| Joined: Jul 2012 Posts: 3,267 Likes: 1 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Jul 2012 Posts: 3,267 Likes: 1 | TPF Induction chemo is controversial, and many do not go on to complete the full induction chemo cycles, and or Chemoradiation or is delayed due to its high toxicities, including mortalities, but is very effective in killing cancer. One study said as high as 50% did not complete it. I had TPF,and ony did 5 days of TPF IC, which put me in a hospital, and acute critcal care nursing home for 187 days, paralyzed me from the waist down, lost over 110lbs in a few weeks, blinded me, and had 3rd degree burns to the hands, face, inside mouth, esophagus, feet, from Steven Johnson Syndrome, and much more. My local doctors said I was given too much chemo. and many doctors who came to see me for my care, including the burn unit who had to debrige the wounds, and couldn't believe chemo did that. As a result, I was unable to continue further treatment for over a year, and as a result of that, I have had numerous recurrences (8), and still have side effects, 4 years later, which were much worse than radiation. If TPF does kill all the cancer, which it can, it is short term only, and is likely to return within a year, if no further curative treatment is not done, and that is surgery, radiation, Chemoradiation. Carboplatin is an alternate to Cisplatin, with less side effects. Mine returned 8 months later, and then had radiation alone, and so on.
God luck to your son.
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
| | | | Joined: Sep 2013 Posts: 10 Member | OP Member Joined: Sep 2013 Posts: 10 | Hi Paul, After my son's chemo, CT scan revealed residual neck lymphnodes , size reduced from 5 to 3.2 and tonsil ca gone. However the onco was not sure what to do next so he moved on to another team that suggested chemoradiation: 6 low dose cisplatin and 34 IMRT. After 2 cycles of cisplatin, he cannot do it anymore. He was nauseated all the time which continued to the present even without having chemo for 2 weeks already. The rad onco said it was not a side effect of RT. My son is not able to eat well and drink and the doc was not recommending peg tube because according to him, no one has ever put a pegtube when undergoing RT in the country where he lives.
April 2012: R neck inflammation, cured with ATB April 2013: R neck inflammation recurred June 2013: Dx: Papillary SCC of tonsil T2N2-3M0 July 2013: TPF every 21 days for 6 cycles (4.5 months)CT tonsil ca gone, R neck residual lymph nodes November 2013: Chemo/RT (cisplatin/34 IMRT)
| | | | Joined: Jan 2013 Posts: 1,291 Likes: 1 Patient Advocate (1000+ posts) | Patient Advocate (1000+ posts) Joined: Jan 2013 Posts: 1,291 Likes: 1 | Trilled to hear the chemo resolved the tumors. After the first round of TPF, there was visual reduction in size. After the second, more reduction. After the third round, it was gone and the CT/PET reported "near or complete resolution".
As we know, cancer can only be killed with radiation or removal. I underwent chemo-radiation after the TPF to ensure there was total annihilation of the cancer. I received carboplatin to reduce the side effects while still acting as a radio-sensitizer to the rads.
The RO is right, HNC rads rarely make people nauseated but very common side effect of chemo.
As to the PEG, it is side effects of rads that require one being put in. The damage to the throat from rads makes it for many impossible to eat orally.
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 | | | | Joined: Oct 2011 Posts: 225 "OCF Down Under" Gold Member (200+ posts) | "OCF Down Under" Gold Member (200+ posts) Joined: Oct 2011 Posts: 225 | The clinic which treated my brother insists a PEG be placed before radiation starts. They prefer people having the procedure when they are relatively well, rather than when they are unable to eat properly.
Brother 49yo DX 22/6/11 Tonsil SCC HPV+ Stage IV T4N1(?)M0. Carbo/docetaxel (Taxotere)19/7, 11/8 (with E-tux), 1/9; E-tux 11/8, 25/8, 15/9, 30/9, 14/10, 28/10; IMRT X 35 (70gy tumour;63gy nodes;56gy gen area) 19/9-4/11/11. Clear PET scan 1/2/12. 1 and 2 year post treatment checks good. | | | | Joined: Jul 2012 Posts: 3,267 Likes: 1 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Jul 2012 Posts: 3,267 Likes: 1 | That is the normal course of treatment, as Don Foo did, after TPF Induction chemo, sequetional Chemoradiation, and is the only real cure in this type therapy, chemo is not. The two chemo's may be enough, many here could only do 2 out of 3 large bag Cisplatins also, and that was without IC or had their last weekly cisplatin stopped. The main thing is to finish radiation. chemo acts as a radiosebsitizer to make radiation work better, how much differs with the type of chemo from 2%-20%, maybe higher with other studies. As far as the peg, the nasal tube in an option, and often preferred during treatment, instead if surgery, so I don't know what the doctor is saying. Nausea can be a side effect of radiation. I did radiation alone, and had nausea, vomiting, although pain medications also had a role too. Some patients even have anticipatory nausea just entering the room, thinking about treatment, will make them sick.
Good luck.
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
| | | | Joined: Dec 2010 Posts: 5,260 Likes: 3 "OCF Canuck" Patient Advocate (old timer, 2000 posts) | "OCF Canuck" Patient Advocate (old timer, 2000 posts) Joined: Dec 2010 Posts: 5,260 Likes: 3 | They can put in a peg at anytime - the drs where he is are wrong. I had mine put in at week 2 of rads. It's a simple procedure that in no way is effected by what he's going through he will feel uncomfortable but he's already uncomfortable - he is mildly sedated they go in and put it in place via ultrasound. It takes no more than ten - 15 minutes some people have had it done even further into treatment. Or he can have a nasal gastric tube put in. He needs his nutrition and hydration to heal and fight this otherwise it's a very steep slippery slope he'll find himself on. However is his caregiver there has to fight for him. I had a friend who reacted the same to cisplatin. He was sick as a dog for 7 weeks. Lived with his head in a garbage pail. He sucked it up and insisted they give it to him. They threatened to stop the last one but he managed to keep enough food down that he didn't lose anymore weight (he lost 50 lbs total) not fun but it's in is best interest to push until he gets what he wants. What country is he in? Hugs
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
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