I have 2 doctors recommending 2 differnt options.
Oncologist says get the feeding tube, radiologist says
no tube needed. Going to have 7 weeks of radiation along with chemo everyother week. Any suggestions?

The decision to get a tube or try to tough it out is a difficult one to decide. Often patients feel like everything is out of their control and when they actually have a choice their first reaction is NO!. Some patients have issues right away while others are luckier and sail right thru their treatments without many side effects. Some patients will prepare themselves with every tool they can and get the feeding tube so they are ready if they need it. Other patients feel they can tough it out no matter what and will drink their calories if it comes down to it.

Ive had a feeding tube and found it to be helpful during some very difficult days. I am one who thinks its better to have one and not need it than to get part way thru and struggle so much where they feel horrible and they have to wait another week or more to get their tube placed. Others have done it without the tube but ended up getting a more temporary nasal tube. This type can be inserted in a few seconds right in the doctors office and removed just as easily.

At least half the patients who go thru rads w/ chemo will struggle by week 4. Rads accumulates so as time goes on the rads build up and the patient feels worse and worse if they are not taking in enough. Even when the radiation treatments stop that doesnt mean the worst is over, the rads keep right on working. Starting now, you should take in at least 2500 calories and 48-64 oz of water every single day. This needs to continue until at least the first year after rads ends. If you are the kind of person who can motivate yourself and push yourself to eat and drink no matter what then you may be ok without a tube. During rads, many of us have had very painful mouth sores, a sore throat and lose our sense of taste and ability to swallow making eating next to impossible.

I suggest reading posts about the feeding tube decision before you make your decision. Pay attention to those who seem to go thru it without many side effects, the common link is they usually do not have chemo and are the ones who do the best with their intake. Use the search function up towards the top right of any page.

Can you find out from your RO how many grays of radiation you are getting? The more grays it is, the more chances you will have swallowing problems. My husband got 70 grays over 7 weeks and that was the lifetime maximum. He needed his feeding tube from about four weeks into radiation. Others can tough it out and these are likely people with high pain tolerance. The other question to consider is how much do you weigh right now and can you afford to lose a large amount of weight during treatment. Start thinking along these lines and, like ChristineB said, read through the posts on feeding tubes.

I think it is important to understand that no matter how high a pain tolerance one might have, depending on amount of rad, area targeted, dosage & type of chemo, toughing it out might not work. It is not necessarily a patient failure of will.

There is a case to be made for having PEG in place or waiting to see how severely swallowing is effected. Christine outlined many of the considerations.

Our RO & MO insisted on PEG placement prior to tx. so we didn't face this issue. My husband lost zero pounds during tx., mindful of exercising muscles with sips of liquid. I believe this speeded up his overall recovery. The other advantage was getting use to the PEG and a formula gradually before it was essential.

Kris has had the PEG inserted on 2 occasions. Our Team would not start treatment without this in place. Kris did manage to swallow ok for the first 3 weeks of radiation and chemo. His oral intake then tailed off dramatically. He was just nauseated and vomited a lot from the thick secretions that developed in the throat. Although he continued to swallow, he could not maintain his weight and he needed to use the PEG. Kris lost around 40 pounds through treatment, despite using the PEG with Ensure for nutrition.
Although Kris had a high pain tolerance and did not use any pain killers through treatment ( very unusual ) it was the thick ropey saliva and secretions that were his undoing, causing excess nausea and vomiting. He also lost all interest in food and eating. The PEG really was a life saver.
Tammy

I totally agree with you. It was mandatory to have the tube in place before I started chemo and radiation. It was a life saver for me and even using the tube I have lost over 50 pounds. Was 138 when I started and down to 86 pounds now. Good thing I am only 5 foot tall. My mouth is always so dry that I can't get anything even a touch chunky to go down. Even with the tube I really struggle on a daily basis to get enough 2Cal and ensure down along with as much water as I can take. 8 ounces at a time is all I can take before I feel like I have been to an "all you can eat" buffet and I ate it all. This is a daily battle and I am sure I would have not made it if I didn't have the feeding tube. I have spent a lot of time researching home made liquids I can get down the tube without clogging it up but alas am still using the the formula. Again, I believe, as was stated above it boils down to how much weight you can stand to lose from the start.

Ideally, you shouldn't lose any weight during treatment. My body needed and used every calorie I put in it during radiation and for about two years after. If I had to do it all again, I'd still use a feeding tube. Made treatment so much more tolerable.

I went thru Induction Chemo, followed by 7 weeks of Rads with weekly Chemo. I did this without a feeding tube but would recommend that most have one. It took all my Marine Corps discipline to make it thru. I drank 3000 cals per day plus ate 4-6 eggs per day for 12 weeks, but it gave me some control over the BEAST. Semper-Fi Bob

I have never done this entered a blog/opinion but for anyone that has oral cancer throat cancer...a port for the chemo and a feeding tube same time...my husband did the port but nixed feeding tube after 3 weeks of vomiting he had to undergo surgery again for the feeding tube...
A port is to avoid ones veins from collapsing from having the chemo put through them...the artery is stronger and safer but this I pick up from sitting in the chemo room with my husband. So much easier quicker cleaner.

Been through radiation treatments twice, once with a tube and once without.

Lots of great input above with good observations from both sides of the question.

Personally, I would recommend the tube for the duration of your treatments just for the ease of calorie intake. It is a pain, but I think in the long term, the ability to maintain consistent caloric intake outweighs the hassle of dealing with the tube.

As for the thick ropey saliva - ask for a suction machine. its a great way to clear your mouth and reduce the gag factor

Welcome to our family, LPV. We're all here to help you get through your treatment and beyond.

Count me as one more who chose not to have a PEG and later regretted the decision. And I did not have chemo.

I was almost exactly your weight and height prior to rads. At the end of it I'd lost 30 pounds, which I attribute to not getting enough calories... which in turn I attribute to the fact that it was so painful to swallow the nutrition drinks (even with viscous lidocaine to numb my mouth) that I did not drink nearly enough.

I'm glad you're thinking about this issue and getting good advice from the folks here.

Please keep us posted as you go along.

I would like to thank everyone for their replies and advice. At this time I have decided not to use the PEG tube. I have an agreement with the Oncologist that at 8% loss of body weight a PEG tube will be inserted.
I will be starting another tread on the Currently In Treatment Forum. Thank you Again. LPV

It's better to have it and not need it, than to need it and not have it. I would schedule it to be inserted around week 4. I also found, it took some time to learn how your body reacts to feedings.