Chemo drugs

Mom was dx with EC at advanced stage (squamous cell) in April 2009 at age 63. In May she had a stent inserted which caused excruciating pain, and the pain medication caused nausea and vomiting. Her PET scan indicated possible mets to lymph nodes and lungs. In June, her doctors started her on radiation and chemo. After only two treatments, she was hospitalized due to constant vomiting. She was discharged with zofran and reglan, and continued her three weeks radiation. Chemo was cancelled due to  her physical weakness.

Now it has been two weeks since radiation was finished and her doctor would like to start chemo and Taxol will be the chemo drug. I read a lot of the postings and found out that commonly used chemo drugs include Cisplatin, Irinotecan, along with docetaxil; cisplatin and 5 fu; Carboplatin and Taxol etc. I have not seen any patients with only one drug. I asked her doctor this question, and was told that Taxol is picked in considering the less side effect for nausea and vomiting, since mom already has nausea and vomiting. I do understand that side effects could be severe, but with medication it could be kept under control, right? I worry that only one chemo drug may not be as effective as a combined of two or three drugs which may attack the cancer cells at different ways.

Any suggestions?

God bless you all!

May

So sorry to hear about your mom.  I am also terribly sensitive to pain medications and vomit almost constantly also when on them.  Actually, I have a worse reaction to pain meds than to the Cisplatin/Irinotecan chemo treatment I received back in 2004.  Zofran and Compazine kept me in a "tolerable" condition during chemo, although I dehydrated several times and was nauseaus almost all of the time.  Feeding tube kept my weight up throughout treatment. 

You didn't say whether your mom was on a feeding tube.  I don't know anything about Taxol, perhaps some others could comment.  Perhaps a second opinion would put your mind at ease.

On 7/14/2009 doingfine wrote:

So sorry to hear about your mom.  I am also terribly sensitive to pain medications and vomit almost constantly also when on them.  Actually, I have a worse reaction to pain meds than to the Cisplatin/Irinotecan chemo treatment I received back in 2004.  Zofran and Compazine kept me in a "tolerable" condition during chemo, although I dehydrated several times and was nauseaus almost all of the time.  Feeding tube kept my weight up throughout treatment. 

You didn't say whether your mom was on a feeding tube.  I don't know anything about Taxol, perhaps some others could comment.  Perhaps a second opinion would put your mind at ease.

Barbara,

We are still debating whether mom should have a feeding tube. However, we asked her doctor to order a Medi-port and a feeding tube which takes time to schedule. Maybe mom can start chemo next week and see how she does. She is afraid of the pain and inconvenience of the tube. I terribly worry about her lack of nutrition. Since mom is stuburn and does not eat many varieties, the feeding tube is appealing to me since I can feed her the good stuff.

If she does need a feeding tube, would J-tube be better than G-tube? My thinking is that with J, it might not be that easy to vomit. Is it true?

It has been almost three weeks post radiation, mom still feels the excruciating pain from her esophagus area, both front and back. I am taking her to see a new accupuncturist tomorrow hoping to relief some pain. She did have accupuncture before, but it was just a temporary relief.

Thank you for your reply. Stay well and God Bless!

May

May

Husband had G tube during chemo and radiation, and removed it before surgery. J tube was put in at surgery. Do not know why they do it that way, but we had a major problem with vomiting with g tube and none with the j tube (of couse he was done with chemo and radiation with j tube, so lack of vomiting may bot be related to tube as much as it was to treatment. We lost ground to nausea and vomiting with chemo and radiation because cost of good anti emetics was beyond us at the start, and we never regained the lost ground. Once we found programs to cover the cost of the anti emetics, or had insurance to cover prescriptions, we did not have a problem with vomiting anymore because we always kept it under control from the start of treatment. I would recommend making tube decision before chemo starts. I have heard of a few people who had a j tube right from the start, and if that is an option I might opt for that. The tubes can leave adhesions when they are removed, so one set of adhesions is better than two in my mind.

On 7/15/2009 tongrenhealer wrote:

May

Husband had G tube during chemo and radiation, and removed it before surgery. J tube was put in at surgery. Do not know why they do it that way, but we had a major problem with vomiting with g tube and none with the j tube (of couse he was done with chemo and radiation with j tube, so lack of vomiting may bot be related to tube as much as it was to treatment. We lost ground to nausea and vomiting with chemo and radiation because cost of good anti emetics was beyond us at the start, and we never regained the lost ground. Once we found programs to cover the cost of the anti emetics, or had insurance to cover prescriptions, we did not have a problem with vomiting anymore because we always kept it under control from the start of treatment. I would recommend making tube decision before chemo starts. I have heard of a few people who had a j tube right from the start, and if that is an option I might opt for that. The tubes can leave adhesions when they are removed, so one set of adhesions is better than two in my mind.

I am thinking exacting the same. Having J-tube in now for chemo will supplement enough nutrition if she indeed vomits a lot. If she responds well and can have surgery later, there is no need for another tube. My understanding is that the doctors prefer to insert G tube. After surgery, only J-tube could be used in fear of food coming up to the esophagus before it is healed.

I thought about J tube before mom started radiation. However, mom is afraid of the pain and inconvenience. Starting chemo before tube will help us evaluate the need for feeding tube and mom will be more willing to accept it.