I didn't notice any constipation from the Zofran, but
for me the Nutren 2.0 for the PEG feedings was constipating so I was also dumping in cup a day of plum juice which might have made the difference.

I don't recall any side effects from the Emend. And unlike Don, I had trouble with the 'canned nutrition' causing diarrhea, not constipation.

On my chemo day, I would get an infusion of Aloxi for nausea before they gave me my chemo. It supposively lasts for three days (I think). I had Zofran and Phenergan at home and I kept up with those religiously. I only had trouble with nausea at the beginning, before I started on the Aloxi.

And I'm with Margaret. Those nutrition drinks clean you out! I had trouble from day 1 in the hospital. At first my stomach wouldn't digest the stuff and they could bolus out the same amounts of liquid that they had put in, several hours later. And then once my stomach decided to start moving the food, it moved at lightning speed!

How soon did all of you start to get a sore throat? Richard's throat is sore at the roof of the mouth at the back. He said it feels raw. He did have a slight temperature last night that went away and the RO thinks it's a bit early for throat pain. She thinks it might be a cold virus and will check him tomorrow. I've had a bit of a scratchy throat myself. Nothing has progressed the way we thought it would, so he is probably just getting sore sooner.

I did not start getting a sore throat until about half way into tx. My mouth however was sore after a couple of weeks. I was not able to drink anything with chocolate at first and then pretty much anything at all besides water.

Patty

I didn't start having symptoms until well into my 5th week - except pink skin, but as I'm sure you have already found out, anything is possible because we are all affected differently. Towards the end of it all, I couldn't put anything in my mouth, including water because the mucositis was so bad. It felt like a million razor blades were in my mouth - but I kicked up the pain meds and made it through!

Love those pain meds because they can turn an ordeal into an inconvenience -- Of course, there're prices to pay in the form of constipation (they're giving me plenty of stool softener) and getting off the stuf (intend to taper down much better this time around!).

Geri,
The sore throat and mouth sores are more often caused by the chemo than the radiation (especially early in treatment - the radiation side effect problems typically occur later in treatment). I was about 3 weeks into it when it started. Some here have reported a sore throat in the first week.

I just got caught up on the threads and had a few other comments:

They have fiddled quite a bit with treatment protocols. The NCCN Oncology Practice Guidelines, in 2003, when I started treatment were Cisplatin X3, every three weeks with the first application starting on the first day of radiation. They had very good (efficacious) results from this treatment protocol (although the toxicity from the Cisplatin was pretty brutal). Then they started experimenting with weekly, smaller doses of Cisplatin and also with hyperfractional RT treatments, in other words twice a day instead of once a day, but in smaller doses. Initial reports have been favorable for the new protocol and more institutions are using it. It's not so much that the odds of beating the cancer are improved as much as the side effects may be mitigated a little. But as has often been stated, we all respond differently to treatment.

I was scheduled for X3 Cisplatin ct but reacted so poorly (or conversely, so well) after the second one that they decided not to go with #3. I also read somewhere that 2X Cisplatin was as effective as X3. It obviously worked for me as I am almost 6 years cancer free now. Most MO's are adamant about completing all of the prescribed treatment protocols however. There is strong evidence to support that persons not completing their treatment prototcol have worse outcomes. Conversely, the radiation IS the primary treatment modality and the Cisplatin is an adjunct to it. It has been reported that tha addition of Cisplatin can improve survival odds and additional 13-15% over radiation alone.

Constipation: I have no experience with Emend but I don't believe that the anti-emetics will cause it. It's the narcotics that are the main culprit for that. Staying well hydrated is key for constipation management as well as Senekot with stool softeners and also speak with your nutritionist. Preparation H will also help. It can be managed - usually better. Honestly it was one of my worst experiences in the whole tratment process. It can also cause nausea and vomiting when homeostatis is stopped. It is important to get a handle on it. I spent more time curled up in a fetal position on the bathroom floor as a result of the constipation than any other reason.

Watch that temperature - if if exceeds 100.5 degrees call your doctor or go to the ER immediately.

Another tip for you, if he is dehydrated, make an appointment and get rehydrated in the infusion unit rather than going to the ER. It's twice as fast and twice as comfortable.

Also, Ciplatin does a number on the stomach so he should also be taking Famatodine (Pepcid AC).

All of this is still a simplistic way of looking at and describing the treatment protocols as cancer is a complex and multidimensional disease.

My 2nd Cis even with the Emends was not as "pleasant" as the first and you also need to keep in mind that he will have had 15 rad Tx's to go along with this so hope for the best but don't be crushed if he still gets sick. It was around this time that things slowly started to go south for me. Also make sure he pays attention to a slight ringing or hummmm or buzzing "noise" in one or both of his ears. That means TROUBLE with Cisplatin and you should let his chemo doc know right away as they may want to switch him to Carboplatin for #3.

Many thanks everyone for all your responses. Richard's sore throat is better this morning, so the RO was probably right about it being a virus. Especially with my scratchy throat. Anyway, it's a relief and hopefully we'll have a good day today. Gary, how do they determine if you get the 3rd dose of Cisplatin? At radiation, they take x-rays frequently and the RO approves before the treatment. I'll ask when we go in today for more info. David, what does (70gy) mean? The RO said that Richard was getting 1600? and the limit was 7000? I'll ask today when we go in.

One nurse said that they will probably only change treatment plans if the blood work doesn't look good. Another nurse said that they might not need to do the third, depending on the progress of the radiation. I might of misunderstood what she said with all the stress of the 1st chemo treatment.

Can they tell if the tumor has shrunk during the treatments or do you go through it all and wait until you can be tested again? I feel like I'm going around in circles with my information. It's like I'll ask something , get some answers, ask more questions, then forget what was said. If you can think of any questions for me to ask the RO today, please post.
Richard calls me his guardian angel( a very tired one) and we have become so much closer through this ordeal. Thanks, Geri