nausea

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Markdale
Posts: 107
Joined: Wed Dec 02, 2020 4:45 pm

nausea

Postby Markdale » Mon Apr 26, 2021 7:43 pm

Hello, I’m on my ninth round of folfoxiri. The nausea is getting worse and worse. Does anyone have advice on how the dealt with nausea during treatment? I’m on the standard anti nausea meds.

Mark dale
09/20:Diagnosed after colonoscopy for bleeding.
MRI and ct scan confirmed tumor at rectosigmoid junction aswell as lung nodules in RLL (1X1.2cm) and RUL (3X.5cm)
10/20: LAR tumour t3n2m1 4/24 lymph nodes.
11/20: pet scan confirmed Mets
11/20: folfoxiri - 10/6/21. 12 rounds in total
1/1/21 thoracotomy 1 met removed
2/2022 sabr to 2 lung nodule
09/22 PET scan progression of sabr’d nodules
10/22 phase 1 trial bispecific antibody
9/23 added pd1 blocker
12/23 bilateral VATS all visible (7) lesions removed

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ginabeewell
Posts: 565
Joined: Wed Oct 24, 2018 10:30 am

Re: nausea

Postby ginabeewell » Mon Apr 26, 2021 8:44 pm

I found that I would get nauseous when I was hungry: so there were a few cycles when I basically ate saltine crackers (I liked saladitas) almost non-stop to keep it at bay.
49 YO mom of twins (11) lucky stepmom of 16/19 year olds
9/17/18 DX stage 4 CRC w inoperable liver mets CEA 931
Currently NED!

Join me on a lookback of my journey via my Strive for Five on Substack here:
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All treatment details here:
https://www.weareallmadeofstars.net/col ... nt-journey

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Green Tea
Posts: 451
Joined: Mon Oct 24, 2016 10:48 am

Re: nausea

Postby Green Tea » Mon Apr 26, 2021 9:03 pm


Rock_Robster
Posts: 1027
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: nausea

Postby Rock_Robster » Tue Apr 27, 2021 8:16 am

What anti-nausea protocol are you on? I found the basic stuff insufficient but things got a lot better when they stepped me up to Akynzeo.
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19>30>140>70
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED 2 years
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial
12/23 Modified FOLFIRI+Bev
3/24 VAXINIA (CF33 + hNIS) trial

boxhill
Posts: 789
Joined: Fri Apr 06, 2018 11:40 am

Re: nausea

Postby boxhill » Tue Apr 27, 2021 3:44 pm

I concur with the crackers. :)

What ever you are on, you need more or different drugs. I've noticed that "the standard" can very quite a bit, depending on the infusion center. For example, they gave me Sustol the first time, then changed it to the IV version (Emend?). while others have reported only getting it after a couple rounds of nausea. As Rock_Robster said, a list would be helpful in making suggestions.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/20 MRI stable/NED
6/20 Stop Key
All MRIs NED

Markdale
Posts: 107
Joined: Wed Dec 02, 2020 4:45 pm

Re: nausea

Postby Markdale » Tue Apr 27, 2021 11:41 pm

Thanks for the replies. I’m on metochlopramide, and ondansteron. I also get a subcut anti nausea before the irinotecan infusion. I’ve only got three more left but the nausea on day one and two recently is getting harsh and I’m just assuming it will get worse.
09/20:Diagnosed after colonoscopy for bleeding.
MRI and ct scan confirmed tumor at rectosigmoid junction aswell as lung nodules in RLL (1X1.2cm) and RUL (3X.5cm)
10/20: LAR tumour t3n2m1 4/24 lymph nodes.
11/20: pet scan confirmed Mets
11/20: folfoxiri - 10/6/21. 12 rounds in total
1/1/21 thoracotomy 1 met removed
2/2022 sabr to 2 lung nodule
09/22 PET scan progression of sabr’d nodules
10/22 phase 1 trial bispecific antibody
9/23 added pd1 blocker
12/23 bilateral VATS all visible (7) lesions removed

Rock_Robster
Posts: 1027
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: nausea

Postby Rock_Robster » Wed Apr 28, 2021 1:39 am

Markdale wrote:Thanks for the replies. I’m on metochlopramide, and ondansteron. I also get a subcut anti nausea before the irinotecan infusion. I’ve only got three more left but the nausea on day one and two recently is getting harsh and I’m just assuming it will get worse.

Ok thanks, this is helpful. Metoclopramide + ondansetron wasn’t sufficient for me, and I vomited once after FOLFOX. After that they gave me Emend (aprepitant) oral before the treatment, plus an Aloxi infusion (after the dexamethasone). No vomiting since. A little while after that the government here approved Akynzeo (Netupitant + Palonosetron) which apparently is even better, so we switched to that and dropped the Aloxi.

I still took the ondansetron after treatment - the key for me was to take it to schedule, not ‘as needed’.

So you might want to ask about the above. Ativan and THC products also have anti-nausea properties, but have their own challenges depending on where you are and what you do.

Good luck,
Rob
Last edited by Rock_Robster on Thu Apr 29, 2021 5:53 am, edited 1 time in total.
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19>30>140>70
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED 2 years
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial
12/23 Modified FOLFIRI+Bev
3/24 VAXINIA (CF33 + hNIS) trial

Rikimaroo
Posts: 436
Joined: Tue Dec 20, 2016 8:48 pm
Location: Florida

Re: nausea

Postby Rikimaroo » Wed Apr 28, 2021 1:47 pm

Rock hit it. Emend was a god send. You get it during your treatment. It helps for 3-5 days, makes you pretty drowsy though for the first 2 days, unfortunately your drowsy but the steroid they give you make its hard to sleep that first night, dexamethasone, or something like that. Honestly ondansetron (zofran) sucks and tastes nasty. That's the tablet that dissolves in your mouth. The problem is chemo is cumulative and eventually your going to throw up, but at least these meds help you not throw up every day for 5 days straight. I threw up maybe one day getting these drugs. Sometimes 2 days, but it should help alleviate to much vomiting.

Good luck my friend.

Riki
RC T3N1M0 12/16
MSS - NRAS Mutation
Chemo Rad, CCR - W&W 5/2017
Recurrence 11/2017
CT Scan 11/2017 Liver Met 5.5cm Stable, Stage IV
LAR/Liver Resect 4/2018
Reversal 10/18
CEA highest 500, lowest .8 throughout process, waiting for latest
Recurrence left vesical/pelvic sidewall - 10/7/2019 resect perm bag,
CEA rise Feb/May 3.7, 8.8, 30, Recurrence in Pelvic
CEA 40 right now, but was 57, so folfiri to beat it back down.
Lots of chemo for the past 4 years.

Markdale
Posts: 107
Joined: Wed Dec 02, 2020 4:45 pm

Re: nausea

Postby Markdale » Thu Apr 29, 2021 3:58 pm

Thank you for the advice, I’ll give it all a try.
09/20:Diagnosed after colonoscopy for bleeding.
MRI and ct scan confirmed tumor at rectosigmoid junction aswell as lung nodules in RLL (1X1.2cm) and RUL (3X.5cm)
10/20: LAR tumour t3n2m1 4/24 lymph nodes.
11/20: pet scan confirmed Mets
11/20: folfoxiri - 10/6/21. 12 rounds in total
1/1/21 thoracotomy 1 met removed
2/2022 sabr to 2 lung nodule
09/22 PET scan progression of sabr’d nodules
10/22 phase 1 trial bispecific antibody
9/23 added pd1 blocker
12/23 bilateral VATS all visible (7) lesions removed

zephyr
Posts: 363
Joined: Thu Aug 18, 2016 7:31 am

Re: nausea

Postby zephyr » Thu Apr 29, 2021 5:09 pm

I can't take the anti-nausea meds so it seems I've tried everything. I never had severe nausea but it was pretty constant and overwhelming at times, and then I would get dehydrated followed by dry heaves and it was a vicious circle. When I started taking an Ativan before bed, that helped me at night. The other thing that provided relief was a Reliefband. It's like a SeaBand but it's electronic. You get a mild zap to the acupressure point on the inside of your wrist. I find that if I start wearing it at the very first sign of nausea, that kind of aura-type feeling like something's starting to be off, it usually stops it. You can buy it on Amazon and return it within 30 days if it doesn't work for you.

https://www.amazon.com/Reliefband-1-5-Motion-Morning-Sickness/dp/B00PG4NUOS
Nov-2009 Early stage CRC, routine colonoscopy
2010-2014 F/U colonoscopies, all clear
Jun-2016 CRC during F/U colonoscopy, surgery, Stage 4, KRAS, MSS
Aug-2016-May-2018 Folfox, 5FU, Folfiri & Avastin
Aug/Sep-2018 YAG laser surgeries (Germany), 11 nodules removed
Nov-2018 clean CT scan
Mar-2019 New lung nodules
Apr-2019 Dec-2020 Xeloda/Avastin, SBRT, cont. Xeloda/Avastin
Mar-2021 Forfiri/Avastin
Mar-2022 Ablation & Thoracotomy
Feb-2023 Folfiri & Avastin
Nov-2023 Xeloda & Avastin

CancerBum21
Posts: 29
Joined: Fri Feb 26, 2021 6:27 am

Re: nausea

Postby CancerBum21 » Sun May 02, 2021 1:37 pm

I can also recommend Emend. I didn't get it my first round and had pretty bad nausea. I'm on my second round now and got it and honestly felt pretty good until day 3. Then I had to take Zofran again. But Zofran and I have a love/hate relationship. I take it, my nausea goes away but then I get constipated. Then I get nausea because I'm constipated. I also take some stool softeners (colase) in the mornings and a fiber supplement. Still trying to work out something that works. Day 4 and 5 are my low points from a nausea stand point.
34/M
DX:(Rectal Cancer) 2/15/21
Stage: T1N0M0
TAMIS Surgery 3/10/21
Pathology: T1NxM0 - LIV positive, 1/1 lymph positive Stage IIIA
FOLFOX 6 rounds
Radation & Xelota 5 weeks


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