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excessive phlegm production five years past radiation

edskid
Posts: 5
Joined: Apr 2005

am writing this for my 79 year old father because he has a hernia and cannot sit for long.

He had radiation which successfully stopped (inadequate word, I know) his throat cancer in 2000. Immediately after the radiation, his body started producing excessive amounts of mucus, which, along with the scarring (affecting the swallowing), has prevented him from eating for the past five years. The swelling in his throat grew so bad that in 2004, he stopped being able to speak.

In March, 2005, he had his voicebox removed, and was told that he should be able to speak (with a prosthesis) and swallow again. He was also told that the amount of mucus he produced was "normal" but that he couldn't swallow it.

Since the operation, the mucus production has increased, and it has gotten thicker. He has difficulty sleeping and lying down. They can't insert the prosthesis yet because the fistula has a leak (common in this type of operation, we're told) which will require further treatment. And he got a hernia from coughing up the mucus.

What he wants to know is:

1. The doctors have said all along that the mucus production is a "normal" side effect of radiation. Why does radiation produce this affect?

2. If the site that was radiated (the necrotic tissue) was removed, why is the mucus production getting worse?

3. Are there other throat cancer survivors who deal with this over a long period of time? Most of the literature talks about dry mouth, but not this drowning in mucus.

4. Does anyone know of any effective treatment for it? Any medication?

At this point, my father is very depressed. Each procedure has been described as promising, and yet he still can't eat, can't speak yet, and the mucus keeps coming. Frankly, the doctors seem stumped by what's happening to him.

Any and all answers would be greatly appreciated.

nanuk's picture
nanuk
Posts: 1363
Joined: Dec 2003

Although I am not a throat cancer patient, I have had radiation to the lungs, and have excessive mucus; I use an over the counter expectorant called Guaifenesin-you can get it from most health food stores, or on line.

Eugene389
Posts: 9
Joined: Jul 2006

Hi,

This information is only my experience and opinion which may not apply to your father. It may help in some small way. Check with your doctor if you're concerned with any of my comments. I am only a layman.

It sounds like your father is going through a very tough time and he is in my prayers.

I had radiation for an unknown cancer in my throat area. As I understand it the heavy mucous is a result of the parotid gland (gland that gives you saliva to keep your mouth moist and also kills bacteria) being damaged from the radiation. The result of this damage is two-fold. It thickens your saliva and decreases the output of saliva. Sometimes my mouth gets very dry and sometimes I have so much gunk in my mouth that I have to spit it out. It also collects in my throat and is hard to expel like your father.

I don't know why your father's mucous has increased since the operation. Guafenesin syrup suppossedly make the mucous less thick. I take that especially when I get a cold (basically it's robitussin syrup which you might have taken as a kid). Also, the more fluid intake you have the thinner the mucous will get. The thinner it is the easier it is to expel. I think water is probably the best; however it may be better for your father to drink fluids (or does he have a feeding tube-I have one and have had it for 9 years) with nutrition, like juices and complete nutrition formulas. I've been told by doctors, on several occasions, that the average person swallows about a quart of fluid that drains down the esophagus which goes into the stomach. The last doctor that I talked to said that was normal for everyone. Your father, of course, is in an extreme situation because of the radiation and possibly because of the last operation.

Also, I have seasonal allergies, and as of recently, allergies most of the time which create more mucous. Check with your doctor and see if he can try some of the over the counter or even prescription medications that will dry up the mucous. I know, it seems that I'm waffling here becaues on one hand I say try to thin out the mucous and on the other hand I say try to dry it up. Both have worked for me in the past and I have even done both at the same time. It's experimental. Sometimes you have to do what works best for you. When I get a cold I take "Benedryl-D Allergy and Sinus" and it pretty much stops all the mucous. The problem with the benedry is it makes you tired and jittery and then you can't sleep (my symptoms anyways). It also isn't good for your prostate. I believe it narrows the urinary canal a little more. My experience is it does do that, but I get off the benedryl as soon as I can and the urine flow returns back to its original state.

One thing I found out by accident is by bending over to pick up something on the floor was that the mucous, by gravity, seems to come up higher in the throat and was much easier to expel. Rather than the terrible coughs which I would make to get the stuff out (and creating a sore throat), I found out that a gentle cough would bring it up and out after bending over. He might have to wait a few seconds or longer while bent over to get it loose. Now when I'm in bed and can't get it out, I just sit up in bed and lean over (bringing my head towards my knees) and it will come loose.

Also what I have always done from day one is take luke warm water and gargle. But even more than gargling I would kind of let some water drop down my throat and it would soften the mucous up and make it easier to expel. I would assume that the warmer the water the better it works, but if your father tries it don't go to hot at first. I've also found that even though I've done that it doesn't loosen up immediately, but maybe 10 minutes later I can feel it has loosened and it will come up with a gentle cough.

When sleeping I sleep on my side. The mucous is subject to the law of gravity. If you sleep on your back, I have found that the mucous is more apt to collect in the throat around the windpipe. Your father may have a stoma through which he breathes; you didn't mention it. But keep in mind, however he breathes that you want to keep that fluid away from his breathing pipe. By sleeping on my side the fluid seems to stay away from my breathing pipe (trachea). I find that having my head elevated while sleeping (I double up on the pillows) keeps me from having so much acid reflux (acid indigestion). I don't know how that would affect your father's mucous.

Another thing I used at first was a device that cost maybe $30-$50 is this. It's a small device that you pour in distilled water. It has its own heating device which you plug in and it simply creates steam. At the top of the device is a plasic mask that you simply put your face into and breathe gently. That will absolutely loosen mucous up in the nasal cavity and probably further down. You could probably just try that with a CLEAN pot of distilled water and have him breathe that. If he has a stoma he would breathe through the stoma.

I use Biotene mouthwash (found with the regualar mouthwashes in most drug stores) all the time. I probably use it 30 times a day. I rinse my mouth and throat with warm water and then put a swig of Biotene in. It prevents dry mouth and has a clean mild flavor instead of tasting all that terrible mucous. I wouldn't buy the flavored Biotene, such as mint.It also has antibacterial properties. I'm sure your father's immune system in that area has been compromised.

Finally, you should get professional help. What you want is someone who specializes in that area. You don't just want, say a visiting nurse, to check on him, but someone who is a specialist in that area. His medicare, I think, would cover it.

I may possibly be having a tracheostomy soon and may end up with similar problems as your father. What my doctor said to me last is that what was good about the hospital that I go to is that all the nurses on one floor are trained to deal with these problems. I'm talking about the Massachusetts Eye and Ear Infirmary. The specialty is Otolarnygology. If you have a large hospital in your area that specializes in this, maybe you can call directly to one of these nurses and talk to them for very specific advise and point you in the right direction. I'm sure the hospital in your area has a home follow-up program.

Some of these things I mentioned to you may be helpful and maybe not. Just remember that the small things you and your family do to make your father as comfortable as possible are important.

I will pray to Jesus in a special way for your father and your family.

Love,

Ed

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