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#128077 01-18-2011 12:13 PM
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I am scheduled to have a G-Tube put in on Friday. I have heard people talking about a PEG on this site. Are they the same? What's the difference? I was supposed to have a special appointment with the surgeon three days prior to getting the G-Tube, but he canceled. His nurse said the doctor will talk to me before the surgery. I am afraid of not getting enough information and then being sent home on a Friday afternoon. My partner is great about stuff like this and I know she will be helpful, but we aren't nurses and have to be told how it all works. The following week we are meeting with a nurse to be shown how to use and clean it, but between Friday and that appointment? I really don't want this G-Tube. Really don't. Are there people who went through 7 weeks of radiation without it? Do I have a choice in the matter? -Michelle


SCC left tonsil, stage IV, HPV+, metastatic to one lymph node. Biopsy 12/23/10; tonsillectomy 1/13/11; DX 1/25/11; Peg in 1/28/11. Peg out 6/29. TX 1/31/11-3/21/11: 35 IMRT plus 3 Cisplatin. Pet-Scan 6/20/11 = CLEAR! Three years out, learning to live with the long-term side effects of radiation while reminding myself to feel blessed.
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I went through 6 weeks of radiation and once a week chemo without a feeding tube. I don't know the difference between a G tube and a PEG. Where I was treated they only put in a feeding tube after you lost a certain percentage of weight. It was not automatic that you would get a feeding tube before radiation treatment was started. They waited to see how you would do and if you were able to keep your weight up. I lost about 10 pounds.


SCC on right tongue T2N1M0 Non-smoker, non-drinker age 55 female. Partial glossectomy April 2009,July 2009, Jan. 2011, lymph nodes removed, radiation & chemo 2009
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I declined the PEG tube at first and even the doctors were confident I may make it through without one. Low and behold around week 4 of treatment I could not swallow my pills anymore or water for that mattter and it was thanksgiving week. I was in bad shape when I showed up to the doctor that monday and they immediately scheduled me for a PEG. It sucked because for one I was so tired and weak, it took them 2 times to get it in. I honestly wish I would have already had it in, because it was a nightmare while going through treatment. I have a PEG tube checkup tomorrow to make sure it has not dislodged, will see what they say. I have had mine about 2 months now.

Your Friend,
Nathan


SCC left lateral tongue, left neck dissection. 2 nodes positive. 3 All Clear then ITS BACK 8/23/11 Shows 1cm in tongue in CT SCAN, Radial Free Arm Flap with Radical Neck Dissection 9/20/11 , All Nodes Negative, But Tongue Tumor Poorly Differentiated. Awaiting next step in treatment on 10/5/11... RIP Nate 7/28/12
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Well my ol' man didn't have one AND he lost tons of weight and they NEVER put one in him. That I never did understand unless he refused one when he went to the docs during treatments which I did not go with him to. That may be it. I never thought about that till right now! duh! I'm gonna ask him now that I thought of it. He is a stubborn man so that's probably what happened. I also really don't know the dif of PEG versus G even though I'm sure I have read it on here somewhere. Ron did have in a feeding tube thru his nose twice, that he pulled out himself both times cuz he said it irritated his throat. He was still able to drink fluids some not what I wished he would have been drinking(beer) but he kept up swallowing thru all 30 of his treatments. Good luck in what you do get and hell I'm no nurse either but we got thru it! any questions call your dr that's what i did and glad you have your partner to help you thru this it's gonna be hard on her but you all will get thru it!


CG to Ron
Out of Pain 4/3/13
4/12-lung and under chin growth no treatment
1/13/12 lung biopsy
6/11 recur 6/30 resection #2 Clear margins
Clear 12/10
Surg 5/13/10 neck dis/nodes part gloss/flap R thigh all teeth out
RAD 30 8/10
DX 4/2/10 "Oral Cavity" T3NOMO
12/28/07 Non Hodg Lymph remission 7/08
passed away 4.3.15, RIP Ron, you are greatly missed
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ps hey nate! lol see ya duckin in here for a bit! lol


CG to Ron
Out of Pain 4/3/13
4/12-lung and under chin growth no treatment
1/13/12 lung biopsy
6/11 recur 6/30 resection #2 Clear margins
Clear 12/10
Surg 5/13/10 neck dis/nodes part gloss/flap R thigh all teeth out
RAD 30 8/10
DX 4/2/10 "Oral Cavity" T3NOMO
12/28/07 Non Hodg Lymph remission 7/08
passed away 4.3.15, RIP Ron, you are greatly missed
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A PEG (percutaneous endoscopic gastronomy )is just a G tube that is put in with an endoscope. If you can't put the endoscope down the throat, then they use a fluoroscope and just put the G tube right into your stomach (like mine). The G tube itself is exactly the same no matter which way the doctors put it in but without the endoscope , there's no E and it's technically surgery if you use the flourscope and "operate" so no P (percutaneous). That's the difference between a PEG and a G tube.
At most places, you do indeed have a choice as to whether or not to get a feeding tube. I have heard of some doctors who insist on their patients getting a tube whether they want or need one, but I went to a CCC where the patient's decisions were honored. I was a stubborn old man who was determined to keep eating and drinking on my own. I ended up on a complete liquid diet halfway thru (Ensure Plus)but never needed a PEG and never got dehydrated or any complications.
Yes, several of us went through both radiation (8 weeks) and chemo without ever getting a PEG. We lost a lot of weight.
We used to have "PEG wars" here whenever this question arose, since feelings ran high on this particular decision. (I plead guilty since I over reacted when posters say a PEG is necessary as though many of us had not done fine without one) Many patients needed a PEG and are very glad they got one. I wasn't one of them. Since I now have a G tube for life (nothing to do with my decision not to have one the first time, but a result of the cancer coming back and surgery and even more radiation over the "maximum"); I'm doubly glad I went without it the first time.
On a practical note, if you can still eat, just don't use the PEG until you meet the nurse if you are worried about that.
You will get lots and lots of opinions here, but remember it is indeed your decision. As Nate pointed out, you can always get a PEG later on, but it harder on you then since you already feel so bad. My post is just my opinion also.

Best wishes
Charm

Last edited by Charm2017; 01-18-2011 03:51 PM. Reason: typos

65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13
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Charm explained the G-tube is the same as a PEG tube. Yes, there were many battles about to get or not to get the dreaded tube. Not one person who got one ever wanted to have it and need to use it. Ive used a feeding tube twice for a total of 3 years. Most larger hospitals have visiting nurses that you can ask for. They will come out and help you with the tube and make sure you are doing alright with it. Its so much better to have a feeding tube and not need it than to need it and have to wait to get one. Always better to be prepared.

If you need help, I have all kinds of tricks for the peg tube. You can use the search function to look up info as this topic has been discussed many times.


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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Getting a tube in is a tough one. I fought it all the way. I wanted to go as long as I could without it. Now I am little... In both the height and weight categories so I didn't have to lose much before I needed it in. I made it halfway through treatment which I don't think was too bad. Like everyone said you can get it put in but don't have to use it. That way if you keep eating my mouth you can get it out later when treatment is done and you are recovered more. And eat as many calories as you can now. That way you can loose some during treatment.


31 at dx 9/06
SCC T4N0M0 with bone invasion upper maxillary
Surgery 10/06
CT's clear for 2 years
2nd recurrence - Laser surgery 1/09 dx
Tumor board - No surgery to invasive for QOL
35 IMRT 3/30/09 Completed 5/15/09
8 tx Erbitux 3/24/09 Completed 5/6/09
HBO for ORN March & April 2010
Fibula flap 5/10
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There is another alternative that is too often overlooked and that is a nasal tube which serves the same purpose but the inserting procedure can be done in a chair in a few minutes and without any meds. You do have to get x rayed to make sure it is placed correctly and then the thin metal rod is pulled out of the tube and that's it. I was one that refused to get a PEG (how dare they suggest a feeding tube, that's for really sick people I told myself) but I did end up agreeing to the nasal tube my first week post Tx (only after I was close to death from dehydration) and I admit it really made a huge difference but I only had to keep in for 2 weeks and I pulled it out myself.


David

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
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My husband went through 39 radiation treatments for stage 4 tongue cancer. From the onset of the cancer through treatment, which was almost a year, he lost 80 pounds. He was over weight prior to the cancer and was quite thin by the end of treatment but he was not weak and never had a feeding tube. He drank shakes blended with bananas, ensure, and ice cream, as many as he could in a day. I also juiced for him every morning, a variety of fruits and vegetables which he feels helped limit the mouth sores. He only had a temporary feeding tube in his nose for 2 weeks after surgery.


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