Re: Gastric cancer, what next - Chemo again

Well the PICC line went in well although my wife did reinact the shower
scene from Psycho when it bled rather well today. All fixed now thanks to a
quick trip to the old workplace for a cleanup. Irinotecan had an immediate
effect on the guts that surprised wifey a bit, but soon went away.

Maybe it's psycological, maybe it's the steroids of maybe even the atropine
but drinking and eating, still only soup and mushey biscuits (cookies for
out transatlantic cousins) seems a little better. Long may it continue.

Has anybody got any info on oesophageal end gastric stents? Do they actually
use them? There is lots of GOO info (the other end of the stomach) but
little input end stuff.

I did an interesting salmon mousse last night. Liquidise the cooked salmon
with cream, re-heat and it goes sorta scrambled egg like but still dissolves
in the mouth. At least it makes a change from veggie soups.

Ian

Bozz wrote:

> Has anybody got any info on oesophageal end gastric stents? Do they actually
> use them? There is lots of GOO info (the other end of the stomach) but
> little input end stuff.

Hello Ian,
There's an irinotecan mongraph here
<http://www.bccancer.bc.ca/HPI/DrugDatabase/DrugIndexPro/Irinotecan1of2/default.htm>

It's in adobe acrobat format. It's best I don't open it at this time, until I
close other windows.
Adobe's tend to drag my computer resources down (too low); so I'm not sure if it
shows expected side efects; immediate, late (etc) as other monographs, on that
website show.

Are you referring to stents that go down the esophagus?
Or a gastrostomy? Percutaneous Endoscopic Gastrostomy (PEG tube)?
On the one hand, I've heard that they (can) get overgrown with the cancer, then
can't be removed.
And can be very painful and patients wishing they'd never had one put in.
Patients aspirating their gastrostomy feeds and asphixating from that.
That would be in hospice, so not something that surgeons might be aware of or
warn of.
Too unwell to remain upright during and after the feed until the stomach has
emptied and asphixating on feeds.

On the other hand, I've heard from a radiation oncologist, that some form of
radiation therapy can be used to reduce the size of the overgrowth, but at that
point, the question becomes is the patient well enough to undergo radiation
therapy and expected to live long enough to warrant the distress of transporting
a patient for such treatment. Or too unwell (or advanced) to withstand the
risks of surgery to try to remove it and what that would accomplish, since the
tumor would probably automatically close over the opening.

Then I've just seen, on web pages, stents are sometimes placed to open the
esophagus, which closed due to scarring from radiation therapy and another which
seemed to imply that RT can cause a thickening and hence tightening of the stent
causing pain.

http://www.ercp.ucla.edu/pages/info/...es/stents.html
This web page has a section on stents, which, in part, says that "Therefore,
dietary modification will always be necessary to prevent obstruction of the
stent and complications such as pneumonia due to aspiration of food and saliva
from the esophagus into the windpipe with resultant pneumonia. The most common
scenario where perforation has been observed is when there esophageal stent
placement is combined with radiation therapy of the esophagus."
So, I wonder if there's any benefit at all to wondering if there's short term
benefit, but major problems in the long run.

Please don't rely on me. What do the EC list people say? I hope the loved ones
of those who've passed are honest about the pros and cons.

Although predicting what will grow where (I expect) is difficult, if it was I or
a loved one, I'd ask for a round table of sorts with oncologist and radiation
oncologist and surgeon (who know the existing locations), discussing what's
available in your country and the adviseability of...then get the point of view
(or experiences) of MacMillan nurses in your area.

I'm not an expert; just giving you some food for thought and perhaps things to
ask about.
J

Bozz wrote:

> Well the PICC line went in well although my wife did reinact the shower
> scene from Psycho when it bled rather well today. All fixed now thanks to a
> quick trip to the old workplace for a cleanup. Irinotecan had an immediate
> effect on the guts that surprised wifey a bit, but soon went away.
>
> Maybe it's psycological, maybe it's the steroids of maybe even the atropine
> but drinking and eating, still only soup and mushey biscuits (cookies for
> out transatlantic cousins) seems a little better. Long may it continue.
>
> Has anybody got any info on oesophageal end gastric stents? Do they actually
> use them? There is lots of GOO info (the other end of the stomach) but
> little input end stuff.

Ian,
I'm looking at your post again.
I thought "GOO" was a typing error for "good", but I see on your other posts,
you also mentioned "goo".
Sounds like your wife has mucus producing cancer.
Unfortunately, gastric cancers are not been especially sensitive to chemos.
The longest we had someone here was fred, his mother, similar, she had multiple
surgeries and was at one point, producing lots of mucus, bringing it up. (he was
here for a little over a year).
After the mucous started coming up, she was getting her nutrition by IV.
Within a month of that she got pneumonia, and passed away 2 or 3 months later.

If I'm understanding you correctly mucous is collecting in your wife's stomach
and you're wanting her to eat more. If her stomach is filling with mucous, she
won't be hungry.

Joe's brother passed away rather quickly. It might be too painful for him to
enter this conversation and his brother lived further away from him, so probably
doesn't have all the details.

Time's ticking by and might be at a premium for quality, since your wife was
diagnosed in January..
I really feel you should have a frank discussion with your wife's doctors on how
they think things will go and guide you on options. There's a limit to what
newsgroups can provide as to information, when the doctors have all the
pertinent information. Sorry I can't be more helpful.
Keep in touch and let us know how you're both doing.
J

Bozz wrote:

> The GOO above was Gastric Output Obstruction.
>
> Actually she could eat a horse, but it won't go down - unless I liquidise it!
> She does spend most of the time hungry but unable to satify that hunger.

Hello Ian,
Well I've posted quite a few links about stents, G tubes, J tubes etc.
Some have illustrations, some don't.
Do they use PEG tubes? Yes, they do.
Some head and neck patients here have used them or are using them.

Since I'm not a surgeon and can't see your wife's scans, hopefully I"ve posted
enough information that will help you discuss the iissue with her doctors.
I hope it helps.
My best to you and your wife.
Keep in touch
J

Bozz wrote:

> Maybe it's psycological, maybe it's the steroids of maybe even the atropine
> but drinking and eating, still only soup and mushey biscuits (cookies for
> out transatlantic cousins) seems a little better. Long may it continue.
>
> Has anybody got any info on oesophageal end gastric stents? Do they actually
> use them? There is lots of GOO info (the other end of the stomach) but
> little input end stuff.
>
> I did an interesting salmon mousse last night. Liquidise the cooked salmon
> with cream, re-heat and it goes sorta scrambled egg like but still dissolves
> in the mouth. At least it makes a change from veggie soups.

Hello Ian,
You must be handy in the kitchen.
That mousse sounds delicious.
How's it going and any progress about stent?
J

Hi all,

Well it has been 10 days since the chemo started and after only the first
cycle my wife can swallow much better already. Toast for breakfast (she only
said she like the porrage to be nice to me I think) and even fish, veg and
unmashed potato for dinner. This is all much better than the soup/blender
meals that were starting to not go down anyway.

So we've gone from the getting desperate stage to everything is ticking
along nicely. Oh, there's that chemo thing, but she's always coped well with
that (he said touching wood).

I know it's not forever, noting is, but we're living again, not dying.

Ian

Hi all,

Well it has been 10 days since the chemo started and after only the first
cycle my wife can swallow much better already. Toast for breakfast (she only
said she liked the porrage to be nice to me I think) and even fish, veg and
unmashed potato for dinner. This is all much better than the soup/blender
meals that were starting to not go down anyway.

So we've gone from the "getting desperate" stage to everything ticking
along nicely so far. Oh, there's that chemo thing, but she's always coped
well with
that (he said touching wood).

I know it's not forever, nothing is, but I feel that we're living again, not
dying.

Ian

Bozz wrote:

> Well it has been 10 days since the chemo started and after only the first
> cycle my wife can swallow much better already. Toast for breakfast (she only
> said she liked the porrage to be nice to me I think) and even fish, veg and
> unmashed potato for dinner. This is all much better than the soup/blender
> meals that were starting to not go down anyway.
>
> So we've gone from the "getting desperate" stage to everything ticking
> along nicely so far. Oh, there's that chemo thing, but she's always coped
> well with that (he said touching wood).
>
> I know it's not forever, nothing is, but I feel that we're living again, not
> dying.

It's good to read she's swallowing better, Ian.
Porridge eh? I think I just had a Mother Goose flashback.
Peas porridge hot, peas porridge cold
Peas porridge in the pot 9 days old
Some like it hot, some like it cold
Some like it in the pot 9 days old.
(I think that dates me)
J

--

BetsyB

"J" <ercent@anon.inv> wrote in message
news:4535CD3A.2E04D207@execulink.com...
> Bozz wrote:
>
>> Well it has been 10 days since the chemo started and after only the first
>> cycle my wife can swallow much better already. Toast for breakfast (she
>> only
>> said she liked the porrage to be nice to me I think) and even fish, veg
>> and
>> unmashed potato for dinner. This is all much better than the soup/blender
>> meals that were starting to not go down anyway.
>>
>> So we've gone from the "getting desperate" stage to everything ticking
>> along nicely so far. Oh, there's that chemo thing, but she's always coped
>> well with that (he said touching wood).
>>
>> I know it's not forever, nothing is, but I feel that we're living again,
>> not
>> dying.
>
> It's good to read she's swallowing better, Ian.
> Porridge eh? I think I just had a Mother Goose flashback.
> Peas porridge hot, peas porridge cold
> Peas porridge in the pot 9 days old
> Some like it hot, some like it cold
> Some like it in the pot 9 days old.
> (I think that dates me)
> J
>
J, tell em I told you that poem. I rememory it.

Betsy

betsyb wrote:

> "J" <ercent@anon.inv> wrote in message
> >> Porridge eh? I think I just had a Mother Goose flashback.
> > Peas porridge hot, peas porridge cold
> > Peas porridge in the pot 9 days old
> > Some like it hot, some like it cold
> > Some like it in the pot 9 days old.
> > (I think that dates me)
> > J
> >
> J, tell em I told you that poem. I rememory it.

oh, that's where I learned it. my older friend
Thanks Betsy,
J