Dear Oncology Nurses
I am confused and lost. I am an ER nurse with zero experience in oncology and my Dad( previously very very healthy 80 year old who golfs daily in summer and plays in several bands and runs all of our lives ) was just diagnosed with Pancreatic Adenocarcinoma with liver involvement after presenting with anorexia and fatigue for a couple of weeks and then developing obstructive jaundice.
He has been slated for palliative Gemcytibine infusions weekly x 7 weeks, one week off and then 3 more weeks. We have lots of questions that the MD is not completely answering and would appreciate all help.
1. Can the chemo cause fever - last PM( 24 hours after cycle 2 and day 8 after cycle 1 ) he had a temp of 101.5 that responded to 2 plain tylenol. No other c/o. Fever returned once in night - also responded to 2 tylenol. Hematologist on call did not want him sent to ER to r/o sepsis. Today he is fine - no fever. Is it drug fever ??
2. What is with this nausea ?? Can Zofran be used longer than the first 24 hours after chemo - the MD gave him 3 doses only. It works better than Compazine( Stemetil ) because of less sedating qualities but is there anything else?
3. NO appetite - we are teasing and tempting him with Instant Breakfast milk shakes - jello - apple juice and ginger ale - to increase fluids in addition to 3 regular meals - he is getting about 1500cc in per 24 hours - Is that enough. Can I do anything else ??
4 Anything else that we can possibly do - there is no pain yet, he is quite fatigues and we have him nap a lot and then do walking laps around the house.
Thanks to everyone
Feb 19, '03
I did some searching and yes the drug can cause fevers. As far as no appetite that is common. He can feel like he has flu like symptoms. Take good care of the mucosa of his mouth. Watch for signs of bleeding. Oh yes and check his mouth good every day looking for sores, white patches or bleeding.
Just so your aware if he has not experienced this he may. Some people with pancreatic cancer may start having hard to control blood glucose levels.
People with this kind of chemo always have alot of nausea and GI/abdominal discomfort. I am not the most up to date on meds for nausea but I thought Zofran was the best. I will await to see what more current hem/onc nurses post here.
My heart breaks for you and your dad,
Last edit by renerian on Feb 19, '03