Thrush

alaskanjan
alaskanjan Member Posts: 42
in Head and Neck Cancer #1
Oral thrush is adding insult to injury for my husband. He finished chemoradiation in February and has suffered with some degree or another of it ever since. He has been on increasing doses of Diflucan combined with Nystatin swish and swallow and we do not seem to be making any headway. He refused a PEG tube and has been able to keep his weight fairly stable with Ensure and milk but cannot eat solid food, or even yoghurt for that matter, because of the mouth pain. Things he has started trying the past day or so are white vinegar rinses, peroxide rinses, and physically scraping his tongue. He is quite discouraged with this problem in addition to the fatigue and the generalized discomfort. Any ideas out there? I think his physicians do not understand what a big moral buster this is.

Comments

  • tuffenuff
    tuffenuff Member Posts: 277
    #2
    Just taking a stab here, but
    Just taking a stab here, but maybe go to the health food store and get some probiotic powder for him. The kind they keep in the refrigerated case. My preferred brand is Jarrow. He can mix with water, rinse and swallow. Its the same premise as taking probiotics while on antibiotics in order to avoid getting a vaginal yeast infection. I would bet money it will clear in a matter of days if you introduce the probiotics. Of course, you should run this by your doc, but it's the same active ingredient you get from yogurt.
  • hwt
    hwt Member Posts: 2,328 Member
    #3
    Thrush
    I am being treated for thrush and saw a marked improvement in the first couple of days. I also have Nystatin 100,000 Units/ML360ML swish & swallow 4 times a day for 2 weeks. It burned quite a bit a first but after 2 or 3 days improved. My pill is FLUCONAZOLE 200 mg take 1 a day for 14days. Not sure which is causing a little naseau but I switched the pill to bedtime and it seems better. My doctor also recommended baking soda rinse.
    You might want to research and ask doctor about the Fluconazole. In the meantime, you might try rice krispies without sugar in plenty of milk. No rough edges. Since he can do milk and the rice krispies don't require chewing it would add some substance. Also suggest lightly scrambled eggs or pancakes with syrup (avoid outside edges) along with chocolate milk. This is my 3rd bout with thrush and it is no picnic. Best of luck
  • longtermsurvivor
    longtermsurvivor Member Posts: 1,842 Member
    #4
    If he is still bothered by thrush, the thing to do is to first have them make sure it is thrush that is being treated. Then, they need to switch to a different drug. Fluconazole and diflucan are the same thing. It works great for the first episode, then less so for subsequent episodes. I personally had nystatin resistant thrush, but did well on diflucan, so I consider myself lucky. Here's a typical quote from the literature:
    "[The] preliminary data suggest that oral-suspension itraconazole is a safe and effective therapy for patients who develop resistance to fluconazole. Some maintenance therapy is necessary, however, because patients who do respond to treatment relapse when therapy is stopped."

    If you do a websearch on "resistant thrush," you will quickly learn everything you need to know. Best to you both.


    Pat
  • alaskanjan
    alaskanjan Member Posts: 42
    #5
    tuffenuff said:

    Just taking a stab here, but
    Just taking a stab here, but maybe go to the health food store and get some probiotic powder for him. The kind they keep in the refrigerated case. My preferred brand is Jarrow. He can mix with water, rinse and swallow. Its the same premise as taking probiotics while on antibiotics in order to avoid getting a vaginal yeast infection. I would bet money it will clear in a matter of days if you introduce the probiotics. Of course, you should run this by your doc, but it's the same active ingredient you get from yogurt.

    Probiotics
    Interesting, I did not know about the probiotic powder and will look into that. I did have him start taking oral probiotics but I think he was not consistent in doing that. We bought yoghurt the other day...several flavors but he says they burn his mouth too much.
  • alaskanjan
    alaskanjan Member Posts: 42
    #6
    hwt said:

    Thrush
    I am being treated for thrush and saw a marked improvement in the first couple of days. I also have Nystatin 100,000 Units/ML360ML swish & swallow 4 times a day for 2 weeks. It burned quite a bit a first but after 2 or 3 days improved. My pill is FLUCONAZOLE 200 mg take 1 a day for 14days. Not sure which is causing a little naseau but I switched the pill to bedtime and it seems better. My doctor also recommended baking soda rinse.
    You might want to research and ask doctor about the Fluconazole. In the meantime, you might try rice krispies without sugar in plenty of milk. No rough edges. Since he can do milk and the rice krispies don't require chewing it would add some substance. Also suggest lightly scrambled eggs or pancakes with syrup (avoid outside edges) along with chocolate milk. This is my 3rd bout with thrush and it is no picnic. Best of luck

    Fluconazole
    I am thinking that he has become very resistant to this drug as he is now taking 200mg twice a day for the second time around along with the Nystatin. Headed to the store for some sugar free syrup! Thanks for the advice.
  • alaskanjan
    alaskanjan Member Posts: 42
    #7
    longtermsurvivor said:

    If he is still bothered by thrush, the thing to do is to first have them make sure it is thrush that is being treated. Then, they need to switch to a different drug. Fluconazole and diflucan are the same thing. It works great for the first episode, then less so for subsequent episodes. I personally had nystatin resistant thrush, but did well on diflucan, so I consider myself lucky. Here's a typical quote from the literature:
    "[The] preliminary data suggest that oral-suspension itraconazole is a safe and effective therapy for patients who develop resistance to fluconazole. Some maintenance therapy is necessary, however, because patients who do respond to treatment relapse when therapy is stopped."

    If you do a websearch on "resistant thrush," you will quickly learn everything you need to know. Best to you both.


    Pat

    Itraconazole
    Thanks, I had not heard of this antifungal before...I will check into that if things are not better after the last few days of the Diflucan. Jan
  • Sam999
    Sam999 Member Posts: 319 Member
    #8
    alaskanjan said:

    Itraconazole
    Thanks, I had not heard of this antifungal before...I will check into that if things are not better after the last few days of the Diflucan. Jan

    I am a big believer in pro
    I am a big believer in pro biotics like Tuffenuff, you would see results in 3-4 days. Spread the lowest dosage for 3 times a day.

    Swash and spit can be done more times.

    Sam
  • phrannie51
    phrannie51 Member Posts: 4,716
    #9
    I too, am a big believer in the probiotics...
    the good ones you find in the refer at the Health Food store. I know it's another thing to swish and swallow...but they do work. Open the capsules into a little water...swish and hold in the mouth then swallow...

    p
  • hislove40
    hislove40 Member Posts: 51
    #10
    I've got this resistant thrush too
    I've had it since 3 days into radiation - no chemo. I've had 3 rounds of difflucan - a little better it seemed then worse - never went away but never had pain associated with the thrush either. Now they have me on nystatin rinse 4 x a day and no change either - so this post was helpful for me too :). My radiation was over 5/1/12 and I just had my follow up scans. We'll get past this!
  • Tim6003
    Tim6003 Member Posts: 1,514 Member
    #11
    hislove40 said:

    I've got this resistant thrush too
    I've had it since 3 days into radiation - no chemo. I've had 3 rounds of difflucan - a little better it seemed then worse - never went away but never had pain associated with the thrush either. Now they have me on nystatin rinse 4 x a day and no change either - so this post was helpful for me too :). My radiation was over 5/1/12 and I just had my follow up scans. We'll get past this!

    Great Post ...
    I swear you guys come along at the best time!! Sorry for your husbands thrush..but remembe to tell him "it will pass"

    I never heard of resistant thrush. Just got off the phone today with my onc. nurse and told her I just finished my Difulcan bottle 3 days ago and still seem to have thrush. No pain but boy is my tongue lit up with white stuff /filmy spots :)

    However I live in a very, very small town..hope I can find this probotics stuff ..and hopefully the onc nurse will give me a different script when I call tomorrow instead of diflucan.

    I felt kind of like she was rushed today (I kept it short?) bc she actually told me thrush is unusual this far out of treatment (I finished tx January 20th 2012) ..is she correct? This will be my 4th bout of it and I have only used Diflucan before ..and it always took care of it before the bottle ran out.

    Best,

    Tim
  • hwt
    hwt Member Posts: 2,328 Member
    #12
    Tim6003 said:

    Great Post ...
    I swear you guys come along at the best time!! Sorry for your husbands thrush..but remembe to tell him "it will pass"

    I never heard of resistant thrush. Just got off the phone today with my onc. nurse and told her I just finished my Difulcan bottle 3 days ago and still seem to have thrush. No pain but boy is my tongue lit up with white stuff /filmy spots :)

    However I live in a very, very small town..hope I can find this probotics stuff ..and hopefully the onc nurse will give me a different script when I call tomorrow instead of diflucan.

    I felt kind of like she was rushed today (I kept it short?) bc she actually told me thrush is unusual this far out of treatment (I finished tx January 20th 2012) ..is she correct? This will be my 4th bout of it and I have only used Diflucan before ..and it always took care of it before the bottle ran out.

    Best,

    Tim

    Tim
    I'm only going on 4 weeks out so not certain how unusual it is at 5 months. Good luck in finding a resolution.
  • alaskanjan
    alaskanjan Member Posts: 42
    #13
    tuffenuff said:

    Just taking a stab here, but
    Just taking a stab here, but maybe go to the health food store and get some probiotic powder for him. The kind they keep in the refrigerated case. My preferred brand is Jarrow. He can mix with water, rinse and swallow. Its the same premise as taking probiotics while on antibiotics in order to avoid getting a vaginal yeast infection. I would bet money it will clear in a matter of days if you introduce the probiotics. Of course, you should run this by your doc, but it's the same active ingredient you get from yogurt.

    Thanks tuffenuff!
    So, I went to our local health food store and sure 'nuff there was the Jarrow brand Jarro-Dophilus....not cheap but what is, and if it works worth it at any price. We are following the instructions of 1/4 tsp. dissolved in water three times a day...just started and hopeful! Sure appreciate your tip.
  • alaskanjan
    alaskanjan Member Posts: 42
    #14
    Tim6003 said:

    Great Post ...
    I swear you guys come along at the best time!! Sorry for your husbands thrush..but remembe to tell him "it will pass"

    I never heard of resistant thrush. Just got off the phone today with my onc. nurse and told her I just finished my Difulcan bottle 3 days ago and still seem to have thrush. No pain but boy is my tongue lit up with white stuff /filmy spots :)

    However I live in a very, very small town..hope I can find this probotics stuff ..and hopefully the onc nurse will give me a different script when I call tomorrow instead of diflucan.

    I felt kind of like she was rushed today (I kept it short?) bc she actually told me thrush is unusual this far out of treatment (I finished tx January 20th 2012) ..is she correct? This will be my 4th bout of it and I have only used Diflucan before ..and it always took care of it before the bottle ran out.

    Best,

    Tim

    Probiotics
    I guess if it is unusual this far out then you and my husband have surely drawn the short, (or would it be the long?) straws! I think that between the chemo and mucositis from radiation in that area it might not be so unusual to have an opportunist like candida set up housekeeping in your mouths. Per tuffenuff's suggestion we are now on the first day of probiotic. I wonder, (if you can't find the powdered stuff), if you could just open a capsule or crush up a tablet and dissolve it in water to swish and swallow? Worth a try. I will keep a update here to let you know if it seems to be working. You might try the Nyatatin swish and swallow too because I hear it works a little differently than the Diflucan.
  • Tim6003
    Tim6003 Member Posts: 1,514 Member
    #15
    alaskanjan said:

    Probiotics
    I guess if it is unusual this far out then you and my husband have surely drawn the short, (or would it be the long?) straws! I think that between the chemo and mucositis from radiation in that area it might not be so unusual to have an opportunist like candida set up housekeeping in your mouths. Per tuffenuff's suggestion we are now on the first day of probiotic. I wonder, (if you can't find the powdered stuff), if you could just open a capsule or crush up a tablet and dissolve it in water to swish and swallow? Worth a try. I will keep a update here to let you know if it seems to be working. You might try the Nyatatin swish and swallow too because I hear it works a little differently than the Diflucan.

    Me too...
    got my prohibotics now ....HUGE PILL ...no way ...have to break them open and mix with milk...lol...2 days on it now ...will keep you posted!!

    Tim
  • alaskanjan
    alaskanjan Member Posts: 42
    #16
    Tim6003 said:

    Me too...
    got my prohibotics now ....HUGE PILL ...no way ...have to break them open and mix with milk...lol...2 days on it now ...will keep you posted!!

    Tim

    Change in antifungal
    So...the ENT doc, at my urging since my husband has not had any change in the appearance or pain of the thrush after beginning his fourth treatment with Diflucan, changed the prescription to Ketoconozole. Between that, the Nystatin, and the probiotic pill and probiotic powder with water rinse and swallow I am sure hopeful that he gets some relief. Good luck to you Tim. That darn thrush, especially when it becomes resistant to the first line attack drugs, is a bugger.
  • alaskanjan
    alaskanjan Member Posts: 42
    #17
    Tim6003 said:

    Me too...
    got my prohibotics now ....HUGE PILL ...no way ...have to break them open and mix with milk...lol...2 days on it now ...will keep you posted!!

    Tim

    Probiotic
    Just wondering if the probiotic helped you Tim? My husband just finished a two week treatment of Ketoconozole along with the Nystatin swish and swallow and probiotic rinses. His mouth does look better and think it is feeling some better now.
  • nebbias01
    nebbias01 Member Posts: 1
    #18
    hislove40 said:

    I've got this resistant thrush too
    I've had it since 3 days into radiation - no chemo. I've had 3 rounds of difflucan - a little better it seemed then worse - never went away but never had pain associated with the thrush either. Now they have me on nystatin rinse 4 x a day and no change either - so this post was helpful for me too :). My radiation was over 5/1/12 and I just had my follow up scans. We'll get past this!

    I have resitant thrush & no saliva. 2 yrs post rad.

    Hello, This is my first post to this message board. I finished radiation 2 yrs ago for tongue cancer and cancer on the inside of my cheek.  I have been treated on and off with Nystatin and fluconazole for 2 years. Now I am under the care of an infectious disease specialist in addition to my head and neck surgeon. I take 100 mg of fluconazole every other day and swish and spit Nystatin (1 tsp) twice a day. I have been told that eventually the thrush that I am keeping at bay will no longer respond to my current treatment. It scares me. I do not know what to do.

    Is there another drug out there for me or do I need to go to a major cancer center for options?

     

  • debbiejeanne
    debbiejeanne Member Posts: 3,102 Member
    #19
    nebbias01 said:

    I have resitant thrush & no saliva. 2 yrs post rad.

    Hello, This is my first post to this message board. I finished radiation 2 yrs ago for tongue cancer and cancer on the inside of my cheek.  I have been treated on and off with Nystatin and fluconazole for 2 years. Now I am under the care of an infectious disease specialist in addition to my head and neck surgeon. I take 100 mg of fluconazole every other day and swish and spit Nystatin (1 tsp) twice a day. I have been told that eventually the thrush that I am keeping at bay will no longer respond to my current treatment. It scares me. I do not know what to do.

    Is there another drug out there for me or do I need to go to a major cancer center for options?

     

    nabbias01, this is a very old

    nabbias01, this is a very old thread and it may get missed by those who would have some answers.  i suggest u copy ur post and paste it in a new thread.  at the top of the pg w/topic u will see "start a new topic".  just click on the and paste your post.  i'm sure you will gt a better group of responses.  i never had thrush so i'm sorry but i have no suggestions.  good luck.

    God bless,

    dj

  • phrannie51
    phrannie51 Member Posts: 4,716
    #20
    nebbias01 said:

    I have resitant thrush & no saliva. 2 yrs post rad.

    Hello, This is my first post to this message board. I finished radiation 2 yrs ago for tongue cancer and cancer on the inside of my cheek.  I have been treated on and off with Nystatin and fluconazole for 2 years. Now I am under the care of an infectious disease specialist in addition to my head and neck surgeon. I take 100 mg of fluconazole every other day and swish and spit Nystatin (1 tsp) twice a day. I have been told that eventually the thrush that I am keeping at bay will no longer respond to my current treatment. It scares me. I do not know what to do.

    Is there another drug out there for me or do I need to go to a major cancer center for options?

     

    As Debbie said...

    You should probably start a new thread for this, since this thread is so old.

    Have you tried chewing acidopholis tablets along with the anti-fungals, and see if the combination of the two might kick some thrush butt?  You can chew several during the day, I don't think there is a real limit....they don't taste good....actually they're just pretty tasteless and since you've already been through treatment, you know tasteless is pretty doable, right :)??

    p

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