I have a recently diagnosed 1cm lateral base tongue HPV instigated tumor and one node that

Michael,

I haven't heard of amifostine.

I did a little research and came up with the following site.
http://www.bccancer.bc.ca/HPI/DrugDatabase/DrugIndexPro/amifostine.htm

My interpretation based on this information and my medline search is that it is a promising drug. I do however, have concerns. Most of the information that I have read keeps leading back to its "antitumorgenic" side effects. I understand this to mean that it decreases the effectiveness of chemo and RT in reducing/eliminating tumor growth. I am in no way an expert or acquainted with this medication.
May I suggest discussing its potential benefit to you with your Oncologist.

Hope this is of some use.

Cheers,

Mike

Amifostine is a very difficult treatment for many here. It is given to prevent loss of salivary function. If you are getting IMRT you may not need it.

MedImmune produced this drug several years ago in an effort to protect the salivary glands from radiation. Many posters here have used it with varying success. While not speaking for them, my impression from the hospitals that I talk with and the posters here is this. It may indeed offer some radioprotection, but it does not work for everyone, and it does not offer 100% effectiveness even in the best cases. It has a brutal nausea component to its use, which can be offset to some extent by anti-nausea meds prior to use. Were it available to me, I would take a shot at it and see if I could tolerate the side effects and hope for the protection it may provide.

Many docs do not tell their patients about it because they have had such difficulty with past ones tolerating its use. But I think doctors recommendation or not, it's worth an attempt. You can always discontinue its use if it knocks you for a loop with no further ill effects. And if you find you can tolerate it, you may have a bit more saliva when the dance is over, and that will certainly improve your quality of life, and the health of your mouth long term.

Respectfully to Dr. Mike, stated by someone who is only a lay person - MedImmune has tried to play on some other collateral benefits of the drug ancillary to its original intended use, to boost use and sales (effects not well documented or significantly supported by evidence of consequence). In that case antitumerogenic mean the opposite of what you have stated; that it aids other treatments, not that it interferes with them.

Brian,

Sounds like you summed it all up. Everybody is different. If you can add it to your cocktail and tolerate it and it works great.

It wouldn't still be on the shelf if it hasn't benefitted some patients.

Mike

Doesn't anyone prescribe Salagen anymore or is it Amifostine or nothing? The only side effect I had from Salagen was heavy sweating for about 15 minutes about a half hour after I took it. I can only assume it worked because I have a fair amount of saliva and no need for the water bottle. Just an alternative with little side effects unless you live in a very humid climate.

Take care,
Eileen

Eileen,
Salagen is one of the trade names that pilocarpine is sold under. The drug is the same, it's like Motrin and Advil thay are both brand names for the drug Iboprofen.

Hope all is well,

Cheers,

Mike

I had amifostine during treatment and salagen prescribed after treatment was over. I still take salagen and it does help a litle in giving me more saliva.

Hi Micheal, Jack was able to successfully complete the entire course of amifostine. He thinks it helped with the saliva and preventing fibrosis. If you'e going to do it make sure you follow the recommended protocols for drinking 2-3 quarts of water, and using heavy duty anti-nausea drugs (Jack used zofran twice a day every day as a precaution, and compazine for breakthru nausea).

I can't stress the need for hydration strongly enough. It helps with all the side effects. He had to drink 16-24 oz of water 90 minutes before the shot. Jack thought getting the shot itself was painful but he'd also do it again. Everyone's experience is different and you're the only one that can decide whether the potential benefit is worth the potential side effects. This is only 1 of many times you'll be faced with that. As Brian points out you can always stop the treatment if you're having any issues with it.

Regards JoAnne

Hi,

Sorry Brian, guess I should be more careful in my typing and read before I post. What I wanted to pass along was the drugs potential interference with the antitumorgenic effects of chemotherapy.

This is a quote taken directly from the website I referenced above.
"...Use with curative chemotherapy: Animal data suggest that amifostine may interfere with antitumorigenic effects of chemotherapy and amifostine is not recommended with curative chemotherapy outside of a clinical trial. Interference has not been seen in human studies of amifostine thus far.2,3 " Medline search gives similar more scientific info but, noone will say for sure.

I'll be more diligent in my proof reading in the future. Correct me anytime, no disrespect was ever even thought of Brian, I, like you want to only pass along timely accurate information. A lay person? My knowledge of your posts and information would make you more of an expert on Oc than anyone I am acquainted with.

Respectfully,

Mike