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Matthew1025 #175172 12-11-2013 10:35 PM
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Matthew,

Many folks here support getting second opinions and going to designated CCC. You have certainly done the CCC part. As you mention, several doctors are present at your visits. That seems like a pretty good time for various opinions to be discussed.

My advise is if you trust this facility and team then go with their recommendation. Feel confident you are getting the best advice and course of treatment then fully embrace and support it and sleep well.

Here's the alternative. You seek another opinion from another group. Your recommended treatment is one of their options but they slightly lean toward something similar but different. They seem a competent bunch but what do you do now? How do you choose? Did you make the right choice? Unless you like second guessing as a hobby, why get yourself into this situation.

You are really really fortunate to be getting care at a truly world class institute that uses a team based approach. It is a no brainer for me.

For most who are seen at lesser qualified groups, the suggestion of second opinions has more relevance. Don


Don
Male, 57 - Great health except C
Dec '12
DX: BOT SCC T2N2bMx, Stage 4a, HPV+, multiple nodes
1 tooth out
Jan '13
2nd tooth out
Tumor Board -induction TPF (3 cycles), seq CRT
4-6/2013
CRT 70gr 2x35, weekly carbo150
ended 5/29,6/4
All the details, join at http://beatdown.cognacom.com
donfoo #175173 12-11-2013 10:40 PM
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Don, thank you so much..you made perfect since to me and provided me with the answer I was looking for. I'm going for it with Stanford, all in and will never look back. This is what my heart tells me I must do. You are so right, I can't keep going back and forth in my head as I need peace of mind to start the healing process.


40 yr old male--very active, ns, rarely drink
T4aN0M0 HPV+
11/21/13--Lesion on back right of tongue, biopsy neg, CT neg
11/25/13--2nd biopsy DX SCC BOT
12/21/13--T4aN0M0 via PET and MRI scans
12/30/13--Begin Cetuximab/Rad Treatment
Treatment currently at Stanford Medical Center
2/14/14--Finished 36 rad treatments
2/18/14--Finished 8 cetuximab infusions-completion of treatment
4/26/2014--MRI showed marked tumor regression
5/27/2014--PET clear
8/18/2014--MRI clear
2/22/2015--MRI clear

Matthew1025 #175909 12-28-2013 11:31 PM
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Posts: 26
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T2NO BOT Squamous Cell is the final diagnosis after 2 biopsies, CT's, MRI's and PET scans. I start Cetuximab on Monday 12/30 at Stanford and will do it every monday thereafter for 7 weeks. The following Monday(January-6th) I will add radiation daily. I am taking part in a clinical trial which pits Cisplatin vs. Cetuximab for efficacy and side effects. Can't wait to get through it and be cancer free!


40 yr old male--very active, ns, rarely drink
T4aN0M0 HPV+
11/21/13--Lesion on back right of tongue, biopsy neg, CT neg
11/25/13--2nd biopsy DX SCC BOT
12/21/13--T4aN0M0 via PET and MRI scans
12/30/13--Begin Cetuximab/Rad Treatment
Treatment currently at Stanford Medical Center
2/14/14--Finished 36 rad treatments
2/18/14--Finished 8 cetuximab infusions-completion of treatment
4/26/2014--MRI showed marked tumor regression
5/27/2014--PET clear
8/18/2014--MRI clear
2/22/2015--MRI clear

Matthew1025 #175911 12-29-2013 12:34 AM
Joined: Jan 2013
Posts: 1,291
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Sounds like you got a plan in motion. Once you get started things will progress along.

Given you are in a trial, did you ask or what answer did you get to the fact that cisplatin/carboplatin given concurrent with rads are supposed to enhance the effect of the rads, acting as a radio-sensitizer. AFAIK Erbitux is not platinum based so is the platinum effect not something you are missing?

Is the primary purpose of the trial to determine if there are less side effects with Erbitux while still being as effective as Cisplatin? Do you happen to have the trial reference number? I'm sure this info would help others who may be offered a seat in the trial bus.

Thanks and good luck, Don


Don
Male, 57 - Great health except C
Dec '12
DX: BOT SCC T2N2bMx, Stage 4a, HPV+, multiple nodes
1 tooth out
Jan '13
2nd tooth out
Tumor Board -induction TPF (3 cycles), seq CRT
4-6/2013
CRT 70gr 2x35, weekly carbo150
ended 5/29,6/4
All the details, join at http://beatdown.cognacom.com
Matthew1025 #175917 12-29-2013 06:22 AM
Joined: Jul 2012
Posts: 3,267
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RTOG 10-16

I made a post containing this info on 12/23/12, but can't link it with my ipad. It was a letter from MSKCC to the editor the Journal of Clinical Oncology about Erbitux vs. Cisplatin. The report mentioned RTOG 10-16, I believe, has been ongoing for almost 5 years. I'll try to link another way.

http://jco.ascopubs.org/content/early/2012/11/30/JCO.2012.46.9049

Last edited by PaulB; 12-29-2013 06:42 AM. Reason: Link added

10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






Matthew1025 #175921 12-29-2013 09:48 AM
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Posts: 5,260
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"OCF Canuck"
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Hi there sorry way back when I was pushing for the surgery I was thinking it was confined to the oral tongue and not HPV related. smile duh... Christmas crap dulled my brain. smile since it sounds very much like what you described - a slow creeping SCC (mine sounds similar - but was confined to the tongue and was not HPV) it only started to hit the nodes (ended up positive in one) after the biopsy - but I am sure I'd had it as a slowly growing lump in my tongue for a few years as that is how long it was bothering me for. smile what you are doing sounds correct for HPV positive base of tongue. I am wondering if it moved from bottom to top. Anyway best of luck with treatment. smile


Cheryl : Irritation - 2004 BX: 6/2008 : Inflam. BX: 12/10, DX: 12/10 : SCC - LS tongue well dif. T2N1M0. 2/11 hemigloss + recon. : PND - 40 nodes - 39 clear. 3/11 - 5/11 IMRT 33 + cis x2, PEG 3/28/11 - 5/19/11 3 head, 2 chest scans - clear(fingers crossed) HPV-, No smoke, drink, or drugs, Vegan
Matthew1025 #175941 12-29-2013 10:16 PM
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Here is a link to an OCF post about the RTOG 1016.

Here is the link to the full study document.

It appears to have started in 2011 from what I read.



Don
Male, 57 - Great health except C
Dec '12
DX: BOT SCC T2N2bMx, Stage 4a, HPV+, multiple nodes
1 tooth out
Jan '13
2nd tooth out
Tumor Board -induction TPF (3 cycles), seq CRT
4-6/2013
CRT 70gr 2x35, weekly carbo150
ended 5/29,6/4
All the details, join at http://beatdown.cognacom.com
donfoo #175950 12-30-2013 08:07 AM
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Likes: 1
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Thanks. Lots of info in the link. This is RTOG 1016 phase III. I believe it may have started in 2009 as a concept phase 0, then onto phase I, II. Phase III started in 2011. I didn't read where it ends, but thought I read before it was a 5 year study, so maybe 2014/15?


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






Matthew1025 #175959 12-30-2013 03:38 PM
Joined: Jan 2013
Posts: 1,291
Likes: 1
Patient Advocate (1000+ posts)
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Here is the link to the status of the RTOG trials. 1016 is still open so it is going to be a few years before the stats are fully compiled.


Don
Male, 57 - Great health except C
Dec '12
DX: BOT SCC T2N2bMx, Stage 4a, HPV+, multiple nodes
1 tooth out
Jan '13
2nd tooth out
Tumor Board -induction TPF (3 cycles), seq CRT
4-6/2013
CRT 70gr 2x35, weekly carbo150
ended 5/29,6/4
All the details, join at http://beatdown.cognacom.com
Matthew1025 #175993 01-01-2014 10:13 PM
Joined: Dec 2013
Posts: 26
Contributing Member (25+ posts)
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Posts: 26
Trial is definitely still open. I talked with one of the Doctors at Stanford who said it was reopened because they needed a little more data. Anyway, took my first large dose of Cetuximab on Monday. Had a world class headache that night and half of yesterday. But, things seem to be normal again today so I can't complain about that.
Also, I was wrong about my tumor...apparently it is a T4a, because of the location deep in the tongue muscle, hence the reasoning to bypass surgery....the size of it was described to me as being T2 sized so that was where the confusion lay.


40 yr old male--very active, ns, rarely drink
T4aN0M0 HPV+
11/21/13--Lesion on back right of tongue, biopsy neg, CT neg
11/25/13--2nd biopsy DX SCC BOT
12/21/13--T4aN0M0 via PET and MRI scans
12/30/13--Begin Cetuximab/Rad Treatment
Treatment currently at Stanford Medical Center
2/14/14--Finished 36 rad treatments
2/18/14--Finished 8 cetuximab infusions-completion of treatment
4/26/2014--MRI showed marked tumor regression
5/27/2014--PET clear
8/18/2014--MRI clear
2/22/2015--MRI clear

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