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It is good to look for trends... not just two values.... but more, like you are doing.
How often are they being checked?
Because if they are being checked too often, then they might reflect tumor cells dying and be falsely high. If they are going up and the CT scans are looking better and he feels better, then I would trust that more. Those things are more important. And even if the numbers are going up a little, you still often want to try to milk each chemo for as long as you can, if he is tolerating that well.
But I always start thinking ahead about what our next options might be when the numbers
Persistent nausea is unusual, and not normal. Talk with the chemo nurses to make sure he is getting enough pre-meds with chemo, and that he has good medicines at home with appropriate instructions about how to take them. For a period, my Mom took a zofran when she got up every morning to block nausea from even coming. Sometimes by waiting for the nausea, it is almost too late....
And make sure he has medication/assessment for gastroparesis (slow stomach emptying). Very common, undertreated, and probably the most common cause of nausea that persists long after chemo days. Reglan (metoclopramide) is the medication to start with, and make sure it is taken properly (15-30 minutes before meals, 4 times per day).
If he is doing well, and fatigue persists, ask about ritalin (a stimulant), or more aggressive treatment of his mood, if that is contributing.
And look to see if there is an Immunotherapy trial near you. This is the future, we hope!
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