Chemo Nausea

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TrojanGirlie
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Joined: Sun Jan 08, 2017 4:17 pm
Facebook Username: Emily Ochoa

Chemo Nausea

Postby TrojanGirlie » Sun Jan 08, 2017 4:33 pm

Hi,
I am new here and am seeking advice for my husband. He is 30 years old and was diagnosed with stage 3 rectal cancer (and Lynch syndrome) in May. Shortly after did 30 sessions of radiation, while taking Xeloda and was supposed to have surgery until we found out in September his cancer was Stage 4 and had spread to his liver. He has been doing FOLFIRI, Irinotecan, and Erbitux every other week (with a few weeks off when he had a fever). Normally he feels tired and has nausea the few days he does chemo. But after this round, he has continued to be extremely fatigued and nauseous. He does take Zofran and Compazine, but they aren't helping as effectively as usual. We were wondering if there was any advice on what to do for nausea? Also, as his chemo rounds continue, are the nausea and fatigue going to continuse to worsen?

Any advice is appreciated.
Thank you!
31 year old Husband DX Stage 3 rectal cancer - 5/16
Xeloda and Radiation (6 weeks) - 8/16
mets to liver, Stage 4 - 10/16
5FU-Erbitux-Irinotecan - 10/16-4/17
Keytruda and XELOX- 5/17-11/17
Keytruda and Xeloda- 11/17-now
Lynch Syndrome positive and MSI-high

Lee
Posts: 6059
Joined: Sun Apr 16, 2006 4:09 pm

Re: Chemo Nausea

Postby Lee » Sun Jan 08, 2017 5:58 pm

Does he get any anti nausea medicine prior to his infusion?

He he being treated at a major cancer treatment center? If not, please consider a 2nd opinion at a major cancer treatment center. Sloan Kittering in New York City is having a lot of success with people with liver mets.

Your husband is young. They can throw the kitchen sink at him. All the best,

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 16 years and counting!

KElizabeth
Posts: 400
Joined: Sat Oct 31, 2015 12:41 pm
Facebook Username: KElizabeth
Location: Omaha

Re: Chemo Nausea

Postby KElizabeth » Sun Jan 08, 2017 6:03 pm

I have two things that help.
On day one and two of the Folfiri cycle I'll take Olanzapine with the zofran to knock out the nausea. I'll usually take something for pain too. The Olanzapine makes me fall asleep for several hours with no nausea. It can be taken more often than the zofran so you can keep ahead of the nausea.
I don't take this on day three because I have to be awake to get my pump disconnected. :D

I also take an an anti-anxiety med before infusion and as I am leaving the infusion center. It's funny but I can get nauseous just thinking about going to chemo, and the long drive home from chemo. When I have less anxiety I have less nausea.

I hope this helps.
Elizabeth
Female age 39- ,2 teens.
Colon Cancer - DX March 2013
Age 34 at DX - Stage III B
Resection surgery -May 2013
FOLFOX - June, 2013 to Sept, 2013
5FU plus leukavorin Sept, 2013 to Dec, 2013
METs liver and lungs discovered Sept, 2015
KRAS - MSS
FOLFIRI plus Avastin - Sept, 2015 - July 2017
Durvalumab and Cediranib Sept 2017 Dec 17
FOLFOX with desensitization protocol - current

jhocno197
Posts: 817
Joined: Mon May 11, 2015 9:33 pm

Re: Chemo Nausea

Postby jhocno197 » Sun Jan 08, 2017 6:51 pm

Tell the doctor the nausea meds are not working well enough.

I have heard many people who had difficulty with nausea mention a med called Emend as being helpful.
DH - dx Dec 2014, stage IV with bladder & peritoneal involvement - non-resectable
Colostomy
FOLFOX failed
FOLFIRI failed
Tumor actually distending pelvic skin
Not a candidate for last-ditch pelvic exenteration
Stivarga finally begun 2/19/16
Tumor growing/fungating
Lonsurf started 11/18/16
Died 3/10/17

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BeansMama
Posts: 959
Joined: Thu Jan 28, 2016 1:38 am
Location: North Carolina

Re: Chemo Nausea

Postby BeansMama » Sun Jan 08, 2017 7:30 pm

I second the emend!

Also talk to his oncologist, they will change / add nausea meds until you have a combo that works.

Also, stay on top of the nausea meds even if he doesn't feel nauseous. It is much easier to keep it at bay than it is to get rid of it once it starts.

The nausea med that worked best for me, especially when I was on the everything but the kitchen sink med was dronabinol - aka marinol.

Other than that I had Zofran, promethazine, and dexamethasone (only used for three days after pump disconnect)

That was the combo that worked the best for me and kept the nausea at bay the most.

Talk with his oncologist, get some different meds to try.

I will add you and your husband to my prayer list.
41 yrs old
Tumor found 9/2015
Surgery 1 - 11/2015 LAR and colostomy
Surgery 2 - 11/2015 wound vac
Surgery 3 - 12/2015 revise resection, move colostomy
Mets to liver - tumor inoperable - one add'l met destroyed
Stage IVa (T3 N2a M1a)
Primary tumor 9 cm x 7.5 cm x 2 cm
Beginning Folfox 1/2016 - Failed
Beginning Folfiri and vectibix 8/2016 — Failed
Beginning Folfirinox + Avastin 11/2016 - Failed
Beginning Keytruda 1/2017
CEA drop from 345 to 7.3 after starting immunotherapy
Lynch positive 3/2016

Nelbel
Posts: 37
Joined: Thu Nov 17, 2016 11:02 pm

Re: Chemo Nausea

Postby Nelbel » Sun Jan 08, 2017 10:48 pm

If you live in a state with medical cannabis your husband should get a license! Talk to your oncologist. Not only is it amazing for nausea but there is a strain that will help with sleep!
DX Dec 2015 at age 41
Stage 3 RC
Radiation and xeloda
May 2016 LAR and temp ileo
8 rounds chemo
Nov 2016 ileo reversed!

TrojanGirlie
Posts: 20
Joined: Sun Jan 08, 2017 4:17 pm
Facebook Username: Emily Ochoa

Re: Chemo Nausea

Postby TrojanGirlie » Mon Jan 09, 2017 9:04 pm

Thank you everyone for the suggestions. We have an oncology appointment this week and I will see if we can try something different.
31 year old Husband DX Stage 3 rectal cancer - 5/16
Xeloda and Radiation (6 weeks) - 8/16
mets to liver, Stage 4 - 10/16
5FU-Erbitux-Irinotecan - 10/16-4/17
Keytruda and XELOX- 5/17-11/17
Keytruda and Xeloda- 11/17-now
Lynch Syndrome positive and MSI-high

karaj
Posts: 49
Joined: Mon Aug 18, 2014 10:17 pm
Location: Boston
Contact:

Re: Chemo Nausea

Postby karaj » Mon Jan 09, 2017 9:31 pm

I second the cannabis! I would come home from chemo, stay awake for an hour or two, eat 1/4 of a special brownie, and then I'd be out for hours. I woke up feeling so much better! The nausea was gone and I'd had an extremely sound sleep.

My doc and n.p. prescribed me all of the nausea meds listed but I would still have a bad day and a half. Their only other suggestion was to give me more steroids which I was not interested in. When I told them what worked, they said "why didn't we think of that?"

The licensing process is really simple and I can get an infused oil for baking so it is extra easy to use.

Good luck!
Kara
36 y/o female, dx at 32
8/14 dx Stage IIIC, 10/30 lymph nodes
8/14-9/14: sigmoidoscopy, fertility preservation, port-a-cath
9/14 - 3/15: FOLFOX (allergic to oxaliplatin, underwent desensitization)
4/15: NED
1/16: dx Stage IV, recurrence in three lymph nodes behind abdomen
2/16: FOLFIRI
8/16: NED
8/17: NED, currently under no treatment, scans every 3 months
http://www.karaincancerland.com

Stewsbetty
Posts: 170
Joined: Thu Jul 14, 2016 7:08 am

Re: Chemo Nausea

Postby Stewsbetty » Tue Jan 10, 2017 1:10 am

I also take medical marijuana when I am feeling nauseated. Nausea isn't a big problem for me so it is only 2-3 times a cycle but I have found it works much better than the Maxaran I was prescribed for mid cycle. I still take the zofran and dexamethasone for the first 3 days of chemo but use cannabis oil when needed the rest of the cycle. I put the oil into capsules as it seems more medicine like. I have kids at home and I want them to see it as a medicine not a rec drug. ;)

Beth
42yo At diagnosis. Female in BC, Canada
Dx: CC ascending
Right Hemi colectomy 06/16 clear margins
Adenocarcinoma 6cm High Grade
pT3 pN2a Stage 3
10 out of 16 lymph involved
MSI-h, Kras mut, Braf wild
Finished chemo Feb. 2017
PET scan showing active area April 2017
July 2017 CT showing LN mass and spread to other LN
Stage 4
Aug 2017 failed Fofiri
Sept 2017 keytruda scans every 3 months showing shrinkage and stability
November 2018 CT shows only 1 small tumour left
September 2019 clear CT finally NED!!!

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juliej
Posts: 3108
Joined: Thu Aug 05, 2010 12:59 pm

Re: Chemo Nausea

Postby juliej » Tue Jan 10, 2017 5:05 pm

I second the Emend and marijuana recommendations! :D

A few other tips:

Keep him hydrated as much as possible. I didn't always want to drink water while on chemo, but when I didn't, the nausea was much worse. Try adding Nunn tablets to the water to provide some electrolytes too.

I carried a sandwich bag of Pepperidge Farm goldfish crackers with me everywhere! I nibbled on them whenever I felt nauseous and that helped a lot.

Try an Ativan before bedtime. This reduced "morning nausea" for me and I slept better.
Stage IVb, liver/lung mets 8/4/2010
Xelox+Avastin 8/18/10 to 10/21/2011
LAR, liver resec, HAI pump 11/2011
Adjuvant Irinotecan + FUDR
Double lung surgery + ileo reversal 2/2012
Adjuvant FUDR + Xeloda
VATS rt. lung 12/2012 - benign granuloma!
VATS left lung 11/2013
NED 11/22/13 to 12/18/2019, CEA<1

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Maia
Posts: 2443
Joined: Fri Aug 24, 2012 8:00 am

Re: Chemo Nausea

Postby Maia » Tue Jan 10, 2017 8:00 pm

All those are the best suggestions. Only to add that there is a new combo; not first hand experience about it.

"AKYNZEO is indicated for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of cancer chemotherapy, including, but not limited to, highly emetogenic chemotherapy. AKYNZEO is an oral fixed combination of palonosetron and netupitant: palonosetron prevents nausea and vomiting during the acute phase and netupitant prevents nausea and vomiting during both the acute and delayed phase after cancer chemotherapy. "

https://www.akynzeo.com/moa

(300 mg netupitant/0.5 mg palonosetron)

James65
Posts: 383
Joined: Thu Mar 06, 2008 9:41 am
Location: Exeter, NH
Contact:

Re: Chemo Nausea

Postby James65 » Fri Jan 13, 2017 12:26 pm

I was very nauseous from the first round and the anti-nausea drugs made me feel way worse.

A little bit of pot (one or two puffs) and Adavan eliminated it right away.

The nausea and other side effects will worsen and the best thing is to try different things to find what works. It is also counter intuitive, but if you don't eat the nausea gets worse. I found that pepperoni pizza worked because the flavor broke through the horrible metallic taste in my mouth. Grapefruit juice and tonic water did the same thing.
Diagnosed with stage III rectal tumor (though probably late stage II) January 2006.
Chemo/Radiation
Full APR Surgery
Folfox Chemo
So far NED.
Oops. Liver tumor diagnosed 10/13 after elevated CEA. Liver resection for 5cm tumor 12/6/13. So far so good.
Oops again, one tumor in each lung diagnosed 8/8/16. One too small to deal with and the other resected in late September. Wait and watch for now.
Oops, another lung Met in upper left lobe on edge of previous resection scar 11/11/19.

Pita
Posts: 637
Joined: Wed Feb 10, 2016 3:48 pm
Location: So Calif

Re: Chemo Nausea

Postby Pita » Fri Jan 13, 2017 4:04 pm

Emend works for me. Good luck and hope you get the nausea under control. oxo
70yo Fem DX: 1/21/2016 RC Stage IV-Nodules lungs
MSS-Kras Wild-Lynch Synd Neg-Lung Biopsy 1/27/16-Port 2/19/16
MRI 7/7/16 Endometrial polyp found, watching LAR 7/19/16, No Ileostomy, Stage ypT3 N1
CT 11/7/16: Most mets stable,1 shrunk,1 new??
CEA Tests: 1/21/16=20, 12/22/16=5.3, 1/20/17=4.8, 2/15/17=6.2
9/20/16-1/24/17 Folfuri & Avastin
#10/10 Done
PET/CT 2/10/16-1/31/17=Some shrunk & growth to 2, Avastin failing ??? :evil:
2/21/17 Folfuri & Avastin

Maelleous
Posts: 125
Joined: Tue Nov 01, 2016 8:13 am
Location: FL

Re: Chemo Nausea

Postby Maelleous » Mon Jan 16, 2017 7:47 am

Emend did not work for me (on FOLFOX) but I had a newer drug called Varubi that everyone told me I loved. My insurance would not cover it because it is newer and it is $320 a pill, but I thought it was still worth it. I had Sudden Cardiac Arrest on my 3rd treatment 2.5 weeks ago so I do not remember that week but based on my texts and what I told people I skated through that treatment. We still don't know the cause of the SCA by it could have been related to the Varubi although no side effects for cardio are listed so proceed with caution.

I'm in Florida so will soon have access to med marijuana which I hear works great.
M 35 yr
DX Rectal Cancer, 10/16 (symptoms Feb 2016)
Dx stage 2 - Surgery Oct 25 201 Loop ileo w/ j-pouch
Close margins within 1mm
9/38 lymph nodes involved on path / Stg IIIc,pT4, pN2 B, p.M0. MSS, K‐ras, NRAS, no mutation
Started Folfox - 3rd Treament, Dec 30th 2016 Cardiac Arrest - Lucky to be part of the 6% to survive!
S-ICD installed / Port Removed
Vaccine Clinical trial at UPMC - last shot June 2017
Reversal 8/1/17 - Praying this is it!
Still NED

DAS43
Posts: 55
Joined: Thu Aug 18, 2016 8:10 pm

Re: Chemo Nausea

Postby DAS43 » Sun Jan 22, 2017 5:51 pm

I take Zofran and compazine also but I find if I snack on crackers, dried cereal it helps with mild nausea. Also drinking root beer seems to settle my stomach the best. I'm told it's the sassafras
11/13 total blockage DX colon cancer IV, colostomy
1/14 folfox
3/14 liver resection NED
8/14 last chemo
12/14 colostomy reversal
8/16 3mets to lungs
10/16 trial at NIH TIL
9/17 partial responder to TIL protocol


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