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#44004 10-20-2004 09:06 AM
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Dolores Offline OP
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During my husband's pre-treatment workups, our hematology oncologist mentioned that 75-80 percent of his patients require a feeding tube after 4-5 weeks, and that his preferred method is a naso-gastric tube. He feels it keeps the esophagus open and has better results than a PEG. Of course, this bothered my husband, although, personally, I don't care if he has tubes in every orifice if it facilitates his recovery. Has anyone had experience with the naso tube versus the PEG tube and any insights as to how easy or difficult it is to use? Ken feels that he will be able to get by without one since after his tonsillectomy, despite considerable pain, he was able to gain ten pounds in three weeks in preparation for the upcoming treatment. I'm not so sure, so would like any advice anyone can offer. Thanks everyone, this board is so helpful!


Sherry (Dolores is the name of my cat) Wife to Ken, starting chemo/radiation 10/25/04. Stage IV SCC of right tonsil, T2,N2A,MO
#44005 10-20-2004 10:19 AM
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hi Sherry,

i had a peg for reasons that your doc is talking about. it was worth it's weight in gold. i spent one night in the hospital when it was inserted. it came out easily about 18 months later... my weight remained almost unchanged.

i've only heard of the naso being used in cases that were quite severe... and i don't recall anyone speaking well of them. i would avoid it if at all possible.

hopefully someone will have a different view of the naso.

best wishes for your husband.

cu,
larryb

#44006 10-20-2004 10:40 AM
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Sherry, welcome. I had a peg and still lost 50 pounds during treatment. I recommend them highly and feel they should be installed as a normal part of treatment. At the end of rad, I couldn't even talk or swallow my own saliva, so a peg was the only way I made it through. Urge your husband to get the feeding tube. I don't know about a naso tube. Does that mean it is inserted through the nose? I don't know but I do know that after my tonsilectomy, which I thought was the worst thing to happen to me ever, was nothing in comparison to radiation treatment. The last week and the first few weeks after treatment ended are the worst. Without the peg I would have shriveled up and blown away. We are all different, but I highly recommend pegs during this treatment. Insertion and removal are very simple, so I would urge Ken to get it done. Will pray for guidance for you both.


Regards, Kirk Georgia
Stage IV, T1N2aM0, right tonsil primary, Tonsilectomy 11/03, 35 rad/3cisplatin chemo, right neck dissection 1/04 - 5/04.
#44007 10-20-2004 11:36 AM
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Sherry,

I had a PEG and I probably would again. To be honest, I can't even imagine how uncomfortable a naso-gastric tube would be. I would strongly suggest you have your dotor stick that horrible thing in his nose and see how much he prefers it then. eek Not to muddy the water too bad but I read a study (can't remember which voume of ANNALS it was in) about more issues with the naso-gastric versus the PEG. Besides, who wants to walk around with a tube hanging out of their nose for a few weeks/months?

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
#44008 10-20-2004 01:05 PM
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Sherry,
I will make a very bold statement here.....GET THE PEG TUBE. It certainly is possible to get through radiation without one, many on this board have. My question, though, has always been "why put yourself through that?" I equate it to any woman now a days going through childbirth "natural" when there are epidurals to make it a painless experience.
Radiation kicks butt, it is THE most difficult part of treatment.
I have never heard of a Naso-Gastric being suggested over a PEG.
Good luck with it,
Minnie


SCC Left Mandible. Jaw replaced with bone from leg. Neck disection, 37 radiation treatments. Recurrence 8-28-07, stage 2, tongue. One third of tongue removed 10-4-07. 5-23-08 chemo started for tumor behind swallowing passage, Our good friend and much loved OCF member Minnie has been lost to the disease (RIP 10-29-08). We will all miss her greatly.
#44009 10-20-2004 01:13 PM
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Dolores Offline OP
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The doctor said he has had patients with PEG tubes who have had their esophagus completely close up and are unable to ever swallow again. Anyone hear of this? This was his reasoning for naso-gastric instead of PEG tubes. I will certainly discuss this with him when the time arises. He is a very well-regarded doctor at Cleveland Clinic; however, I have no problem arguing with God himself when it comes to my husband.


Sherry (Dolores is the name of my cat) Wife to Ken, starting chemo/radiation 10/25/04. Stage IV SCC of right tonsil, T2,N2A,MO
#44010 10-20-2004 01:41 PM
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Sherry, in the hospital where I got treatment, only about 25% of the Head & Neck patients are given feeding tube during their treatment. It is more common to use naso-gastric tube than the PEG one because the doctors think that it is easier to operate and has less complications. I was threatened to have one inserted when I could not swallow food. The idea of getting the tube into my nose scared me to death and I refused to have one on. I don't know if I would have agreed to having a PEG tube if I had been offered one. Anyway, I survived the whole treatment without a feeding tube and lost 16 lbs. I consider myself very lucky and everyone's experience is different. But here in Hong Kong, doctors will not suggest inserting any feeding tube at the beginning of the treatment unless there is an absolute need and that explains why majority of the patients do not have one. By the way my stage of tonsil cancer is very similar to your husband's (T2N3M0).


Karen.


Karen stage 4B (T3N3M0)tonsil cancer diagnosed in 9/2001.Concurrent chemo-radiation treatment ( XRT x 48 /Cisplatin x 4) ended in 12/01. Have been in remission ever since.
#44011 10-20-2004 01:48 PM
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Sherry,
My husband had a PEG for about 6 months. About three weeks into chemo/rad treatment, he stopped eating overnite...thank God the PEG was in and ready. He couldn't eat for about 5 months and never would have made it w/o the PEG. A naso-gastric was never mentioned by any docs to us.
God bless,
Debbie


Debbie - Caregiver for husband, Dan, diagnosed with tongue cancer 7/03. Partial gloss., mod. neck dissections, graft. Recurrence neck tumor 12/03. Radical left neck dissection 12/24/03-unable to get all the tumor. 8 weeks chemo/rad beginning 1/12/04.
#44012 10-20-2004 05:30 PM
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I fail to understand how a small nasogastric tube carrying food to the stomach will have much effect on the esophogus?? I had a PEG and ate NOTHING by mouth after the 4th week of radition until at least a month after treatment. But I did drink water all day long to keep my swallowing strong and to keep hydrated. I'm a strong woman but I cringe at the thought of enduring radiation and the months after without a PEG. The tube caused me no issues. I kept it tucked into the waist of my pants and forgot about it unless I was "eating". My tube was put in during my surgery, a full 6 weeks before radiation started.
I could not imagine having a tube in my nose for more then a few days.
If the PEG were such a risk I don't believe the top doctors in the country would be using them.
Minnie


SCC Left Mandible. Jaw replaced with bone from leg. Neck disection, 37 radiation treatments. Recurrence 8-28-07, stage 2, tongue. One third of tongue removed 10-4-07. 5-23-08 chemo started for tumor behind swallowing passage, Our good friend and much loved OCF member Minnie has been lost to the disease (RIP 10-29-08). We will all miss her greatly.
#44013 10-20-2004 05:45 PM
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Hi Sherry

I got through without a feeding tube but I didn't have chemo-related nausea to deal with.

My radiation oncologist also suggested the nasogastric tube, rather than the peg. Best wishes to you and your husband on your journey.

Love from Helen


RHTonsil SCC Stage IV tx completed May 03
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