nose feeding tube vs G-tube
Hi Everyone,
I was wondering, can you get a feeding tube down thru your nose instead of the G-tube into your stomache? Dad is supposed to be starting RADS on Thrusday and this is a question he has. Also, how quickly will the RADS affect his mouth, saliva glads, dry mouth, ect?
Comments
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not everyone gets a tube
and the opinions on this seem pretty well split in advance of radiation. Yes, you can get an NG tube. It is unpleasant, annoying and in the road. I only had one for about 9 days after my surgery, and I was very happy to get it out. The PEG tube is a listed alternatiive, because people find it quite a bit easier to manage than an NG. So I guess the question begins with, does he need one at all? And if he only needs one if things dictate he has to have one, can that decision wait until the moment. I'm one of those people that has actually been through full radiation on two different occasions. I didn't need a tube either time.
best to you and your dad
Pat
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Feeding Tubelongtermsurvivor said:not everyone gets a tube
and the opinions on this seem pretty well split in advance of radiation. Yes, you can get an NG tube. It is unpleasant, annoying and in the road. I only had one for about 9 days after my surgery, and I was very happy to get it out. The PEG tube is a listed alternatiive, because people find it quite a bit easier to manage than an NG. So I guess the question begins with, does he need one at all? And if he only needs one if things dictate he has to have one, can that decision wait until the moment. I'm one of those people that has actually been through full radiation on two different occasions. I didn't need a tube either time.
best to you and your dad
Pat
Thanks Pat for responding so quickly. Wow, so you were able to eat the whole time on radiation without any problems? I guess I just assumed he would not be able to do that and that a feeding tube was something he had to have. He has stage 3 cancer and has decided not to take Chemo and really doesn't want to take the RADS either.
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It might help your fatherKell82 said:Feeding Tube
Thanks Pat for responding so quickly. Wow, so you were able to eat the whole time on radiation without any problems? I guess I just assumed he would not be able to do that and that a feeding tube was something he had to have. He has stage 3 cancer and has decided not to take Chemo and really doesn't want to take the RADS either.
to spend some time on this board himself. None of us want to go where this disease takes us, but our choices are somewhat limited. I didn't want to suggest I could eat normally. The radiation is quite difficult, and although the first time I had rads I ate pretty well, I was reduced to liquids the second time. My mouth was just to sore to eat solid food. So I went with a diet that was mostly ensure or boost, in the amount of at least 2000cal/day. That got me through the tough part of radiation, and recovery.
Your dad needs to carefully think through the decision on chemo, and certainly on radiation. These modalities are offered for a reason--- they save lives. Granted they are not fun, but the alternative is pretty final. Induction chemotherapy is generally offered to everyone at or beyond stage 3. The improved survival is at least 20%. Even more so the radiation. You haven't said exactly what the surgical plan is, but curing stage three disease with surgery alone would be pretty lucky. Radiation can cure stage three without surgery at all, so although I understand his response emotionally, he is in a situation where he really needs the rads.
Others will come along to talk to you. Suggest strongly to your dad that he participate in this discussion himself. It is his disease, and only he can make these choices on which his future depends.
Pat
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Hi Kell
I hope your Dad will reconsider the treatments the Drs want to do~~~cancer is no longer a death sentence, head and neck treatment is brutal, but doable. I went into surgery pretty naive, had not found this site yet, I'm 66 and doing great, had a nose feeding tube for a couple months, was never offered a peg...during that time, I was also doing therpy to learn to swallow correctly, but eating through the tube. To get it in your nose, you have to swallow it...ugh, lots of gagging going on that day.All and all looking back, the surgery and the year and 3 months since, have passed quickly, I'm pretty much back to normal.. I was blessed that no chemo or rads were necessary after my surgery, Good wishes to you and your Dad as you begin this journey....he'll be okay, trust your Docters
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LTS....induction questionlongtermsurvivor said:It might help your father
to spend some time on this board himself. None of us want to go where this disease takes us, but our choices are somewhat limited. I didn't want to suggest I could eat normally. The radiation is quite difficult, and although the first time I had rads I ate pretty well, I was reduced to liquids the second time. My mouth was just to sore to eat solid food. So I went with a diet that was mostly ensure or boost, in the amount of at least 2000cal/day. That got me through the tough part of radiation, and recovery.
Your dad needs to carefully think through the decision on chemo, and certainly on radiation. These modalities are offered for a reason--- they save lives. Granted they are not fun, but the alternative is pretty final. Induction chemotherapy is generally offered to everyone at or beyond stage 3. The improved survival is at least 20%. Even more so the radiation. You haven't said exactly what the surgical plan is, but curing stage three disease with surgery alone would be pretty lucky. Radiation can cure stage three without surgery at all, so although I understand his response emotionally, he is in a situation where he really needs the rads.
Others will come along to talk to you. Suggest strongly to your dad that he participate in this discussion himself. It is his disease, and only he can make these choices on which his future depends.
Pat
LTS....I always enjoy reading your posts bc you are direct, objective, and knowledgable and have been through it multiple times witof determination. So....here's my question....my husband had 3+ cm mass in left lymph nosed and very small mass ito left tonsil....nothing else lit up on PET. He is 41 and hpv+. His MD said it was caught early...little disease to start with and did 7 weekly cisplatin and 35 rads. I assumed it was stage 4 bc it had spread to lymph node and was larger than 3cm. I think he was T1N2a although I would have to look at my records. Could he be a different stage and why no induction or fu???? I want to ask his MD at the next follow up in 3 weeks.....but I also have to watch what I ask so as not to freak out my hubby. No reason to question now....it is completed on th round and hopefully for good. But I do wonder. That being said....I trust Dana FarbeI.
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G-tube vs NG tubelongtermsurvivor said:It might help your father
to spend some time on this board himself. None of us want to go where this disease takes us, but our choices are somewhat limited. I didn't want to suggest I could eat normally. The radiation is quite difficult, and although the first time I had rads I ate pretty well, I was reduced to liquids the second time. My mouth was just to sore to eat solid food. So I went with a diet that was mostly ensure or boost, in the amount of at least 2000cal/day. That got me through the tough part of radiation, and recovery.
Your dad needs to carefully think through the decision on chemo, and certainly on radiation. These modalities are offered for a reason--- they save lives. Granted they are not fun, but the alternative is pretty final. Induction chemotherapy is generally offered to everyone at or beyond stage 3. The improved survival is at least 20%. Even more so the radiation. You haven't said exactly what the surgical plan is, but curing stage three disease with surgery alone would be pretty lucky. Radiation can cure stage three without surgery at all, so although I understand his response emotionally, he is in a situation where he really needs the rads.
Others will come along to talk to you. Suggest strongly to your dad that he participate in this discussion himself. It is his disease, and only he can make these choices on which his future depends.
Pat
Hello,
Well I'll give you my 2 cents too. Personally if your dad needs a tube for nourishment I'd recommend the G-tube or PEG (same thing) over the NG tube. The NG tube tends to not be the most comfortable and your dads throat will become pretty sore with radiation alone and to add a tube to that would be undesirable.
The PEG is easy to use and once it's in place you hardly feel a thing. It's also concealable where the NG tube is not. All this being said, your dad may be one who doesn't need it all. I needed it and several of us do but some get by without it.
Stage III responds very well to rads and chemo too. Honestly for me I had Erbitux as my chemo and it was easier than the rads. Not sure what type of chemo they advised for your dad to get but chemo has come a long way and doesn't cause people to become near as sick as in the past. Erbitux is more antibody based and not chemical based, maybe see if he'd be eligible for that?
Many people say they don't want treatment, especially the older folks but once they are convinced to do it and complete the treatment with good outcomes they are happy they did it.
I also advise that you don't allow your dad or yourself for that matter to search the Internet. It will only freak you out and most of that info is old and outdated. Treatment has come so far and is so successful. Have your dad stop in here and say hello to us and ask us anything he may have on his mind.
Take care,
Billie0 -
First of all...
nobody "wants" to do the treatment....however, most of us want to live and getting the full treatment seems to be the best option to getting a long life. I hope he changes his mind about the chemo. I found radiation tougher than chemo, partly because I was getting Amifostine everyday with it....plus the fact that it was every single day. Chemo was every three weeks, and at least for the Cisplatin part of it, the side effects were gone in 5 days or so (and even they weren't that bad). The adjuvant chemo of Cisplatin and 5FU was tougher, because I really reacted to the 5FU....and THAT is where the feeding tube became a godsend. There was no way I could put anything into my mouth after starting the 5FU....not even water.
If given my druthers.....I'd skip the nose tube....we're talking several weeks of having it hanging down his face....in the way....what a pain in the butt! Maybe starting out with no tube, see how he does without one.....but keeping an open mind that if eating and drinking become too tough, getting a PEG somewhere during the treatments. I was glad tho, that I had mine in before I started....getting it placed when you already feel crappy would seem like adding insult to injury.
p
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there are a number of newer protocalsvermontgirl said:LTS....induction question
LTS....I always enjoy reading your posts bc you are direct, objective, and knowledgable and have been through it multiple times witof determination. So....here's my question....my husband had 3+ cm mass in left lymph nosed and very small mass ito left tonsil....nothing else lit up on PET. He is 41 and hpv+. His MD said it was caught early...little disease to start with and did 7 weekly cisplatin and 35 rads. I assumed it was stage 4 bc it had spread to lymph node and was larger than 3cm. I think he was T1N2a although I would have to look at my records. Could he be a different stage and why no induction or fu???? I want to ask his MD at the next follow up in 3 weeks.....but I also have to watch what I ask so as not to freak out my hubby. No reason to question now....it is completed on th round and hopefully for good. But I do wonder. That being said....I trust Dana FarbeI.
to treat some of these HPV+ cancers. Your husband's presentation was a pretty common one. Small primary, one big node. Cure rates are extremely good in these people, and there are protocals being developed to back off of the standard full-court press treatments. Not doing induction is one such. Giving 28 radiation treatments in stead of 35 is another. There are not yet any definitivve answers as to what the treatments will be if they are ever standardized, but they will be less than the old stand-by's. Having said that, by TNM classification he would be a stage III. Stage IV is spread beyond the throat, or distant metastasis. Here's a better website for staging: http://www.cancercenter.com/throat-cancer/throat-cancer-staging.cfm It's all good for your husband. Ask away at the next appointment, but my bet is they will answer something like this.
best
Pat
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My Doc Insisted on A PEG
My Doctor insisted i get a PEG tube and I guess it was the right thing to do because I used it and kept up my weight. I only lost 15 lbs, but that got me down to 150. I had to use the tube for a few days only. Most of the time I could drink Ensure. Started solid food about 3 weeks after last radiation. Taste is still an issue, but had tube out soon after last radiation. just wanted to feed myself. All in all having the PEG tube was not so bad and it did help.
I agree with everyone else get the full treatment even though it sucks. Neck cancer has a great cure rate if things go well. The side effects are hell but they do go away or at lest so I am told. I am functional about half days now and looking forward to a Canadian fishing trip in the spring and Europe this fall.
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you gotta eat
Kell82,
I had a NG tube and a PEG tube and the PEG wins hands down for use and comfort let alone visibility. I can’t imagine having the NG during rads, when there is barley enough room for air in my throat. Now going without either is an option (to start with) and if you fail to get enough nourishment they can pop in a PEG. You may not want to snake a NG tube down once your throat is raw.
I always managed to drink one meal a day and possibly could have gone PEGless, but having one sure was convenient and easy.
As for surgery, rads and chemo, I had all three and I feel pretty good and my results to date are good. They gave me some options, but with less treatment my odds of success were less. If I knew all I would have avoided cancer in the first place.
Whistling in Oregon,
Matt
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NutritionCivilMatt said:you gotta eat
Kell82,
I had a NG tube and a PEG tube and the PEG wins hands down for use and comfort let alone visibility. I can’t imagine having the NG during rads, when there is barley enough room for air in my throat. Now going without either is an option (to start with) and if you fail to get enough nourishment they can pop in a PEG. You may not want to snake a NG tube down once your throat is raw.
I always managed to drink one meal a day and possibly could have gone PEGless, but having one sure was convenient and easy.
As for surgery, rads and chemo, I had all three and I feel pretty good and my results to date are good. They gave me some options, but with less treatment my odds of success were less. If I knew all I would have avoided cancer in the first place.
Whistling in Oregon,
Matt
I had the feeding tube in my nose 2 weeks in the hospital and was never so happy to get it out and get the g-tube in my stomach. The g-tube in my stomach was a walk in the park in comparison to the nose. Hoping your Dad has an easy journey with few side effects.
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PEG is the way to go...... (my opnion of course)..hwt said:Nutrition
I had the feeding tube in my nose 2 weeks in the hospital and was never so happy to get it out and get the g-tube in my stomach. The g-tube in my stomach was a walk in the park in comparison to the nose. Hoping your Dad has an easy journey with few side effects.
My feeding tube was placed in my stomach the first week radiation began. It was a lifesaver. I'm a wimp compared to many on this board . I lost 70lbs during treatment, lost taste just a few weeks into rads and stopped eating via mouth by week four. Truly I am ashamed when so many worked, ate and went without a tube at all....how in the world they did that I will never know.
Seems like I had it rough out the gate, bad reaction to my chemo, very painful throat issues and neck burns like an atomic accident ....lol...but by golly I made it.
Everybody responds different, however one opnion I might part ways with on most on this forum is the peg tube (stomach) ...I say getting one at the begining is the best insurance policy just in case you find yourself in bad straights of getting needed nutrition half way through treatments. However, with that said if that were to be the case you MUST continue the swallowing exercises and you keep those muscles going (if only drinking liquids) ....that is very, very important and that is why some doctors (I think anyway) do not like to provide the assitance of a feeding tube of any kind so as to keep the throat muscles exercised and prevent feeding issues later after treatments.
Best,
Tim
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