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#181987 05-27-2014 03:49 PM
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TomCA Offline OP
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Hello from Tom in northern CA. As you can surmise from my signature, I had SCC (HPV 16+) in my right tonsil and spread to a single lymph node. I am being treated by a major CA HMO where my Medicare is used as well. I have felt from the start that I was getting superior care through this HMO. They have been right on it and no time was wasted.

I have been lucky from the start as first symptoms was a sore and persistent throat in early Dec. 13, which went away; however, soon after I mentioned it to my dental hygienist who immediately alerted my dentist. When she noticed the unilateral nature of the swelling, my dentist became quite alarmed and insisted I get immediate screening. The head and neck guy thought cancer for sure and the biopsy of the tonsil proved out. 1/09/2014

When I read some of the cases on this site, I do feel lucky as the HPV involvement augurs for a good outcome and my case was not too far spread. I will stay positive that the cancer is now gone for good.

A week later (scans and MRI performed in the interim) I had to travel to a center for a cancer panel where I met with a team and was told that the percentages were good for my situation as of the HPV involvement. I was very impressed with the surgeon and qualified for surgery, so decided to have the surgeries done (TORS, Neck Dissection). Yowsah! Ordeals for sure, but thanks to my love, I survived them in good spirit. Learned I can tolerate the opiates, but they really throw me off and constipate me totally.

After a suitable healing period I was on to the next and more difficult stage of RAD and Chemo: RAD x 30, Cisplatin twice, on first day and half way through RAD. Again I had good fortune with the RAD as the surgeries allowed for a reduced regimen both in duration and RAD levels.

Again I was lucky, as a study that was presented at the 2014 Multidisciplinary Head and Neck Cancer Symposium was released around this time and I was so fortunate to find it. It concluded that �Unilateral Radiation Therapy for Advanced Stage Tonsil Cancer Results in Favorable Outcomes�. I sent the study to all my doctors and really lobbied my RO for unilateral treatment. He agreed and in our next meeting urged me not to get the feeding tube which prior he was an advocate for. Unilateral radiation reduced the impacts enough for me to keep eating throughout. I did lose some weight, mostly from the surgeries, but now feel I am at an ideal weight.

Pain. I did not use any pain meds after the surgeries with the exception of Cannabis. I ate half a cookie every morning and still continue to do so. Several of my docs hinted or came right out and recommended Cannabis and my surgeon wrote the CA RX. For me, it is the best for keeping pain in the distance and stellar for managing the frequent nausea and butterfly stomach.

Current hurdles: rehab ROM in right shoulder; eating/taste; dry mouth; neck stiffness and pain from the dissection; fatigue; remaining positive, one day at a time.

I will probably address these in other topic forums and ask for advice.

One comment I would make here. I find the necessary evil of RAD and Chemo to be very destructive and a horrible torture for anyone to endure. My plan is to go through this protocol anyway as a prophylactic when I am sufficiently healed from this current regimen.

Almost 5 weeks since last RAD. Feeling a bit better now and then and now and then a bit worse. Generally trending to better. Starting to get some yard work in, hooray!

Thank you to all the caring and compassionate people who read and comment on these forums.



Tom, age 67 - Stage IVA HPV16+ oropharyngeal SCC, T2N2aM0, Right tonsil, lymph node
1/9/14 Positive biopsy diagnosis
1/16 Cancer Panel
1/21 TORS (Trans Oral Robotic Surgery) to remove tonsil; 1mm margin clear.
2/10 Neck Dissection 1 involved lymph node (extra-capsular activity puts chemo in the mix), 40+ nodes removed
3/17 Begin IMRT RAD & Cisplatin. RAD of 30 treatments, 5 days a week.
4/7 2nd of 2 Cisplatin
4/25 Last RAD
Never installed feeding tube.
Now in recovery.
Joined: Jun 2007
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Welcome to OCF! This site is a great resource that you can learn tons of info about your illness. We are here to help with info and support.

As you are 5 weeks post rads, you probably have seen the worst of things. Recovery can be a long, frustrating road but in time you will get much better than your current status. It can be a full 2 years to reach a complete recovery with taste and rebuilding your body. Your intake is the key to getting better. Every day push to take in 2500+ calories and 48-64 oz of water. After what you have been thru it takes alot to rebuild your cancer's damage. Your sense of taste will slowly return, this seems to be everyones biggest hurdle to get past. In time it will improve.

Best wishes with your continued recovery!


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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Posts: 8,311
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First off a HUGE CONGRATS for completing that Tx, as if you had a choice smile....

You will continue to have bad days mixed in with good days but slowly the good days will win out. My taste and saliva, which I feel go hand n hand, returned in spurts. First noticeable improvement at 4 months PT; some more at 5 months; a huge improvement at 14 months and then a final bit at 24 months.

First year of "recovery" is the obviously worse but soon for you it will be all good, just be patient and do continue to consume at least 3000 cals a day. I did that and I didn't gain a pound my first year so it tells me that there's a lot of cellular recovery going on.


David

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
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TomCA Offline OP
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In my original post I had a web link redacted by admin. So ignore this paragraph:

One comment I would make here. I find the necessary evil of RAD and Chemo to be very destructive and a horrible torture for anyone to endure. My plan is to go through this protocol anyway as a prophylactic when I am sufficiently healed from this current regimen.


Tom, age 67 - Stage IVA HPV16+ oropharyngeal SCC, T2N2aM0, Right tonsil, lymph node
1/9/14 Positive biopsy diagnosis
1/16 Cancer Panel
1/21 TORS (Trans Oral Robotic Surgery) to remove tonsil; 1mm margin clear.
2/10 Neck Dissection 1 involved lymph node (extra-capsular activity puts chemo in the mix), 40+ nodes removed
3/17 Begin IMRT RAD & Cisplatin. RAD of 30 treatments, 5 days a week.
4/7 2nd of 2 Cisplatin
4/25 Last RAD
Never installed feeding tube.
Now in recovery.
Joined: Apr 2013
Posts: 319
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HI TomCA,

First, congratulations on getting through your treatments. MY observation is that the way that radiation and chemo (namely Cisplatin) affects different people differently. Your reaction sounds like mine, but "horrible torture" is at least a couple numbers up the scale for me. On the other hand, I sure won't quibble about the toll it takes on the body.

I don't mean for any of what I say to be taken as anything but a simple "Here's another perspective;" and certainly not to downgrade, belittle or dismiss anything you've said. Each of us is unique, each of our experiences is unique to us alone.

I'm stage IVc and am like my famous ancestor, Daniel Boone Barton. He was famous because in the late 1700s, he once fought and killed 6 bears with his bare hands.

Alas, he was fighting with 7 bears at the time... But I digress.

Counting the original dx, I've on my 7th occurrence, and the last 6 (recurrences) have all been distant Mets.

We haven't started on #7 yet because of some body parts that aren't cooperating. Saturday before last, I developed a inlingual hernia from extremely violent "dry heaves" that (it turns out) were (are, had one last night) the byproduct of neuropathy my colon, which has quit squeezing the contents on down the line.

I can't get that taken care of until I get the hernia fixed and my first consult with a cutter is tomorrow. No idea when he'll do the simple repair, but soon would be an excellent choice from my perspective.

Once the hernia is repaired, the colon can be addressed, but that will depend on how much the latest (#7)
lymph node has grown in the interim. It's all good, these things all work themselves out in the end.

The current plan is 3 more weeks of "beam" radiation for good ol' #7, the a wait until I'm not too hot for a valid PET, and re-evaluate at that point.

I've had my "pain and suffering" scale re-calibrated a couple of times; recovering from getting gut shot is my current 10) and surviving a Flail Chest, and those were over 40 years ago.

But there was a lengthy period during my initial Cancer treatments where I couldn't keep anything in my stomach and I lost 38 lbs, mostly solid muscle (now I look more like a Bataan death march survivor.) It's questionable whether I would have survived without Cannabis to give me a chance to hold something down long enough to benefit from it.

Honestly, I'd give the initial treatments a solid 7, maybe an 8; packing both lobes of my liver with radioactive microspheres a 6 or a 7, and everything else pretty much a "walk in the park."

In fact, I recently downgraded all of my subsequent radiation when I learned that the constant low-level nausea that I've had for the past year or so is really related to my obstructed colon, and not directly a result of the various rads.

Well, that's enough words to keep the board functioning smoothly, so I'll quit and save some for another time.

Bart


My intro: http://oralcancersupport.org/forums/ubbt...3644#Post163644

09/09 - Dx OC Stg IV
10/09 - Chemo/3 Cisplatin, 40 rad
11/09 - PET CLEAN
07/11 - Dx Stage IV C. (Liver)
06/12 - PET CLEAN
09/12 - PET Dist Met (Liver)
04/13 - PET CLEAN
06/13 - PET Dist Met (Liver + 1 lymph node)
10/13 - PET - Xeloda ineffective
11/13 - Liver packed w/ SIRI-Spheres
02/14 - PET - Siri-Spheres effective, 4cm tumor in lymph-node
03/15 - Begin 15 Rads
03/24 - Final Rad! Woot!
7/27/14 Bart passed away. RIP!
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Welcome TomCA to NOPEG, I mean OCF. :-)

You been through the worst and should be feeling at least some good days mixed with not so good days. In short order, you will be feeling better and better.

Hang around, read a lot, and ask if you are not sure.

fyi - I'm in NorCal too. Would this big HMO also have some history with ship building?


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
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Posts: 6
TomCA Offline OP
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Posts: 6
Not sure about the ship building, but think German emperor and you will get the drift.


Tom, age 67 - Stage IVA HPV16+ oropharyngeal SCC, T2N2aM0, Right tonsil, lymph node
1/9/14 Positive biopsy diagnosis
1/16 Cancer Panel
1/21 TORS (Trans Oral Robotic Surgery) to remove tonsil; 1mm margin clear.
2/10 Neck Dissection 1 involved lymph node (extra-capsular activity puts chemo in the mix), 40+ nodes removed
3/17 Begin IMRT RAD & Cisplatin. RAD of 30 treatments, 5 days a week.
4/7 2nd of 2 Cisplatin
4/25 Last RAD
Never installed feeding tube.
Now in recovery.
Joined: May 2014
Posts: 6
TomCA Offline OP
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Posts: 6
Bart,

My heart goes out to you. I don't know how you do it. I don't know if I could face what you have been/are going through. It is a testament that you can keep a good attitude and stay with the battle. Best to you through all this.

Tom


Tom, age 67 - Stage IVA HPV16+ oropharyngeal SCC, T2N2aM0, Right tonsil, lymph node
1/9/14 Positive biopsy diagnosis
1/16 Cancer Panel
1/21 TORS (Trans Oral Robotic Surgery) to remove tonsil; 1mm margin clear.
2/10 Neck Dissection 1 involved lymph node (extra-capsular activity puts chemo in the mix), 40+ nodes removed
3/17 Begin IMRT RAD & Cisplatin. RAD of 30 treatments, 5 days a week.
4/7 2nd of 2 Cisplatin
4/25 Last RAD
Never installed feeding tube.
Now in recovery.
Joined: Apr 2013
Posts: 319
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Posts: 319
Thanks Tom, I'm cool with the whole bit.

The thing about suffering is that it takes place in the mind, and if you don't get into the "Woe is me"s, and hold on to it and nurse it (the suffering,) when the cause of the suffering (the damage to the physical source) passes, so does the suffering. Pain always passes and is behind you when it does, IF ONE DOES NOT ATTACH TO IT!

That's what I'm a living testament to; proof that if you don't let it become what it is not, the most severe and horrific pain and trauma are merely rocks in the path. Not a continual suffering, just another set of experiences to talk about over a cold beverage.

Anyone can do this, but it has to be taken seriously and you have to believe in yourself. Beyond that, it's duck soup; you just need to know the technique, and that's why I write about it. Sort of "See, I did it, anybody can."

But thanks for the compassion in your note, I truly appreciate that.

Bart


My intro: http://oralcancersupport.org/forums/ubbt...3644#Post163644

09/09 - Dx OC Stg IV
10/09 - Chemo/3 Cisplatin, 40 rad
11/09 - PET CLEAN
07/11 - Dx Stage IV C. (Liver)
06/12 - PET CLEAN
09/12 - PET Dist Met (Liver)
04/13 - PET CLEAN
06/13 - PET Dist Met (Liver + 1 lymph node)
10/13 - PET - Xeloda ineffective
11/13 - Liver packed w/ SIRI-Spheres
02/14 - PET - Siri-Spheres effective, 4cm tumor in lymph-node
03/15 - Begin 15 Rads
03/24 - Final Rad! Woot!
7/27/14 Bart passed away. RIP!
Joined: Oct 2013
Posts: 559
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Hello Tom, and welcome to the family; it's good to have another survivor/fighter in our midst.

Your story is basically a carbon copy of mine albeit a few months later. Only two differences 1) my state doesn't have a medical cannabis law. You are the first on the forum I've read about that had the option available. 2) I had no lymph node involvement so no chemo. Lots here on the forum thought I should have chemo anyway, but my docs said nope.

Back in your first post you mention current problem rehab ROM in right shoulder. I presume that means range of motion, if not please clarify. I didn't have any shoulder problems from disease or treatment, so I'm a little curious about yours.

You mentioned you're about 5 weeks since last rads and the symptoms you are having at this point. I am now 5 months post rads and about the only symptoms left are really thick sinus drainage that sticks in upper throat (above and behind uvula). It feels like dried glue. It happens most notably at night while sleeping. I use a sinus irrigator from NeilMed and that loosens it enough to clear it. I also use a bedside humidifier at night while sleeping.

Most of my taste has returned, even the savory part of the taste spectrum (steak & cheeseburgers) which many told me would be the last to return. Sadly the only thing I've noticed that still tastes bad is Blue Bell ice cream Moolineum Crunch (which before cancer I considered a real treat).

Outside of that, no post treatment symptoms remain. I lost 42 pounds during treatment and have kept 38 of them off.

Keep fighting, it gets better with time.

Tony


Tony, 69, non-smoker, aerobatics pilot, bridge player/teacher, avid dancer (ballroom, latin, swing, country)

09/13 SCC, HPV 16, tonsillectomy, T2N0.
11/13 start rads, no chemo
12/13 taste gone, dry mouth,
02/14 hair slowly returning
05/14 taste the same, dry sinuses, irrigation helps.
01/15 food taste about 60% returned, dry sinuses are worse in winter.
12/20 no more sinus problems, taste pretty good

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