Pain killers and lung cancer

Ckim · Experienced user Joined: 15 Aug 2008 Posts: 53

Hi my dad has been through the ringer. Survived Stage IV throat cancer, dx Stage 3a lung cancer in 12/06, mets to brain in 12/07, he's maxed on radiation --head, chest, neck--all sorts of chemo.

Now, on Alimta. tumors prevalent in both lungs, partial lung collapse on the right lobe due to tumors.

everyday he can do less and less for himself

he is on a lot of pain meds oxycontin 2 pills 3x/day and insists on taking hydrocodone as well. Little bit of scotch with the ensure or boost and he is incoherent.

he starts a sentence and cannot finish it. he will start it again and again and not finish it.

At this point right now i am not sure that it is the chemo or the cancer--of course the neuralgia is very bad. I have to put his feet on the power chair, lift his legs into the bed. he can do almost nothing for himself

he was taking 1 ocycontin every 12 hours, then 2 every 12 and now 2 every 8--these are the time release pills.

steadily we go downhill

(sorry, my shift key is not working so capital letters are a pain)

I am planning to go and talk to the pharmacist at the place where all his scripts are filled and ask some questions about drug interactions etc.

As near as I can figure, he is on:
Liquid dilantin
some sort of cough suppressant pill
Oxycontin
oxycondone
steroids
prilosec
stool softener
Zanax

there may be more

I accidentally gave him a half pill of oxycodone (at his request) right after my mom had given him 2 time release oxycontin

I just found him to be all but completely incoherent.

I think we have to wait another 2 -3 weeks to see if the alimta is working--he had the 2nd does 6 days ago.

He also takes in less than 1000 calories a day--sometimes as little as 500.

does anyone have any experience with this?

I don;t know if he is just very sick or actually dying...

simplyklb · Posted: Sun Aug 24, 2008 12:38 am Post subject: Re: Pain killers and lung cancer

Hi,
My dad has small cell lung cancer... He's been thru 10 radiation treatments and three rounds of chemo since May. He's lost over 50 lbs. since he was diagnosed. Dad has a lot of mental issues so with the pain meds it makes things much worse. My dad has a 75 mcg/h Fentanyl patch, takes four Oxycodone per day. He takes 30 mg a day of of Remeron for depression and anxiety. I have to speak with the social worker and palliative care nurse on Monday because my dad has suddenly become paranoid. I can deal with the confusion but not the paranoia. In the meantime, I cut back on the 1 mg of Ativan.

Kristi
_________________
Dad - Andy, 70, diagnosed with SCLC in May 2008
2/20/38 - 10/15/08 Fly high, Dad!
Mom - Jackie, 67, diagnosed with NSCLC in May 2008

Ckim · Experienced user Joined: 15 Aug 2008 Posts: 53

[quote="simplyklb"]Hi,
My dad has small cell lung cancer... He's been thru 10 radiation treatments and three rounds of chemo since May. He's lost over 50 lbs. since he was diagnosed. Dad has a lot of mental issues so with the pain meds it makes things much worse. My dad has a 75 mcg/h Fentanyl patch, takes four Oxycodone per day. He takes 30 mg a day of of Remeron for depression and anxiety. I have to speak with the social worker and palliative care nurse on Monday because my dad has suddenly become paranoid. I can deal with the confusion but not the paranoia. In the meantime, I cut back on the 1 mg of Ativan.

Kristi[/quote]

I am soooo very sorry to hear about your dad. small cell is not good to deal with at all.

I can understand the paranoia--i think I see a little bit of that in my dad--I thought it was just my mom being weird--he doesn't really trust her 100% which is odd.

I will ask the doc about fentanyl and taking the Oxycodone instead of oxycontin.

it seems to me that there is something to taking meds regularly as opposed to one pill that is supposed to last 8-12 hours. it seems like you have more control if you can take something as you go through the day

the time release pills are more convenient but i think that he thinks that they don't really work all that well. they do at night.

I can't imagine that the confusion or the paranoia are easy to deal with at all. My heart goes out to you.

EFP · Posted: Sun Aug 24, 2008 9:35 am Post subject: Re: Pain killers and lung cancer

What works best for pain probably depends, at least in part, on how exactly the cancer is causing the pain. I have hip pain from a bone met that is not in the slightest alleviated by Oxycontin or oxycodone (or both) but that is quite effectively managed with large doses of Ibuprofen (800 mg 3 or 4 times/day). OTOH, I have pain in the upper back from another bone met that Oxycontin handles beautifully. Go figure... The moral of the story is to try different drugs in the hope of finding one that does the job and that doesn't have unacceptable side effects. Good luck!

EFP
_________________
64-yr-old woman dx 12/07 Stage 4 NSCLC (adenocarcinoma), with mets to lymph nodes and bones (pelvis, L3). Only symptoms are blood clots, for which am taking Lovenox, and some pain from the bone mets, for which I had radiation to the pelvis and spine. Have opted to do no chemo or chest radiation.

Ckim · Experienced user Joined: 15 Aug 2008 Posts: 53

[quote="EFP"]What works best for pain probably depends, at least in part, on how exactly the cancer is causing the pain. I have hip pain from a bone met that is not in the slightest alleviated by Oxycontin or oxycodone (or both) but that is quite effectively managed with large doses of Ibuprofen (800 mg 3 or 4 times/day). OTOH, I have pain in the upper back from another bone met that Oxycontin handles beautifully. Go figure... The moral of the story is to try different drugs in the hope of finding one that does the job and that doesn't have unacceptable side effects. Good luck!

EFP[/quote]

Do you find that the oxycontin puts you out a bit much?

It's hard for me to ascertain what exactly his pain is because the pain drugs he takes make him unable to finish a sentence.

As far as I know, he has no bone mets. But, I would imagine that having partial lung collapse would be painful. His pain is in his chest--right side and middle.

I am going to check into the ibuprofen. In general, I do find that very good for certain pains and not others.

Also, in my own experience with pain drugs (I have chronic pain) I find that sometimes the drug doesn't take the pain away so much as just make me not care that I hurt.

I cannot really understand what it is like for him and he cannot communicate it to me. I am worried that he is now addicted to the oxycontin and is using it to deal with not pain, but simply having cancer.

Thank-you for the reply. If there is pain that increasing amounts of oxycontin will not help, then ibuprofen is a simple and effective thing to try. And i can talk to his doc about it.

I want him to be out of pain, but I don't think it's good for him to be semi-conscious.

Thanks!

EFP · Posted: Sun Aug 24, 2008 3:09 pm Post subject: Re: Pain killers and lung cancer

Hi CKim.

In answer to your question, Oxycontin has no effect whatsoever on my mood or mental state. But, given its popularity as an illegal drug on the street, I'm sure I'm the odd man out in that respect. How long has your father been taking it? (I certainly wouldn't worry about addiction per se in this situation or even being 'out of it' -- but paranoia can't be fun, for sure.)

Good luck.

EFP
_________________
64-yr-old woman dx 12/07 Stage 4 NSCLC (adenocarcinoma), with mets to lymph nodes and bones (pelvis, L3). Only symptoms are blood clots, for which am taking Lovenox, and some pain from the bone mets, for which I had radiation to the pelvis and spine. Have opted to do no chemo or chest radiation.

bnot · Posted: Sun Aug 24, 2008 5:10 pm Post subject: Re: Pain killers and lung cancer

I'm new here so I don't know a lot about cancer yet.

But I do know when my Mom was on steroids cause she couldn't seem to snap out of a chest cold, she had hallucinations. Hallucinations and paranoia go hand in hand a lot of times.

Ckim · Experienced user Joined: 15 Aug 2008 Posts: 53

Update:
My mom took my dad off the oxycontin. He started with 1 every 12 hours then 2 every 12 hours then 2 every 8 hours in addition to hydrocodone.

I told her that according to his pharmacist the 2 every 8 hours is a usual does for people who are expected to die.

the next day--she took him off--he takes the hydrocodone only now and is much more "sentient' as my mom put it.

right now it is after 8 pm and he did take a short nap today, but we are going to watch TV tonight until 10 pm. Last night we watched until 9 pm.

being more awake allows him to take in more nourishment. He doesn't seem to be in any more pain that he was before and he can move a bit better.

I am now still hopeful that if we can get him through the coming weeks of Alimta that maybe he has a chance at some normal life yet. It's a marathon, but at least some hope is good. And having him be conscious is good!

pbj11 · Site Admin Joined: 12 May 2007 Posts: 1265

Ckim,

Having no experience with pain meds, I'd say that tweaking them obviously was the right thing to do. I'm glad you are seeing a change in his patterns already.

Keep going Dad!!!

PBJ
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

Ckim · Experienced user Joined: 15 Aug 2008 Posts: 53

The only problem now of course is that he is conscious enough to be mad as the devil at us for taking away his oxycontin!

He was not a happy camper when going to bed tonight.

However, tonight while we were watching TV he actually gave me a half smile in response to a joke and it occurred to me then that I hadn't seen him smile in over 3 or 4 weeks!

So, it was the right decision. Like night and day!

Very Happy

pbj11 · Site Admin Joined: 12 May 2007 Posts: 1265

Ckim,

Oh boy --- did I treasure those smiles. I'm so glad. Hey, these are crusty guys who have a lot of spunk, so it's all okay.

It did my heart good to hear he smiled. YOU made MY day!

Hugs,
PBJ
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

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