3+1 cycles(cisplatin,docetaxel,5FU)- complete May 31
Chemoradiation (IMRTx35 + weekly cisplatin)
Finish Aug 27
Return to work 2 years on
3 years out Aug 27 2013 NED smile
Still underweight
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