Severe nausea/esophagitis - 1251822

dkm5859
Posts:89

Hello to everyone. I need some help for a serious situation that may become deadly serious at some point. My Mom was dx w/ Stage 3A Aden in mid Aug 2012. She had a 1.9 cm tumor removed when her upper left lobe was removed along with three medtasinal lymph nodes but two contiguous nodes were left which were near the aorta as it was deemed to danergous to touch these two nodes. She had six weekly rounds of chemo which was carbo platin and taxol starting on 10/08/12. She also had (25) concurrent sessions of conventional radiation and immediately followed by (9) sessions of proton radiation. Well.. the biggest issue was and still is major fatigue, very serious nausea and esophagitis and very serious weight loss. She has lost about (45) to (50) pounds overall but (35) pounds of this total has been lost over the last three to four weeks. Her treatment ended on 12/03/12 but her last chemo was on 11/15/12... she was admitted into the hospital on 12/10 and was discharged on 12/23/12. She was and has tried many different anti nausea and pain meds...at times yet since w brought her home she still can only eat soft foods and sometimes she can't even keep small amounts of that 'food' down even when she just first attempts to eat small amounts.....sometimes immediately but at other times it might take a couple of minutes and the pudding, ice cream, yogurt...comes back up. Since the 23rd the best food intake she has kept down is in the morning when she has eaten cream of wheat. She has at times not been able to keep her pills down even when she takes them with just water.
I've also asked her at what times of the day, duration of the nausea incidences or has it been constant nausea all the time with different levels of severity trying to determine what is going on.
Could she also have strictures in her esophagus? As she has only been trying to eat soft foods only... and certain soft foods like cream of wheat she seems to do better with.
She had an 'all clear' MRI on 08/05/12.thxs

Forums
Full Archive

Reply # - December 25, 2012, 07:37 PM

dkm5859
Posts: 89

She has a CT scheduled for January 3rd which was scheduled as her first follow up scan since her 1st treatment plan ended. Are there any tests/procedures that I should ask and or insist for her? She turned 70 years young on 10/18. What can I do for her to begin eating normally and becoming much stronger?
Thank you very much and yes I am very sorry on the length of this post?
My Christmas wish is kind of obvious as I'm sure many of yours are similar. God bless you all and thank you.

Reply # - December 25, 2012, 09:32 PM

Dr West
Posts: 4735

I'm sorry it's been so difficult for her recently.

An esophageal stricture would generally occur later than this, as a longer term complication, rather than in the days and weeks just after treatment.

I would have to imagine that the docs there have been doing just about everything they can think of to improve her situation, so it's hard to think of some obvious component to the work up that would have been overlooked. I think one factor that could potentially be helpful is to have a gastroenterologist involved in her case to see if that perspective could generate some new thoughts for a new angle of the workup, perhaps with an EGD (upper endoscopy, directly visualizing the esophagus and stomach), perhaps taking biopsies of any lesions that look concerning or puzzling for what they represent), and/or offering suggestions for treatment that the oncology team hasn't pursued yet.

Good luck. Please bear in mind that we really can't get too into the weeds on an individual case, and we can't provide medical recommendations for someone who isn't our patient.

-Dr. West

Reply # - December 26, 2012, 02:06 PM

catdander
Posts:

dkm, yes I'm sure we do have similar wishes. What a horrible ordeal for her and you as well. I wish she can get hold of the nausea. I'm not a doctor, just a wife with a lot of hours on Grace. My husband's story started a lot like your wife's. Even the timing. He had surgery late August 2009, started chemo/radiation mid sept and unfortunately found a spine met on for halloween. They did radiation on the spine met which caused his esophagitis. The weight was most worrisome. For he started out as a thin man, lost weight before even thinking cancer, lost more after surgery, and more with the esophagitis.

There are suppository nausea meds that may be helpful if she can't keep pills down.

It seemed that my husband got nauseous after moving around a bit. So what worked for him was to take them before waking. I'd wake him just enough to take the pills then go back to sleep. Then he was able to get up move around without becoming nauseous.

As for eating, that was tricky. But he came to be able to drink Ensure's, a dietary supplement/meal replacement. He still does. He'll drink vanilla, plus. They have 350 calories in about 8 ounces. I bought all kinds of foods because he wouldn't eat his usuals. He ate a lot of sugar and bacon. Like you've found out about the oatmeal it takes trial and error. Let her listen to her body and eat what she will. Protein is important.

Magace also worked well for him. I still get it out on occasion when I notice he's not eating much. As you can see from my signature at the bottom of this post he's doing very well and we are very lucky. He's 5'11" and weighs a mere 120lbs but he's here and doing well, just a skinny azz guy. :).

Here are some blog/posts on the subjects of pain, eating, and nausea. All very important to control.

Reply # - December 30, 2012, 05:28 PM

dkm5859
Posts: 89

How long can radiation work after last treatment?
I guess the degree of its effectiveness would also somewhat correlate to how long and to what degree someone may experience radiation side effects?
How long can a severe case of esophagitis last?
I don't want to ask this but can brain mets develop first without a recurrence first developing somewhere else in the lung and or chest area?
She had all clear head MRI in early Aug 2012. She her ULL removed, chemo and radiation during fall ending Dec. 3rd 2012.
She is not eating and or drinking well at all... stating that she is still having esophagus pain and a lot of nausea. I think we've tried about every food, liquid, drugs in liquid and or pill form. She gets nausea from the anti-nausea drugs.
Please help. I am become extremely worried. Thank you.

Reply # - December 30, 2012, 06:01 PM

Dr West
Posts: 4735

We typically don't do repeat imaging after chest radiation for at least 3-4 weeks after the radiation has been completed, because it very often continues to shrink for several weeks. Severe esophagitis can continue for a few weeks, but it shouldn't last into months.

I don't believe that studies have shown that patients who experience more side effects have more of a response or continue to have their cancer shrink for longer...thoughI suppose that's possible.

Unfortunately, it's very possible for a lung cancer to recur first or only in the brain after chemotherapy and radiation. That happens in about 25-35% of cases of patients treated for locally advanced (stage III) NSCLC.

I hope she recovers soon.

-Dr. West

Previous PostNext Post