Thank you in advance for the unwavering support this forum provides. I am a 50 year old male that was recently diagnosed with HPV P16+ SCC with a 2.5 x 1.9 x 3.4cm primary tumor of the right palate/ tonsil area and two lymph nodes measuring less than 1.5 cm. (T2N2C0)
Just had my first consultation with my oncologist, Dr Weiss, at UNC Chapel Hill. Cisplatin is off the table due to the tinnitus in my right ear. The other courses of treatment are as follow:
1) Cetuximab, three infusions (Once every two weeks) with six weeks of radiation, provided I am not allergic to it. (Standard treatment)
or
2)Pembrolizumab (Keytruda), six infusions (once every three weeks) and seven weeks of radiation. (Clinical Trial)
Leaning towards the Keytruda due to least risk of overall long term health problems. Keytruda is to Opdivo as Pepsi is to Coke. I'd rather hit a nail with a hammer not with a screwdriver.
Any advice would be greatly appreciated.
Welcome to OCF, Rick! You have found the very best place to get info and support to help you get thru your upcoming battle and recovery. Our site is made up of fellow patients/survivors and caregivers so we know what its like to go thru this. Its not easy but it can be done! The very best thing you can do is to focus on your intake starting right now. Every single day up until (at the very least) you hit your one year post rads mark take in a minimum of 2500 calories and 48-64 oz of water. Water intake is especially important for patients who are getting chemo, you need to flush that poison out of your body. I didnt do the best with my intake during rads and suffered way more than I had to because of it. I wouldnt want to see you or anyone else struggle without understanding how vitally a patients intake is during rads and recovery.
Prior to starting your treatments your doc should do a full blood panel including thyroid and testosterone levels. Down the road, its common for patients who had rads to have problems with their thyroid and testosterone levels. By having baseline numbers on file of what they should be for you, it will help your docs to make it easier to prescribe the proper dose of meds to stabilize your thyroid and testosterone levels.
This site is full of medical info all about OC, treatments and recovery. I suggest reading to learn about it so you can be a stronger advocate for yourself when going thru rads. An educated patient is a strong patient!
Anyone who offers their assistance tell them when the time comes you will let them know what they can do to help. Too often well-meaning friends and relatives want to help but they dont know what to do. When going thru rads, may patients are not able to drive to their treatments. Transportation, picking up prescriptions from the pharmacy, doing a load of laundry, walking the dog, cutting the grass, are just a few of the many things your 'helpers' can do to help make it easier on you.
Stick with us and we will help get you thru whatever you may be facing.
Thanks Christine. What is your opinion on Keytruda versus the standard care for SCC.
Without a medical degree or years of medical training Im speaking as just another OC patient/survivor. Our sites members are like me, not medical professionals so its not always easy to give answers to complex questions. What Ive heard about Keytruda is its one of the new immunotherapy drugs that has shown great results in OC patients who trialed it when they were diagnosed with OC mets to the lungs. Im very sorry but as far as Ive heard Keytruda has not yet been used in place of the usual chemos (cisplatin, carboplatin, erbitux or 5FU). Of course since Keytruda is so new, its probably just beginning to become an option. You are the first one here Ive seen have a choice of getting Keytruda instead of the other chemos normally given. Being that your tumor is HPV+ you should have a better response to treatments and have less of a risk for a recurrence than other patients who had other things (like tobacco, trauma, etc) cause their OC.
One thing I would ask your doc is instead of the larger doses of chemo if you are able to be given smaller weekly doses. Most patients find the weekly doses much easier to tolerate and they have less severe side effects. Its worth a shot to ask and see what your doc says.
Best wishes with these difficult decisions!!!