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.

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!!!

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.

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?

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.

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!!!

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.

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!