Chemo Nausea

[TrojanGirlie]

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!

[Lee]

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

[KElizabeth]

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.

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

[jhocno197]

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.

[BeansMama]

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.

[Nelbel]

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!

[TrojanGirlie]

Thank you everyone for the suggestions. We have an oncology appointment this week and I will see if we can try something different.

[karaj]

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

[Stewsbetty]

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

[juliej]

I second the Emend and marijuana recommendations!

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.

[Maia]

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]

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.

[Pita]

Emend works for me. Good luck and hope you get the nausea under control. oxo

[Maelleous]

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.

[DAS43]

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