Sister with stage 4 metastatic involves liver a stomach lymph… feeding tube placed yesterday before the can begin chemo in 2 weeks. My question: if vomiting is a common side effect of chemo, how can she do it if she cant even swallow food?
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I am sorry to learn of your sister's diagnosis and her esophageal obstruction. As she is yet to undergo either radio or chemo therapy, It's most likely that her esophageal obstruction is attributable to her tumor mass/. I have experienced total esophageal obstruction over the course of my disease albeit in my case it was due to the formation of radiation-induced strictures.
One's ability to vomit may be severely compromised by the obstruction. There are several approches that may be used to alleviate this issue. Generally the first approach in most treatment plans is the use of targeted radiation therapy to "debulk" or reduce the size of the tumor. This may take a few weeks before she may notice symptom improvement with regard to her blockage. In extreme cases, depending upon the location and the structural integrity of the esophageal tissues, they may perform limited surgical procedures to debulk the tumor in an attempt to create a passage through the area of obstruction and restore limited patency. Usually, in most treatment plans radiation therapy is followed by the institution of chemotherapy. After 1-2 cycles of chemotherapy, assuming she is deemed a suitable candidate, they may perform an esophagectomy.
In the interim, prior to the use of palliative procedures, she may need to utilize any one of a number of anti-emetic drugs (dramamine, granisetron, odansetron, compazine, cannabinoids etc) to help with the control of her nausea. These may be delivered in a slurry of ground pills or liquids through her G-tube
Her inability to vomit and expel her gastric contents can be extremely discomforting and painful at times. There are a number of drugs that may be utilized to ease her pain, discomfort and anxiety to improve her ability to cope with these issues and ease her discomfort.
Her G-tube will critical in assuring that she recieves adequate nutition, hydration and drug administraions until her obstruction is rectified.
While her present situation is less than ideal, she should experience some relief as her tumor is reduced in size. Esophageal cancer is an awful disease and it requires the patient to adopt a warrior/survivor's attitude. As they say in the military, you must learn to embrace the "suck". She has a difficult road ahead but it is imperative that she develops and maintains the proper positive mental attitude (PMA) and the determination to own her disease and not let it own her. She will get through this with the love and support of her family, friends and care team.
The currently avaiable chemotherapies and targeted immuno-oncology adjuvant therapies are proving more effective in treating esophageal cancer and inducing better sustained/long term clinical responses in esophageal cancer patients. I am living proof.
I am a 4+ year survivor of stage 4 squamous cell esophageal carcinoma. It's been a long and difficult fight thus far but one that's been well worth fighting. I constantly remind myself of my Southern Baptist grandmother 's comforting phrase she often said to me when I was suffering relapses of several of the debilitating auto-immune diseases I was first afflicted with in my 20s. When I was miserable and in pain, she would often remind me "the good Lord don't put more on you than he knows you can stand so stop worrying about your troubles of today as it only steals from the promise of tomorrow." Regardless of your religious beliefs, I still think it's good advice.
I was wondering how my husband was going to manage the expected nausea & vomiting. He was only able to swallow liquids when he was diagnosed with Stage 4 adenocarcinoma and started chemotherapy/ immunotherapy on Sept 8th.
Turns out that he had a constant upset stomach, “queasy”, but no real inclination to vomit.
2 months later & he can now eat whatever he wants, whenever he wants (with the limitations of small portions chewed thoroughly & swallowed slowly). Chemo still gives him a constant upset stomach. Still no inclination to actually vomit.
I had a lot of anxiety about this as we started this chemo stage of life. Turns out it was all for naught.
Prayers sent up just now for your sister’s wellness & peace.
(Also, if interested, Google “molecular hydrogen therapy”. This home-based complementary therapy may have played a role in the seemingly quick reduction of my husband’s tumour. Major extremes from Sept 8 (when he couldn’t swallow watermelon) to mid-October, (when he “accidentally swallowed a piece of steak”).
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Did your husband suffer severe nausea and pain before any treatments? She just had her g tube placed and is extremely nauseated. Food ingestion is problematic for her.
No. He only experienced regurgitation (It was like vomiting, but different because it was because the food couldn’t go down). He never had any type of tube placed—though after losing 50 pounds (he was only 185 to start with), I really felt like he should have.
Sorry, I can’t speak to any experience of nausea or vomiting. I’m so sorry she is going through that!
We went through times where he could eat nothing except broth, shakes, etc. so I have some experience with diet. But it sounds like her diet is now based on tube feeding.
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