My father is 78 years old with stage 4 cancer of the tonsils and lymph nodes (both sides of the neck). He just started radiation and Dr. said at 4 weeks into the treatment he would recommend chemo as a "boost". Is this the same as traditional chemo and is it adminstered the same way. At 1st my dad did not want chemo but is considering this option. Any information would be helpful. Apparently surgery is not an option because he would lose too much of his face/tongue/neck.

Any info would be helpful..thanks~!

Maureen, I had stage 4 cancer of the tongue and lymph nodes on the left side. I started out with surgery then started radiation a few weeks later. I also had three sessions of chemo concurrently with the radiation. Since radiation is the primary treatment for head and neck cancer the chemo was given as extra treatment kind of as insurance. My doctors didn't call it a "boost" but they told me that there was less chance of the cancer returning if I had the chemo. My chemo treaments were one early during the radiation treatments, one in the middle, and one toward the end. Each chemo session was around three hours long.

Thank you very much for the information...it is very helpful! I noticed that you had a PEG removed in 2009. Do you think that it is likely my dad also might require a temporary feeding tube later in the treatment. I have read quite a bit about it and he is having trouble swallowing and eating but so far the Dr. has not mentioned it to him but he is only 5 days into 40 scheduled treatments. Thank you.

Hi, Maureen,
My doctor insisted that I get a PEG before I even started my treatments. I hated it, but was glad that I had it in the end. My mouth got so bad that it was very difficult to eat. I resisted using the PEG at first, but I finally made myself use it. There are a number of people on this site that got by without it, but I'm not one of them. Of course, I had surgery, too, so that might be another reason why they wanted me to have the PEG. There are other types of feeding tubes, also, but the PEG is what they gave me.

I am starting radiation on monday with a chemo boost. The doctor said chemo will add a 10% chance to my long term survival rate. I am getting low dose chemo weekly only as an aid to the radiation. Doctor said large doses are primarily to reduce size of tumor and or palative care. He said my doses will make the radiation more effective on the cancer by making it weaker. Said the side effects of the chemo will be reduced due to lower doses.

I am surprised they are waiting until then. Most with nodal involvement start the chemo when they begin radiation.

Chemos of choice are usually Cisplatin (high dose or low) or Erbitux, both are used in conjunction with radiation to enhance survival rate, Cisplatin is also used in palliative care but never as a stand alone curative option.

Many of the top programs seem to be going to the low dose cisplatin option for lower side effects and I'm assuming effectiveness. All chemo is administered VIA IV to my knowledge. I had high dose cisplatin and never had an issue, it was the radiation that kicked my a.. I'd do it again if I had to though

Good luck

Eric

Initially my father refused all form of chemo so I think that is why the doctor said that he will revisit it with him at 4 weeks. His original recommendation was 40 treatments of radiation and chemo together. I think that my dad is starting to get really scared and is now considering letting them start the chemo if the dr. is not getting the results that he wants.

Tell your Dad that EVEN with the suggested treatment one person dies of oral cancer EACH and EVERY HOUR OF EVERY DAY so he needs to start his recommended chemo ASAP. Every day he waits could be allowing his cancer to spread beyond it's current site(s) where it has proven almost impossible to cure.

Hi Maureen

It sounds very much to me as if your father thinks radiation might be easier than chemo? Or maybe he has some aversion to something associated with chemo(resistance to taking drugs? fear of needles? unwillingness to sit in hospital connected to an IV?)?

Neither chemo nor radiation are any fun and having watched Alex go through both, I would suggest they are equal in their lack of fun.

Your Dad might be starting to realise that radiation is no picnic and decide that if he has come this far he might as well do the chemo too - especially if as Kelly211 says, it increases his chances of survival.

I am sure his doctors are giving him a bit of space and waiting for him to get used to the idea of chemo. I am betting they will be in his ear every day advising him to add the chemo boost.

With regard to your other question about how chemo is administered, all are administered via IV which means he will have to spend more time at the head and neck unit on "chemo" days. The type of chemo will dictate the amount of time with cisplatin taking the longest and others being a bit shorter. My Alex had low dose cisplatin once per week instead of once every 3 weeks. This was done to minimise or avoid side effects while maintaining the same effect. We arrived at the hospital at 8.30am got out about 2 or 3pm on "chemo" day to go down to radiation. It didn't actually take that long to administer the cisplatin, it was all the other stuff that went with it - anti nauseants, hydration, waiting between bags of goop etc which are also administered via IV. You get the IV needle inserted at the beginning of the day (so only one needle) and this connects via a tube to all the bags of medicine which are administered one at a time through that one tube. Some chemos do not take as long, but the procedure is the same.

If your Dad chooses the chemo boost, he will likely only get one sort of chemo so it is not as bad as the full triple therapy that constitutes true chemotherapy.

Think of the boost of chemo as adding a stock cube or a dash of your favourite sauce to your stew to boost or improve the flavour ...