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Radiation therapy

daunab
Posts: 1
Joined: Dec 2009

I'm new to this today. My husband has base tounge cancer. Its stage two and he's in his second week of radiation. He's doing well and only now starting to need softer foods.
He refused a feeding tube. He's 42 and healthy otherwise so the doctor agreed to no feeding tube. If he loses more then 20 lbs though he has to have one, thats the deal.
How bad does the swelling get? Some people are not able to swallow. Can someone give me some advice. I know everyones different and alot of the cancer I'm seeing here is higher then stage two.
Thanks, DaunaB

Hondo's picture
Hondo
Posts: 5608
Joined: Apr 2009

We are glad to have you here with us on CSN although I am sorry to hear about your husband Rick having cancer, but this is the right place to be to get real information that will help you. Everyone’s body reacts differently to the treatment so it is hard to say if and when he may need to have the feeding tube put in. I was lucky I was able to go through treatment twice with no feeding tube, but I did have a wife behind me all the time encouraging me all the way through, it was the best help I ever had and I love her even more for her support.

Take care and I will keep Rick also on my prayer list

SASH's picture
SASH
Posts: 276
Joined: Apr 2006

I too refused the tube after the softer foods, he might need liquid nutrition like boost, ensure, or other such liquids. There are powders that you can add to these to add calories called weight gain powder and is available at places like GNC.

As Hondo said, everyone is different so it is impossible to say if he will be so swollen that he will have difficulty swallowing.

While my doctors respected my wishes on not having the tube, they were not happy with it because of the excessive amount of weight I lost through radiation and chemo. By the time I was done with radiation and waiting to completing my chemo the only thing I was able to get down was a single glass of Gatorade per day.

If he is experiencing pain when swallowing, which might come in the near future, ask the docs for a prescription for Magic Mouthwash or Magic Mix. This helps as it numbs the mouth, throat, etc as it is made up of lidocaine and other ingredients. Just make sure to shake this well if you do get it as the lidocaine is the lightest ingredient or his entire head might be numb for days.

pk's picture
pk
Posts: 192
Joined: Aug 2009

My husband went thru 35 rads and weekly Erbitux infusions. Protocol for his Onco and radiation oncologist were to place the feeding tube prior to starting treatment. He wasn't thrilled with the idea, but thankful he had it when eating became tough. My husband had some weight to lose so his 30 lb. loss was ok, but some people do not have the extra lbs to lose. This is not a time to be a hero. He will need all the nutrition and strength he can summon. PK

Pam M's picture
Pam M
Posts: 2194
Joined: Nov 2009

Dauna,

I just got a feeding tube put in place. I didn't like the idea of tube feedings, but feel like I have a safety net in case I can't get enough nutrition in.

You may want to experiment with several different kinds of supplements now, while your husband is able to eat. Then, if the time comes when he cannot, you'll know what he likes and what his body can tolerate. There are lots of nutrition/protein mixes on the market. Your husband's doctor/nutritionist should be able to give you dietary goals for number of calories needed per day, as well as grams of protein needed. For instance, my recommendation from my nutritionist is 2,250 calories a day/ 105 grams protein. I am a 5'7" overweight woman; recommendations for nutrient intake will vary from patient to patient. I have found the taste of some supplements to be overwhelming; I've had good luck with egg protein powder. The taste is OK and the consistency (when mixed with liquid) is smooth. There are many supplements to choose from - your husband's doctor may have some good recommendations (mine didn't).

There are other people here who went through treatment without a tube. They'll have more tips to share. Good luck to you both.

- Pam

ratface's picture
ratface
Posts: 1231
Joined: Aug 2009

Hi and welcome. The prognosis for stage two is excellent. If in fact it is base of the tongue and not spread anywhere with a small primary tumor the radiation field may not invlove the tonsils and in my opinion will make swallowing easier. I had the tube installed and lost appx. 40 lbs. during the process. I actually only needed the tube for about a week and that was because my right tonsil was so fried by the radiation that anything touching it caused severe pain. Is the primary to the right or left of the midline and might it affect one side more than the other? Lots of variables. Sounds very doable for your husband, age wise and physical condition wise. Good advice already given, pack on the weight now and remember that those supplements are drinkable in most cases. may taste bad but just getting them down is enough to get by.

Scambuster's picture
Scambuster
Posts: 975
Joined: Nov 2009

HI DaunaB,

I went thru the same treatment as PK's hubby. I am 47 and healthy. I started all without a PEG but was losing too much weight. Couldn't tolerate the Ensure and other similar drinks so in week 3 I had the PEG installed. It got me through though the treatment and also post treatment for nearly 2 months. I had to find alternative supplements to put through the tube due to intolerance. I lost 44lbs in all (was 200lb to start)

Bottom line from my post is you can opt to have it in midway through treatment if necessary. The rads will cause pain and that was was stopped my taking of food or even water by mouth. I could only take water if it had Glutamine Powder mixed in. You might want to google Glutamine Powder and consider it to assist heal the mucosa and also prevent lose of muscle tissue if he does lose weight.

Hope this is of some use.

Regards
Scambuster

delnative's picture
delnative
Posts: 452
Joined: Aug 2009

My doctors insisted on me getting the PEG a couple of weeks before treatment started, simply because if I didn't have one but needed it later, I'd already be going through all that crappy treatment -- and who wants to go through even minor surgery during that battle?
I was thankful that I did get the tube. I didn't use it until about the fourth week of my six-week treatment, and I only used it for three or four weeks after treatment ended. But even so, I lost about 40 pounds -- and I'm sure I'd have lost a lot more if I hadn't had the PEG.
As you and others have noted, everyone's different, so your husband might not need the PEG. But it makes more sense to me to get it and maybe not need it, than to not get it and wish you had.
Good luck!

--Jim in Delaware

Kent Cass's picture
Kent Cass
Posts: 1746
Joined: Nov 2009

Like Jim, I got mine before any treatment. Unlike Jim, I started using at the end of the first week, and used exclusively thru week #8. Lost 18% of my body weight with the tube, and woulda been a lot more if I had not had it installed. Onco told me I had no option- had to get it before, and so I did, and glad I did. Not as bad as it may seem. Still have it, but haven't used since early-April. As for whether or not- I would get, but would rely on your Onco's opinion as to whether or not it will be necessary.

kcass

ratface's picture
ratface
Posts: 1231
Joined: Aug 2009

I just wanted to say that I am in the camp of getting one at the onset even though he may get by without it. Getting it put in is very unpleasant and not something i would want to do in the middle of therapy. It may also cause some missed radiation appts if done after DX has started. Getting it out is a breeze comparitively speaking and he can really insist on it gone if able to eat through treatment. The tube can also be used to administer meds in a pinch which could be a useful side benefit. He is going into battle so why not wear all the armor that is available.

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