My father has been diagnosed with Squamous Carcinoma on the right cheek. ( pT2N3M0). The post OP biopsy of specimen of right cheek excision measuring 6.0 x 4.3 x 3.0 cms mentions one out of five level I B lymph nodes isolated shows metastatic carcinoma (1/5). Nodal parenchyma is completely replaced by timor. Perinodal extension is see. Doctors in India are recommending adjuvant Chemoradiation with weekly Cisplatin at 40 mg/m2 + Radiotherapy to a dose of 63 Gy in 30 fractions. Please give your valuable suggestions about going for immunotherapy and metabolic therapy at Verita Life in Bangkok will be beneficial or not.

Hello, I am saddened to read of your Fathers diagnosis.
The proposed treatment plan of concurrent Chemo and radiotherapy sounds like the normal plan for this cancer.
I am presuming that he has had the tumour removed and has also undergone a neck dissection. Perinodal extension tells me that cancer cells have escaped into surrounding tissue and he will need radiotherapy to deal with this.
It is my understanding that immunotherapy is usually used in metastatic Head and Neck cancers that have previously been treated with Cisplatin chemo..
Are you able to get a second opinion on treatment options from a top cancer centre? I would advise that, although I think the proposed treatment is correct according to current standards.
I'm sure someone with more knowledge than I have will come along shortly to advise you further.
Take care,
Tammy

Welcome to OCF! Im very sorry your father is going thru this. We will do our best to help but please understand we are not physicians and do not have knowledge of how medical systems operate in other countries.

The conventional method of chemo (cisplatin) and radiation treatments sounds to be what our US patients do and what works. At this time surgery, radiation with or without chemo are the only known cures for this type of cancer. Immunotherapy drugs here have just been fast tracked thru the trials and are working for some patients. So far, only opdivo/keytruda (pembrolizumab) has shown great promise being used in recurrences where there are mets to the lungs. Other things like what the doctors are doing in Bangkok I do not have any info about if it is successful or not. As far as I know, its not done like that here in the US.

Best wishes!

Thank you for the replies. Kindly let me know what precautions do you generally take when the person is undergoing radiations and chemotherapy. What diet should he be following and what kind of supplements should he be taking to reduce the side effects.

As far as supplements, make sure to check every thing with your fathers doctor. Some things (even over the counter vitamins) can interfere with his treatments. Your father will likely develop painful mouth sires, manuka honey should help with this. Im sorry but I cant remember whats the best number to get. The higher the number, the better it will work. As treatments continue everything will get progressively more difficult. Rads continues to work even after treatments have ended.

Your fathers sense of taste will change and his ability to swallow may be compromised as he goes thru rads. Try your best to focus on what is within your control to help your father... his intake. I cant stress how vitally important this can be during rads and for his recovery. Every single day he must take in at least 2500 calories and 48-64 oz of water. This will help to flush the toxicities of chemo out of his body. Losing weight during and after treatment is NOT a good thing! If you can push him to take in 3500 calories daily that should help him avoid weight loss. When losing weight he is also losing muscle which may never return. Here in the US many patients will find its easiest to drink their calories with over the counter products like Boost or Ensure. In other countries, I do not know if these are available or another similar product could be available instead.

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