| | Joined: Apr 2015 Posts: 5 Member | OP  Member
Joined: Apr 2015 Posts: 5 | My father-in-law finished his treatment (seven weeks of radiation, Cisplatin and Taxotere) for stage III base of tongue SCC about six weeks ago, and yesterday he started feeling nauseated again after having little or no nausea for at least the last month. It seemed like everything was improving (with the exception of the mucus and some unhealing mouth ulcers), but now, all of a sudden, he's feeling very unwell. Zofran and Ativan help a little, but he's still nauseated. He has a PEG tube through which he receives all of his nutrition (Isosource 1.5) and hydration, because he still cannot eat anything.
Anyone have any ideas about what's causing this and/or what I can do about it? I don't understand why he would be getting worse at this point! Please help.
Richelle
DIL/associate caregiver to stage III BOT SCC survivor
Dx: Dec. 2014
Tx: 7 wks rad plus weekly Cisplatin and Taxotere completed 2/29/15
| | | | | Joined: Jun 2007 Posts: 10,507 Likes: 7 Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) | | Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts)
Joined: Jun 2007 Posts: 10,507 Likes: 7 | Welcome to OCF! Im sorry you have the need to use our group but I know we will be able to help you with your FIL.
Nausea can be caused by many different things. Since he is using the PEG tube for his intake it could be linked to that. First, make sure to always notify his doctors when there are any changes to rule out any serious health problems. Most common causes for nausea when using the feeding tube is the thickness and speed of the formula. Try slowing down his feedings and add some extra water. Usually those will stop the nausea if that is the cause. Also make sure he is sitting up when doing feedings and sits still at least an hour after a feeding. Its not unusual for nausea to hang on for several weeks, maybe even months after finishing rads, especially when chemo is used. Chemo and radiation both continue to work well after treatment stop. Im hoping these tips will help.
Best wishes!!!
ChristineSCC 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  | | | | | Joined: Dec 2003 Posts: 2,606 Likes: 2 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Dec 2003 Posts: 2,606 Likes: 2 | Six weeks out of treatment, this is something that needs to be communicated to the medical team. It could be something as little as an ongoing sinus infection draining to the digestive system, thrush or even something worse. Any sudden changes at this point go straight to the doctor's office.
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
| | | | | Joined: Apr 2015 Posts: 5 Member | | OP Member
Joined: Apr 2015 Posts: 5 | Thank you! I really appreciate the quick responses.
I have already tried reducing the speed of his feeding pump, but I don't think that's it because he's still nauseated. He says the feeling is more in his chest, so maybe it's from the mucositis. He's having hiccups too now, not sure if that's related. He hasn't vomited today (he did twice yesterday), but if he's not better by morning I'll call the doctor. I have a feeling the doc will just tell me to do all the things I've already done, though! There isn't anything more they can give him for the nausea besides Zofran and Ativan because he has bad reactions to the other antiemetics.
Is it really very abnormal to have nausea at this point?
Richelle
DIL/associate caregiver to stage III BOT SCC survivor
Dx: Dec. 2014
Tx: 7 wks rad plus weekly Cisplatin and Taxotere completed 2/29/15
| | | | | Joined: Jul 2012 Posts: 3,267 Likes: 1 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Jul 2012 Posts: 3,267 Likes: 1 | In addition to the above, some use ginger, like making a ginger tea with honey, to help with nausea. I also used marinol, by prescription, which helps with appetite, but also with nausea. Another is to question when the nausea or vomiting starts. It is in the morning, after doing a chore, feeding, lying in bed, etc. to help find a possible contributor. I mainly got ill after raising from bed too soon, so slowed that down, had to reduce the amount per feeding, changed the type of feeding, and Oxycodone pain meds seems to make me sick, still does.
Good luck.
10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs
| | | | | Joined: Jun 2007 Posts: 10,507 Likes: 7 Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) | | Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts)
Joined: Jun 2007 Posts: 10,507 Likes: 7 | The problem with vomiting and nausea is malnutrition and dehydration. This can very quickly sneak up on a patient when they have stomach or digestive issues. Its happened many times to me as well. Its a viscous cycle of not eating and drinking (or doing a feeding) because of not feeling well but by avoiding putting anything into the stomach the patient becomes malnourished and dehydrated making them feel even worse. Just remember everything that comes out needs to be put back in. The doctor can prescribe anti-nausea meds in suppository form if your FIL cant keep anything down. I always rule on the side of caution and advise to see the doctor. There could be many other issues going on.
Keep us posted. Best wishes!!!
ChristineSCC 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 | | | | | Joined: Jul 2012 Posts: 3,267 Likes: 1 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Jul 2012 Posts: 3,267 Likes: 1 | As far as reduced feedings, instead of 2 cans at once, I used one can, but more frequently instead of the usual 3, and spaced out during the day, make me feel less ill, so it was still the same amount of nutrition each day.
10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs
| | | | | Joined: Apr 2015 Posts: 5 Member | | OP Member
Joined: Apr 2015 Posts: 5 | He feels better today, thank goodness! Must have been just a little random blip in the recovery process. Thank you for all of the advice and support!
Richelle
DIL/associate caregiver to stage III BOT SCC survivor
Dx: Dec. 2014
Tx: 7 wks rad plus weekly Cisplatin and Taxotere completed 2/29/15
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