Has anyone acquired strep throat after having throat cancer?

I had bilateral tonsillectomies with positive cancer on the left in August of 2012.

I had a cold, which come along with a sore throat, but now the cold is better (almost gone) and my throat has gotten worse.

I just looked in the mirror and I can see white patches in the back of my left side. This is the same side as my cancer. I'm starting to freak out a bit.

Should I contact my doctors on Monday?

~Kerri

You probably should see your doctor as it looks like an infection. However, at this point I wouldn't assume it's strep. I've had multiple bouts with throat issues that looked like infection both during and after treatment (which ended 5 months ago).

They have cultured it (and nothing grew) showing it's not bacterial (ie it's viral). They have said the viral just has to run it's course as there isn't a lot available to treat viral infections with. In all instances, give it a week to ten days and it's been gone (for me).

I have also been told that at the surgery site (I only had one tonsil removed) you can expect white puffies that look like infection for awhile. Your's being two years ago worries me a little more than mine (5 months) does, another reason to discuss with the doc.

I hope this helps
Tony

Kerri,

With the immune system roller coaster ride for a while after treatment, you need to get it checked by a doctor. One if the dangers if strep is the body's natural immune response creates antibodies that cause things like RA, scarlet fever, rheumatic fever. They all are permanent lifelong problems. Identification of strep is important and maybe one of the easiest things to treat.

When in doubt, consult with a doctor. You are reaching the point of looking for a family physician if you don't have one. Many don't like to deal with after effects of treatment but at some point, oncologists don't manage the day to day.

See your doctor on Monday. It can be a number of oral conditions or infections, which can be bacterial, fungal or viral origin, and would need proper medications to treat. Strep throat can be bacterial, but there are viral ones too, and white patches in the mouth can be thrush, a fungal infection, or combination of infections, and in the throat thrush is esphogitis, can go to the stomach, become systemic from there into the bloodline, which is then invasive or dissemintared candiasis, which has a high rate of failure, the same with strep throat, can go to the lungs, become systemic too, and be more difficult to treat.

Good luck

hey everybody,
I hate that the stuff always seems to happen over the weekend. I just went to the local urgent care center in my rapid strep came back negative. They're sending it out for a routine throat culture.

I am having a bit of a freak out. They're going to put me on augmentin. I saw a PA, and she said that I had someone millimeter ulcers in my throat and I have an ulcer on my tongue right in the middle.

I sent a message to my med once fellow, as I have her email.

I hope it's nothing serious.

Mucocitis causes ulcers too, as well as other oral conditions, some quite common with treatment, but you're doing the right thing by keeping on top of it, visiting urgent care, and letting your treatment team know. You had me laughing, not thats its it's funny, but ironic, everything seems to happen at night and on weekends! That's why I keep an arsenal of meds ready lol. Good question everyone should ask the treatment center, who do I contact off hours? I had a list of numbers for chemo, but not always or everywhere I was treated. If in doubt, there is always the ER.

Thanks, Paul. I'm so sorry that you've had so much trouble, after reading your signature. I'd call the on-call at the cancer center, but I'm sure there's not much they could do until they see me. The one who is on-call doesn't know me.

If you have dry mouth, I'm guessing oral thrush(candidiasis)... I just went thru this, looked like I had cottage cheese growing in my throat, onset was almost overnight,4

Brian,

I do have dry mouth, despite constantly drinking water.

It has worsened today and aside from the ulcers, my tongue does seem to be turning a bit white. The pain is nearly or just as bad as when I was in treatment. I'm taking methadone, oxycodone, and motrin and it still makes me wince every time I swallow.

I will be calling the cancer center first thing in the morning.

The white makes me think its thrush. That can be very painful. Get yourself checked out today and start on some meds. Feel better!

Hi, friends.

Just an update.

Today was worse. I feel like I did when I was in the midst of radiation treatment. I can barely talk, swallow, and could not even have Ensure because it stung my tongue so badly. The Ensure also seemed too thick to swallow and seemed to be coming back up before it could go down. The only way I can swallow is to instantly chase something with a sip of water and clear my throat.

I called my surgical oncology fellow this morning. I told her what was happening and I thought I might need to be seen. She opted for the "wait and see" and continue to take the Augmentin. Well, I had to crush that horse pill and mix it with apple sauce this morning and I threw it back up within a half hour. I cannot eat enough for some of these meds so that they don't upset my stomach. She said that she would call in some magic mouthwash for me, but I think that she must have forgotten because it never was filled at the pharmacy and they had no record of any of their stores getting the order. Of course, it was after hours when my (awesomely supportive) hubby went to pick up the script and he found out that it was never faxed in.

Dan, (my hubby), got home with the kids around 6:15 and told me the bad news. He also said that he had to go back out to get me some Ensure because he was running out of time to get the kids from daycare/preschool. He made the kids a quick dinner and went back out to the store to get it. I tried it when he got home and I couldn't drink it...not 3 sips without nearly bursting into tears.

I decided that I could not wait until tomorrow to talk to the doctor again. I had the head of my medical oncology team paged. She was very nice (always is, but I never know whether to page her or her fellow). She agrees that it seems like thrush, but didn't think that I necessarily needed to come in just yet. Since my rapid strep came back negative, she told me to discontinue the Augmentin, especially since I couldn't tolerate it and it could possibly make my thrush worse, if that is indeed that correct diagnosis. I hope it is, because she said the the Nystatin should get me feeling somewhat better in a couple of days. She faxed in some liquid Nystatin and the Magic Mouthwash (which is no longer covered by most insurance plans because it contains some medicines that are OTC (gotta love insurance, but you've gotta have it). A seven day supply of the mouthwash cost $65! Still, I'd pay for it, but it seems a bit ridiculous.

I was able to dip some white bread with a bit of Smart Balance melted into it) into some water and slowly, but painfully chew and swallow. I wanted to have some food in my stomach before I took my nighttime meds (pain meds and a few others, plus the Nystatin). It certainly stung at first, but if it's going to do the trick, I'll push through it.

I just hope that this is the problem that can simply be solved. From what I learned about thrush, it can come about due to chronic drymouth, but also the hormonal changes with pregnancy.

As always, I am grateful for you help and welcome any feedback or shared experiences. I will certainly keep you posted.

xo,
Kerri

From what I recall, eating yogurt or taking over-the-counter acidophilus capsules can help with thrush. When I was going thru RT, the hospital gave me some recipes for smoothies. I still have a few a week and I will often add yogurt to it. Perhaps it will be easier to drink a smoothie as you can make it thinner and add things that won't burn your mouth or upset your stomach. One of my doctors had suggested olive oil to sooth my mouth.

Thanks, Susan.
I'm trying some soy milk right now because I had to get up to take the magic mouthwash.

It seems like dairy irritates things more, especially should not have gotten chocolate Ensure!

Okay call me crazy - if you want to try this - do. Nystatin didn't do anything for me post treatment when I told my RO i was coming down with thrush, so I went back to a tried and true treatment I'd been using through rads. Manuka honey.

It's about $20 a jar (try using 16-20 umf - organic). Take a spoonful. Let it melt in your mouth - swish for a few minutes (1-3) It works like hydrogen peroxide and is anti fungal. hopefully it will help.

Thrush sucks and can be quite painful.

For mouth pain and sores, there are several things to try. Baking soda and salt mixed in warm water. Swish around for a minute then spit. I used a teaspoon of each in a glass of water. Mix well.

The magic mouthwash works but the main ingredients are Benadryl and lidocaine. Ask the doctor for liquid lidocaine and mix with some Benadryl. Swish around and this will ease the mouth pain. Check with doctor before you become a junior pharmacist though. :-)

The other thing I did was when I had serious open mouth sores was to just take raw salt and rub it on. Yep, it hurt but felt better after the initial treatment.

One other thing to try is high PH water. It is very soothing. Give it a try. Look for ph 9+

It takes almost 7-10 days for the nystatin to really knock thrush that's why the scrip is 14 days... You will get a lot if relief in the first 2-3 though. I'm not sure on the manuka helping this aspect of your journey... You really want to cut down on sugars as yeast thrives on it. Unpasteurized yogurt is great, the baking soda and salt swish, and I also used a 1:10 ratio of hydrogen peroxide to water mix to swish/ and brush my tongue with, definitely don't swallow it tho.

Thanks for the advice, guys. I have missed 2 days of work and I'm guessing I won't be in on Friday. (I work part-time.) Considering, I am barely able to talk, swallow, etc. Believe me, it'd much rather be at work! This is awful!

I am going in for a check up with my medical oncology team tomorrow.

Sending you hugs and many positive thoughts Kerri.
Tammy

Hi - re manuka / sugar. It actually helps in wound healing same premise as oral ulcers and thrush. It may or may not work on an individual basis but I found, for me, that it worked way faster than the nystatin, (like 2-3 days) and as for sugar, it is sweet, but not a sugar sweet. The study actually said you could use it without concern for cavities etc, because it is also antibacterial. Therefore it actually worked against plaque which is what damages teeth. It's antiinflammatory/antibacterial/antifungal/and antibiotic in nature...

Just throwing it out there. That said it's an individual choice, some people swear by it - some don't just wanted to clarify fact wise what it's actual properties are.

Hi, friends!

Here's an update for you all.

I went to the MGH cancer center today and was thoroughly evaluated by my fellow MO and an attending MO, not my primary MO, but I have seen him a few times over the past few years and have been quite impressed with him.

They scoped me and agreed that my problem is indeed thrush and that it has traveled down to my larynx and most likely down my esophagus (as I suspected since I felt like everything, including fluids, has been getting stuck before entering my stomach). All other structures seen through the scope looked "great", which is always assuring.

Since it has been very difficult getting in anything orally, they recommended that I stay a couple of hours for some IV fluids. They gave me a 2-week supply of diflucan, which should wipe out the thrush/candida systemically and I will no longer need the nystatin. I am also grateful that it will take care of the thrush that has extended into my esophagus and now beginning in the "lady parts" (please excuse me, guys).

I do have to have EKG monitoring due to Diflucan being a medication that can cause lengthening of the QTc interval and cause a potentially life-threatening arrhythmia. I normally take 2 other drugs that have the same potential, so I get periodic monitoring. Today's baseline was normal, but I have to be checked on Friday and Monday with repeat EKGs while I am on this drug. I'm glad that they are covering all of the bases.

I was scheduled to have my routine MRI next week, but they pushed it back a week in order to let things "cool down" in order to avoid any unnecessary areas lighting up with the contrast.

So, here's to speeding up this recovery and feeling better soon! I'll let you know how things are going. Thanks for all of your continued support!

xo,
Kerri

Yeah!

Glad to hear it is 'just' thrush! :-)

Good news Kerri.

Do you think if I boil my plastic/reusable water bottles in water for 10 minutes, it will be enough to kill the yeast. I always drink from them and I just didn't trust hot water and soap to do the job.

Also, I think I will have to use one tooth brush a day and toss it for a while, unless someone out there has a tried and true method of killing the yeast and/or other germs...still fighting off a cold. I never know when to use a new toothbrush in those situations!

Thrush is not contagious. As far as replacing your toothbrush, that may be a good habit, having suggested it before, and for other bacteria, infections, but for thrush, everyone's body has candida anyway, needs it, balances it, and just gets out of control when our bodies can't manage the flora balance anymore due to our compromised immune system, medications, treatments, and others. So wether you replace your toothbrush, you will still have thrush until your body can balance the candida flora. The same with someone with thrush can't infect another person, and if so, they probably already had it or were immunocompromised.

I hope this helps.

Good to know, Paul. Thanks!

Kerri... plastic water bottles and boiling... a bad idea. A glass or stainless steel water bottle in the dishwasher will kill any bacteria. hugs.

Thanks, Cheryl. I just did it the way baby bottles, nipples, and binkies were instructed. They are also BPA free. Good to know about the dishwasher being enough.

Just an update...

The Diflucan has been helping quite a bit and I seem to have turned a corner. I will be having my EKGs monitored while on this medication since I take a couple of other meds that can cause EKG changes, as well.

Hopefully, all will continue without complications and I can complete the 2-week course and be done with this!

The toothbrush swap is actually a good idea. With compromised saliva and history of thrush you may need to take extra precautions. I do things like wash my water bottle every day, use an ultrasonic cleaner for my Sonicare toothbrush. I generally make sure things that touch my mouth get thoroughly washed and dried.