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Friend of a friend


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Old 11-30-2006, 08:25 PM   #1
jaydees
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Friend of a friend

A guy I went to university with, shared an apartment with him, has e-mailed me about a friend of his. (we live 1000+ miles apart now)

His friend had been diagnosed with rectal cancer. The info he has given me so far is

- cancer of the rectum. The tumor is about 5-6 inches in from the anus. Treatment:
- 14 weeks x 5 days per week of radiation accompanied by a bottle of chemotherapy serum ( intravenous) which he carries under his shirt in a pouch. Goes for a chemo refill every week.

- one month of rest and no treatment followed by surgery to remove tumor. They think they can save his anus……


He would like to know if it is particularily bad.

I don't think there is enough info yet to fully determine that.
I have told him what I do know, mostly about dealing with the effects of chemo. Anyone have anything they can think of that I might have missed so far.

this is what I have said so far

Quote:
What you describe could be a chemo pump in which he would be getting a lesser dose than I was getting but it will be continuous during the months he is on it.

I had chemo 5 days a week each day it was infused all at once(about 40 minutes) then I would be off two weeks then back on for another 5 days. This continued for 6 months.

My chemo was a chemo drug called 5FU( short form of the longer name fluorouracil) plus leucovorin(which is not a chemo drug as such but it makes cancer cells more sensitive to the 5FU). My chemo was post operative to take care of anything that was not removed during surgery since some microscopic cells might escape the knife. My tumour was only a few inches from the anus. The doctor originally found it during a digital(finger you-know-where) exam. The proximity to the anus is why they could not save it.

Things one can do to make life easier during chemo. Dehydration is one of the worst effects. It makes a person dizzy, fatigued and just plain feeling like a piece of $4it. It can creep up on a chemo patient. The obvious cause is diarhea but just getting a little dehydrated makes one feel dizzy and not feeling like eating or drinking. This adds to the dehydration and also the loss of electrolytes (salts and minerals). The best thing for this is sports drinks such as Gatorade or Powerade. They are specifically designed to rehydrate and keep electrolyte levels up(since this also happens to athletes). They also contain a fair amount of sugar but since he will likely not be eating as much as usual a little added glucose is not a bad thing. A daily multi-vitamin is also a good idea. Can I assume he is in good shape other than having a life threatening disease? If so then even if he puts on a few pounds pre-surgery it is far from a bad thing since surgery will see him lose between 10 and 20 pounds. Not that I am encouraging packing pounds on but not to worry about a few more.

Depending on the chemo drug used there can be mouth sores develop. Cold drinks help prevent them. Popsicles are good to. The cold keeps the blood circulation in the mouth lower. There is also a mouthwash specifically for this. It requires a prescription and is named after a Catholic Saint if I recall correctly, but that name escapes me.

Diarhea can be a problem as I said above. Immodium works but is only sold in packs of 8 at a time. He should ask the doc for a prescription for loperamide, the generic form of Immodium and then he'll get 50 tablets for the price of 8 Immodium. When the trots started I would usually wait for a while to see if it would stop on its own. If i went 4 times in a row then I'd take a tablet, if that did not stop it I'd take another after the next bout. I would then continue taking one after every trot until it stopped. More than one occasion saw me taking 8 in a row this way. That's why he needs the bottle of 50.

If acid stomach is a problem then the long lasting antacids such as previcid are called for. Seems to me there is a generic form of it as well. Yogurt and pepermint tea both help sooth a queasy stomach. Peppermint tea is not all that appealing though. I used a regular tea bag plus a peppermint one in the same pot. If he doesn't like yogurt then acidopholus (the active yeast in yogurt that aids digestion) pills are available too.

The generic forms of these is important since most drug plans won't cover those drugs since they are also over the counter drugs.

It is not unusual for the regime to be chemo first then surgery. It is designed to shrink the tumour and make it as compact as possible prior to surgery. This is most important if the docs want to save as much bowel/rectum as possible, with a goal of perhaps retaining normal function.

You don't have enough info to tell if this is a bad situation yet. The major aspects are the size of the tumour, how far through the wall of the rectum the tumour extends or if it actually does go through the wall, and how compact the tumour is. some of these can only be answered by surgery. However, since he is getting chemo first then the tumour is not causing problem blockage. My mother's caused a total blockage in the desending colon, she had emergency surgery. Mine tended to flatten the stool into a thick ribbon. It was that and the blood that would not go away with application ofprep H that had me go to the doc.

Positive attitude counts for a lot. He is going to be bored, feel ill and generally those can cause depression which lowers immune action. My attitude was that I was getting through this, the bad stuff was temporary, not worth dwelling on. Its the future to look towards, not the present, during chemo, surgery and recovery.

Now the bad news about the surgery. The nerves for bladder control, erectile function and ejaculation are all in a bundle almost next to the rectum and thus can be affected during surgery.

<<snip>>.

He may also have a colostomy when he wakes up after surgery. This is very common, many times it is temporary but sometime permanent. Mine is permanent and it was known that it would be going in. My tumour was just too close to the exit. A colostomy is not the end of life as one knows it. I eat whatever I want, I do everything I did before including swim shirtless(I have a suit that comes up just above the pouch. No Speedos but boxer type suits can be used.). There almost certainly will be oops moments when first getting used to a colostomy. Learning to go potty took a few years the first time around back when we were a year or two old. It will take some time relearning it when a colostomy changes the SOP concerning going potty.

White cell count is important. I got tonsillitis for only the second time in my life during chemo. That was the only problem though. I washed my hands a lot, kept my fingers out of my eyes and stayed at home during my weeks on , and the first week following, chemo. Since his will be continuous he will have to be careful throughout. Gloves on when going out is easy to do at this time of year and helps isolate one from things other people have touched especially when he goes to the doc's office or the hospital.

 
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Old 12-04-2006, 11:35 AM   #2
Anders
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Re: Friend of a friend

jaydees,

What you wrote sounds good, my only concern is radiation treatment. Is that correct, 14 Weeks??? Is this chemo and radiation??? I had 6 weeks of radiation (with chemo 5 days at the beginning, and during the last week) and lives by the toilet during that time. 14 weeks seems like a long time for radiation, when 6 weeks about did me in.

A few things you might want to add.

1) Have this person see an ostomy nurse prior to surgery. My surgeon got my referral for me. Seeing the ostomy nurse allowed me to make an INFORMED decision. For me living with a bag is easier than dealing with bathroom issue for the rest of my life. And after radiation, I had MAJOR bathroom issues.

2) Followin surgery, walk, walk, walk. It really does help in the healing process.

3) Getting a 2nd opinion is not a bad idea. I got mine with a phone call thru the Mayo Clinic (that had a cancer center) near us. It was nice to know, the produre my doctor recommend was also the same procedure the mayo clinic recommended.

I wish your friend much success.

Lee

 
Old 12-09-2006, 09:41 AM   #3
jaydees
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Re: Friend of a friend

Yow!, good catch lee a. I did not notice that my friend had said that it was 14 wks of radiation. Mine was also only 5 weeks long. I'll e-mail him and ask.

I don't know if he has gotten a 2nd opinion. Montreal has a top notch university medical center and several very good other hospitals. I 'll ask about that too.

I have since told him that contacting an ostomy nurse would be in order even if the doctors say it is not likely he will need a colostomy. I have told him also that there is a very dictinct possibility of incontinence with a surgery so low down in the bowel. We all know CD's history.

 
Old 12-09-2006, 12:56 PM   #4
happymom28
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Re: Friend of a friend

My dad was diagnosed with the same thing in June '05. He went through the 12 weeks of radiations 5 days a week and carried the chemo in a pump that got changed weekly. The only difference is, yes it was 14 weeks total, but he would go for 4 weeks, take a week off, 4 weeks on, 1 week off, etc. He had the time off and went in for surgery hoping they could save his anus (his doctor told him he couldn't be sure until he went in because of how close the tumor was to it). Unfortunately, because of how close it was to the anus, he had to get a colostomy. The good news is a year and a half after his diagnosis he is cancer free, and knock on wood, will stay that way.

Everything that you said seems pretty accurate aside from that. Also, the lee added in are very good. Exercise is very important. And a second opinion never hurts.

Best of luck to your friend!

 
Old 12-09-2006, 09:33 PM   #5
jaydees
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Re: Friend of a friend

Thank you very much happymom.

How badly did the radiation burn your Dad's skin? My 5 weeks gave my bum a bad sunburn and it is now almost as hairless as the day I was born (a radical change from just prior to the treatments).

 
Old 12-10-2006, 12:44 PM   #6
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Re: Friend of a friend

He was very sore for a while. He was taking at least 2 baths in epsom salts a day to help releive it.

 
Old 12-11-2006, 08:06 PM   #7
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Re: Friend of a friend

Jaydees, you may want to mention to your friend that if Oxalpalatin is used during chemo, he won't want a popsicle or anything cold. That drug may have come out after you had your treatments.

 
Old 12-11-2006, 09:01 PM   #8
jaydees
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Re: Friend of a friend

Indeed I had 5FU.

What is it about Oxalpalatin that makes cold things bad? Does it make one sensitive to cold in the mouth?

 
Old 12-12-2006, 11:09 AM   #9
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Re: Friend of a friend

Hello, hello,

Just thought I'd chime in! The ox makes you sensitive to cold of all kinds. You need gloves to reach for the pickles from the fridge, or your hand will cramp and you will drop said pickles to the ground!! (Speaking from experience here!) I had to drink warm beverages, as even room temp would cause a "Yikes I just swallowed glass chards" feeling in my throat. Hats, mittens, scarves are a must this winter... That said, I may have had an increased reaction to the ox as I had to stop it after 3 treatments due to severe neuropathy/ left sided numbness.

I hope things go well for your friend!

 
Old 12-12-2006, 03:23 PM   #10
hiswife1
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Re: Friend of a friend

Hi Cats,

I just wanted to say that my dh had the same reaction to the ox. They went ahead and gave him the full number of treatments and I was worried sick because I was afraid it was doing permanant damage. Toward the end he was even having to be very careful walking because his feet started to get numb. Thank goodness the side effects went away but it took a while.

Take care. dee

Last edited by hiswife1; 12-12-2006 at 03:30 PM.

 
Old 12-14-2006, 08:28 PM   #11
jaydees
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Re: Friend of a friend

Thanks again, new info passed along.

BTW the patient probably won't be on this forum as his English is not great thus the relay since my French is really bad.

 
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