ongoing treatment resistant nause during carbo/alimta - 1293806

Hi Kemptem,

I'm so sorry about your ongoing symptoms of nausea. Have you tried aloxi or emend? Emend is now often given simultaneously with chemo. When my husband started cisplatin and etoposide emend was given the morning after. He did best when I woke him about 30 minutes before time to get up, give him the pill and have him stay in bed for at least the next 30 minutes. The difference was remarkable for him. The point is to get ahead of the nausea/before the steroid wears off. The problem I ran into was the affordability of the drug when he got it in pill form with a prescription. I was able to get the pills (even with insurance they were several hundred dollar a piece). A chemo nurse gave me a coupon to bring the cost down. Calling the pharma is also often helpful for getting a drug at a affordable cost.
Other things I found helpful for Don were adding bacon and or ginger to just about everything he ate. The drug magace in generic form was also very helpful in increasing his appetite. "Ensure Plus" and Publix's version was often the only thing Don consumed when on Chemo and is still a staple in the house.

Carbo can be a bear for nausea. 4 cycles is the maximum number of cycles that have been proven beneficial and many oncologists go to 6 cycles just to go as far as possible. At 6 cycles hypersensitivity to the platinum becomes too likely to push much further. Stopping at 4 cycles would be very appropriate especially when having such severe side effects. Taking a break until progression would also be appropriate at this point. Hopefully the doublet will have given the cancer a kick in the butt for a bit. At progression a trial or alimta alone would be appropriate.

Here is a link to Dr. Harman's video post on the subject which also includes a link to a transcript.
http://cancergrace.org/cancer-treatments/tag/chemotherapy-induced-nause…

I hope you a feeling better soon.
All best,
Janine

I look forward to hearing about excellent scan results!

If you've not try the newest drugs like emend and aloxi don't assume they won't work. Some of the classes of drugs, not sure which, only work if taken before getting nauseous, I think emend fits into that class. Don had terrible trouble with his appetite and feelings of nausea, still does. I often wonder is it's lasting effects of all the chemo. He's always had a scant appetite but has never regained what it was before cancer. Bacon, for those who eat pork, if like a siren of appetite. Ginger has actually been shown to improve nausea. Since we like it I just use it as a spice whenever possible. Herbs and spices in general have nutritive properties we don't fully understand so I just try to use them as much as possible in hopes of gaining some benefit while hopefully enhancing my cooking (which needs all the help it can get). :)

Yes, I know how you like to push the limit. The old poker adage works here, you want to know when to held'em and know when to fold'em...sometimes less is more. I'm glad you're having these conversations with your onc.

Janine

Hi Kempten,

I can appreciate your frustration. We wait anxiously for scan results, but when they are as confusing as those you've received, it's tough. Although I was the worst offender during Liz's illness, looking at scan images and reports prior to meeting with her oncologist, it's generally not the best course of action. In an effort to be comprehensive, radiologists at times report items which are questionable, and that's often why some items will be described though they've never appeared in a report before. The current radiologist may see things when reviewing the previous scan that the prior radiologist didn't find significant. When you get a chance to meet with your doctor, their prior experience may allow them to immediately dismiss these "findings" as irrelevant.

I hope your pulmonologist can clear up the confusion.

JimC
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