Hello guys,

My mother-in-law is done with her chemotherapy - 3 once a month. It was confirmed that she has stage 4 oral cancer since the cancer spread to her jaw bones. My mother-in-law will NOT be having radiation treatments since her body is too weak to even survive it. They are considering another 3 chemo treatments then that would be the last she will get.

The question to you guys is: If there is no radiation what are they trying to accomplish? Does it mean that she will deteriorate in time? Does it mean her cancer will reoccur can reoccur?

Thanks

Ina,

The treatment your MIL is receiving can only be described as palliative since chemo alone will not stop head and neck cancer if there was any left after surgery.

Your question about what they are trying to accomplish is a good one to ask the doctor. Also, ask about clean margins during surgery. This is something that needs to be discussed with both your MIL and the family.

Wishing you strength right now,

Deb

Ina, Im not sure why she would have been given chemo. But being in a another country where medical care is different, its hard to understand the why behind what is being done. Sorry but I really dont have any idea why she is being treated like she is. Chemo alone wont get rid of cancer if its present. All it will do is to keep her stable and to help stop cancer from growing. That is if she has cancer, it may have been completely removed during her major surgery a few months ago.

Not knowing all the facts about the surgery pathology leaves question what the next step is, and increase chance of recurrence or spread. In T4N0M0 oral cancer there are several ways to go, and just surgery alone is one of them, and radiation can be optional, depending on surgery, scan results, according to NCCN guidelines, if you care to look at that, but chemo alone after surgery is not listed in T4, except for for T4b, very advanced cancer, where single agent chemo treatment can be used probably due to limited choices. Everyone's situation is different, and health status has an effect on choices, and these are just guidelines.

http://oralcancerfoundation.org/treatment/pdf/head-and-neck.pdf

Hello I just a talk with my inlaws and I was told that the cancer has spread to her lungs that is why they are doing chemo. I need to clarify things with them since the conversation was brief. Thanks

There are different chemos used for different cancers. What would work to keep her stabilized for the SCC OC may not work for the lung cancer. I know how difficult it is for you to get a clear picture of whats going on over there and also with the lack of involvement with other family members. Its a hard situation for everyone involved, especially Joyce.

Wishing you all the best with all you try to do to help. Pretty hard to be a caregiver from the other side of the world but you are doing your best to pass along correct medical procedures and info. Im sure it helps!

Hello again, Joyce oral cancer met to her lungs. My sister-in-law spoke to the oncologist and she was told that Joyce's oral cancer has metastasize to her lungs. Joyce has small Metastatic tumors scattered throughout the lung. The chemo she is having is no longer for her oral cancer but for her lungs.

Treatment plan: CT Scan will be done in 2 weeks (from the date of her last chemo which is Jan 9). If the tumors decrease in size she will have another 3 chemo treatments. If there is no change then the treatments will stop and her condition will be monitored every 3 months.

Now I understand. Thanks for clarifying! Unfortunately, I dont know much about lung cancer. Even though its common with OC patients to have mets to the lungs, its not something I have learned very much about as members with this condition dont post much about their condition.

Wishing your family and Joyce all the best with everything!

Christine,
I just sent an email to my SIL to ask the doctor the primary aim of the chemo, truthfully I think it is more of palliative care and no longer a cure.

Since her first surgery they have been saying clear margins, that was the tongue cancer. this time they are saying clear margins again.

Honestly MIL never not undergone a PET scan due to cost. But CT has been done a couple of times. Next CT is in 2 weeks. That will be the determining factor of the treatment.

Thanks for all the help

This is sad - have they biopsied her lungs at all. I'm not sure if she's a smoker or was or lives with someone who is - but to assume that her lung cancer is OC mets - though likely correct - should be confirmed - as chemo is specific to certain cancers - it does sound like what they are doing for her is palliative. I'll say a prayer that the chemo does it's job. Hugs!

Yes Cheryl it is OC mets. My FIL used to be a smoker until the age of 35. We will be certain about the final prognosis in a few weeks after the CT-Scan. I am not sure about the biopsy but based on her email, there were several small tumors all over her lungs.

This looks like palliative care for end of life treatment.

This is how they explained palliative care to me when U of M was going to start that course of treatment.

They put you on a chemo program and monitor how effective it is. The goal is to stop the growth or even shrink the tumors. If this is working they continue until it stops working. Once it stops working they just monitor you.

On average, the chemo adds 2 to 4 months of life before it stops working. Some patients can go out 18-24 months but this is rare. The average survival time for an oral cancer patient once on palliative care is 9 months.

Lucky for me I had a trial I qualified for and could opt out of the U of M plan. If I had no other choice I was wondering if I would have subjected myself to all the chemo side effects for just a few months� time.