I was wondering if anyone here has had experience of oral cancer in combination with diabetes (type 2).

My boyfriend is one of those people. He has cancer, stage iv, of the upper part of his mouth, left side. He had surgery about a month ago in which they basically removed the left roof of his mouth, along with 4 teeth. He also, in the same operation, had reconstructive surgery where they removed tissue from his leg to close the hole in the top of his mouth. They also removed all the lymph nodes from the left side of his neck, but non were cancerous. (As a result, he does not need chemotherapy.) The cancer was stage iv because it was found in the bone.

So the next step is radiation, beginning probably within a couple of weeks. I am very worried about his weight. He has lost about 15 pounds since the operation. The radiation doctor wants him to gain back all that weight, but I don't see how it's possible in two weeks! His appetite is not great. I know that loss of weight is a problem during radiation, so I am very worried.

The fact that he's diabetic does make it hard to get calories, because he has to be careful about carbs. It's hard to take lots and lots of calories that don't contain too many carbs! I was wondering if anyone has had experience with this problem.

(I should add that he is not overweight -- he is 5'11" and currently weighs 149 pounds.)

Thanks!

At our hospital, the advice is to mix some powdered skimmed milk in with milk to increase the calories in each cup of milk the patient drinks, but since Hank is diabetic, I would not think this is appropriate for him. Do you have access to a dietitian at the hospital? This is a person you really need to talk to. He/she will make suggestions which are tailored to Hank’s health situation and can keep an eye on his weight as well as his blood sugar content. At the hospital, all the patients have a dietitian assigned. If Hank doesn’t have one, see if you can get a referral from his surgeon/RO or his family doctor. This is a good person to have on your side as he starts radiation.

SOUNDS LIKE MY HUBBY, THOUGH HE HAS TONGUE CANCER. HE IS ALSO DIABETIC , been looking at high calorie, low sugar/carb meal substitutes today. He only had surgery a week ago, I have been pureeing soups, having him drink Glucerna , Boost etc. But he is a light eater to begin with, lost a few pounds . Been keeping track of calories, 12-1400 0n the average, will be hard to keep over 2, 000! did find a few powders that I think I will try, may become even more difficult after rads. Rads are really scaring me! Had them for breast cancer but what I read ,this is a whole different situation , with a lot of possible side effects. He also was in the midst of getting new partial dentures , when he was diagnosed. Looks like that will be on hold for a long time. With so many teeth already missing, doesn't help. Seems like this whole process is more than either of us expected. Have a surgeons appt tomorrow, maybe he will elaborate. on what I have been reading here!

Sorry to hear he has joined the club no one wants to be part of. Nutrition is critical during and after treatments. The body is being bombarded with things that not only kill the cancer but some amount of heathy tissues and cells around the treatment area as well. So it is in a state of daily repair which requires a sound diet to optomise not just high calories, but balanced nutrition, and additional proteins.

Most people lose weight during treatments and some require interventions like feeling tubes for a period of time to keep their nutrition optimum. The mouth is very sensitive to radiation and chemo, and he will ultimately develop oral mucocitis sores as a result. This can be wildly painful depending on the treatments and their duration, often requiring pain medication to tolerate it. He must have the calories and the balance of proteins, carbs, and healthy fats that give his body the building blocks of keeping up with the damage. But given his diabetes, you will need to be more careful than others about what he gets fed. Obviously there is likely a nutrition specialist on his team to help you sort this out. But we can help as well.

Blending things for him is a good start for as long as he is able to eat by mouth during treatment. By about week three, my mouth was too sore to do that, and I slacked on my eating, which when I lost 12% of my body weight the docs insisted on putting in a PEG tube for me to eat. I had that for about six months past the end of my treatments. Without it my healing would have taken much longer.

I would encourage him to as much as possible, continue to swallow and eat a soft diet normally, and even if he ends up with a feeding tube doing both types of feeding. Transitioning back to all oral eating will be much easier if he does not stop completely. But with a good blender like a Vitamix, you can make him things that will pack on weight and nutrition and taste good as well. When you need help with that please ask, I did it for years, before I became totally PEG tube dependent. I still blend everything for my PEG feedings as I have learned plenty about the shortcomings of canned pharma company foods. I would be happy to help you sort out what to blend for him if you want help in general, but given his diabetes you will need some professional input as well. Good luck to both of you as you go through this. We all wish him a rapid trip through treatment and a return to a normal life. B