What to Eat With Radiation of Throat, and What to Expect...

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What to Eat With Radiation of Throat, and What to Expect...

by Joann_d on Thu Aug 24, 2006 12:00 AM

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My husband has been diagnosed with Squmous cell carcinoma stage 4A ( deep base tongue and lymph nodes) We have decided to go with radiation and Chemo. They say that he will need a feeding port soon, befor he gets too sick. They also told us that he will get a bad sore throat. Right now he has a sore throat from two biopsies. If he can't eat now, what can I expect later. I have a juicer...any reciepies for good blood building juices or high protein drinks. Any sites out there to help? Joann d.

Thoughts

by Amnia on Fri Aug 25, 2006 12:00 AM

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His diet is not the problem. I suspect the problem is/was possibly smoking or chewing tobacco. I am wrong all the time so why should today be different, but oral cancer is so often the result of tobacco use. Blood building juicing - this is basically a lot of sugar which is not what he needs, nor will he be able to swallow it orally, nor will it provide the calories he needs to avoid malnutrition. The feeding tube is a tube that goes through the skin near the belly button directly into the stomach. This tube will be attached to a bag that is hung from a high place such as an IV pole or a post of a 4 poster bed. The food can run into the stomach by gravity or by a pump attached to the IV pole. The bag will be filled with a nutritional supplement similar to ensure, and he will do this several times a day as well as possibly overnight. A regular meal can be put in a blender with some liquid and set on "liquify" till smooth, and that can go through the tube as well. There are many nutritional supplements, each being a unique mix of fats, carbs, proteins, and vitamins/minerals. Some are better for diabetics, some are better for post surgical patients, some are better for cancer patients getting chemo. His oncologist will either suggest a supplement or refer him to a dietitian who will do some math to figure out the best mix for him. In my opinion, the dietitian probably is more familiar with the nutritional supplements and their uses than the oncologist and your husband would be better off seeing one of them. If you plan on using the blender to make some meals for him, talk to the dietitian for specific advice before putting together a concoction of your own. You may think a high protein shake is a good thing, but it is gummy (elmer's glue is a high protein shake) and will clog the feeding tube. This will result in a visit to the ER to unclog the feeding tube, or more surgery to replace the feeding tube. Chemo and radiation will place great stresses upon him. He will require more calories in a day than usual. For a normal 70 kg man who normally exists on 1800 cal/day, he will probably require in the neighborhood of 2300-3500 cal/day. In addition, if you must use vitamins, stick with stress vitamins in the B vitamin family (these usually are available as a liquid which is good), and perhaps antioxidant vitamins. Let the oncologist know what vitamins and such you plan to use. Some natural products can interfere with medications. Your husband does not need iron. Even if he becomes anemic from the chemo, it will not be the type of anemia that responds to iron. Women who are anemic because they are menstruating need iron. When your husband starts to menstruate, you may give him iron, not before. In all seriousness, if he becomes anemic, it is the result of bone marrow suppression by the chemo. His doctor will give him meds called CSFs such as aranesp or neulasta if he needs "blood building." Giving iron to someone who is not iron deficient can lead to iron toxicity, and "blood building juices" will do nothing. I think you believe that blood building juices or high protein shakes may help to fight this cancer. He did not get this cancer because he did or did not drink juices and shakes. What he actually will need will be adequate calories, otherwise he will become malnourished. The reason I keep harping on this is that his five year survival with stage 4 oral cancer is only 35%. The combination of chemotherapy induced immunosuppression and malnutrition can turn a minor infection into a life threatening one, further lowering his chances of survival. I understand the desire everyone has to help any way they can. Certainly from the infomercials they play on TV, it would seem that fresh juiced products have magical properties. But the reality is that stage 4 oral cancer, no matter what juices he drinks, has a 35% five year survival rate. Instead of juicing, I would think a back rub, being a good listener, or remaining kind and understanding even if/when he becomes depressed and irrational after getting bad news about a scan or a blood test.. those will be far more appreciated than a glass of juice. just my two cents, -Amnia

What to Eat...

by Joann_d on Fri Aug 25, 2006 12:00 AM

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Wow, Yes my husband was a tobacco user, Skoal chewing tobacco,for 32 years. I will indead talk to a dietitian at the hospital. They have alot of different help. I am a little scared to hear that the survival rate is 35% in 5 years. I believe that you are given the sentence that the Dr. tells you, so hopefully, we can get the odds in our favor. Reading through this, I guess you are a spouse to a cancer patient or maybe a nurse? I will do my best with helping him cope, and my children are ready to help also. Thank you for your "two cents". Very helpful and eye opening. Joann

What to Eat

by Madmaw on Sun Aug 27, 2006 12:00 AM

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My husband is undergoing similiar disease process. He will be getting his lifeport and feeding tube this week before starting treatment. he had already lost 20 pounds over a 3 week period so we had started a high calorie-high protein replacement. He has regained about 6 pounds. He doesn't handle solids very well so have concocted a drink that he will be able to use for both oral and tube feedings. It consists of 2 scoops of vanilla ice cream, 1/2 cup whole milk, 1/2 cup 1/2 & 1/2; a packet of instant breakfast; 1/3 cup whey protein powder; 2 Tbsp Benefiber and either a banana or 1/2 cup of orange juice all blended together until liquified. He uses this at least twice a day in addition to drinking what ever other fluids he wants. It is very important not to become dehydrated while receiving chemotherapy. I am a nurse and have seen this used successfully in the past as well as double checking with the dietitian. Her only other suggestion was to add a liquid vitamin supplement once the feeding tube has been placed, as he currently can't stand the taste.

What to Eat

by Pauldbld on Mon Aug 28, 2006 12:00 AM

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I am a sixty year old male who was diagnosed with stage iv squamous cell carcinoma at the base of the tongue last August. Prior to my sixty sessions of radiation and seven doses of chemo, I had a PEG tube inserted into my stomach. After less then one month of radiation, which I was getting twice a day, I had to be fed through this tube. I used a Nutritional suplement called Isosource 1.5 Cal. Needed seven cans per day to maintain my weight. If your husband has a sore throat already I suggest he has the tube inserted ASAP and use it as a suplement to normal eating as long as he can. That way he will be used to the tube by the time he needs it full time. I agree that you should talk to a nutritionist about what to feed through the tube. Before, during and after treatment, nutrition is one of the most important things, in fact it could be a life saver. I was given a 17% chance of five year survival by one doctor, 45% by another, 70% by a third and a "We routinely cure this type of cancer" by a fourth. Survival is going to be an individual thing, have faith and finish all of your treatments this will make your chances better. Good luck to your husband. He is in for some rough times, don't let him give up. My wife wouldn't let me quit and one year after diagnosis I play tennis five days a week and feel stronger than I did before the cancer. Have been cancer free since Jan 06. Paul

More Thoughts...

by Marthakay on Mon Aug 28, 2006 12:00 AM

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My husband just completed his radiation and chemo treatment for squamous cell carcinoma of the left tonsil and two lymph nodes. He received chemo and radiation daily for 7 weeks, 5 days a week at Johns Hopkins Head and Neck Cancer Center. He is under a clinical trial and received two chemos, Tarceva (pill) and Cisplatin (IV) and radiation of the neck (both sides) His G-tube and Hickman IV site were both put in before he started his treatment (only 2 days before). He really didn't start using his G-tube until 2 1/2 weeks into treatment. He consumes 6 cans of Nutren 1.5 which is 375 calories a can and uses a gravity bag. He still has not been able to eat anything yet and probably won't for another month or so. He does get some water and Gatorade down but with difficulty. I haven't seen where anyone has addressed the mucositis problem with radiation. That has been the worst side effect for him. It is a heavy thick mucos that he is constantly coughing up to the point that it makes him throw it up. We were warned well in advance by the radiation oncologist and our support group. He does have a sucking machine which has helped immensely and we have used Robitussin through the G-tube which has helped by thining out the mucos. We and others have had dehydration concerns as a result of this and he now gives himself IV fluids at home until he can drink enough liquids by mouth to stay hydrated. The G-tube is a life-saver and he has lost 20 pounds which is normal considering the treatment. As his radiation oncologist explained, this treatment for oral cancer is the worst of all treatments because they take everything away from you...swallowing, drinking, eating, taste buds, saliva.....but IT DOES GET BETTER. His last treatment was August 2nd and he is off his pain meds and working 1/2 days. He is working on his swallowing and eventually will start trying soft foods, milk shakes....taste is slowly coming back. The docs keep telling you to use your pain meds to help you to eat soft foods but with terrible taste buds and a terrible sore throat, you just can't do it. As my husband said, "there isn't enough pain medication to get you to do it." You get plenty of nutrition from the liquid nourishment. Take care and let me know if I can be of any help to you.....it has been quite a journey and there are ups and downs...just hang in there. Be strong. Also, the website for the support group for oral, head and neck cancer is www.spohnc.org. Lots of information there.

What to Eat

by Madmaw on Mon Aug 28, 2006 12:00 AM

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Lifeport and PEG tubes will be inserted 8/29/06. Surgeon plans to keep him in hospital overnight for extra hydration as he doesn't want him to put anything in his stomack for 24 hours to prevent any leak. Secretions are very thick and we are using the Robussin to thin them. Haven't seen much help from that yet, but just started that. Will start chemo and radiation later this week. 5FU continous for 1 week with Cisplatin for 2 days then no chemo for 3 weeks and repeat. He will receive radiation to the right side of his neck Monday through Friday for 8 weeks and the chemo cycles over 16-20 weeks depending on progress.

What to Eat,,,

by Joann_d on Mon Aug 28, 2006 12:00 AM

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Thank you SO much for the imput... We went today for the maping. My CHILDREN ASKED INDEPTH QUESTIONED,,,.,DID NOT GET THEN ANSWERES THEY WANTED. Very sad. We will keep the faith. They are all meeting this weekend to see if they should tell Dad the prognoses. Only 20 -30% Survival rate. Hopefully, they will keep it to themselves. I believe, you live the prognoses you are given. Lots of support from family & fRIENDS JoAnn D

What to Eat

by Pauldbld on Tue Aug 29, 2006 12:00 AM

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Joann d, I would not put too much into the survival rate, as you can see I was given four different ones from four different doctors. In fact, the American Cancer Society has a web site www.cancer.org on staging of Oral Cavity and Oropharyngeal Cancer, which also shows the general five year survival rates. Keep in mind, these are only averages. Some stage four patients may be higher and some may be lower. Each patient is unique to himself. I was staged as T2 N2c M0, which is stage IVA. I do not think of five years from now. I live today and listen to the advise of my doctors, plus have constant check-ups and tests looking for recurrence. You should also put it out of your mind, it can only depress you. This is a time when your husband needs all of your support, don't torture yourself with survival rates that are general averages. Plus, I feel you should inform your husband of everything the doctors have told you and keep nothing from him. Realization of what exactly is happening to him might give him that extra strength to fight. I wish him the best of luck in the struggles ahead. If he wants to talk to another person who has had similar cancer and treatment, let me know and I will find a way to get him my e-mail address. Paul

Mucus

by Skippy on Wed Aug 30, 2006 12:00 AM

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I had almost identical the same problem and treatment as your husband. The recovery with the mucus was horrible. It is just something that goes with the recovery. I finished the last rad. treament June 21,2006. Lost my voice, which I am gradually getting back. However, can swallow some water and fluids. Test shows there isn't any blockage in my throat, and they say I should be able to eat. It is just difficult, and I can see it is going to take some time. Guess it all just has to heal. I have been using Nutren 2.0 which gives me 500 calories a can. Try to get 3000 cal.a day. Then my supplements were recommend by the cancer society which seem to work very well. Oh if he has a dry mouth I use a product called Oasis which comes in a spray. This I find very helpfu. You can get it at Wal-Greens or probably have the local pharmacy order. The spray type works the best for me. I wonder if he complains about fatigue for I go well until mid day, and then run out of gas? Also, the mucus becomes worse. Tell him this is the worse thing I have ever experience, but like they all say it does get better. My family and that has kept me going.
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