Expert: Margot RN BScN CGN - 6/18/2006

Question
After nearly 98 years of relatively good health, my father-in-law is now suffering from a stage III oral cancer, squamous cell.  Declining surgery because of his age, he had radiation twice, but the cancer is not gone and now appears to be advancing rapidly.  I've looked everywhere, and I can find no information describing what we can expect as this cancer plays out.  We would like to prepare for and alleviate his discomfort as well as we can.  Is this kind of cancer very painful as compared with, say, bone cancer? He declines pain meds such as vicodin because they cause constipation, declaring he would rather be in pain.  That said, he appears to be in considerable discomfort, finding it hard to open his mouth and swallow.  Are there any pain meds that are nonconstipating?  
  I apologize for the length of this note and all the questions.
Thank you so much, Margie

Answer
Hi Margie and tanks for writing,

Oral Cancer can be quite painful depending on the exact tumor size and location. Your FIL should not be afriad of analgesics due to constipation and that's so easy to prevent and he must control his pain to maintain quality of life.

I would have someone talk to his GP and at least get a moderate-strong narcotic analgesic to keep on hand for discomfort and have him take a natural laxative along with it. I highly recommend Psillium as a safe and gentle daily source of fiber. I also recommend LBT3 by Wild Rose 2-4 tabs/day once you're on narcotics and this WILL prevent constipation but not cause gas or cramps. You should go to a Health Store now and talk to someone who knows what they're talking about and get some natural supplements now for his bowels.

I hope this helps, all my best.

Margot