Hello guys I am back. Joyce just had her 2nd chemo last week with an interval of 24 days. Her treatment is very conservative due to her kidneys (last stage before dialysis). She is having a hard time after treatment #2 and extremely weak even after 10 days of treatment. Her next treatment is scheduled in January depending on her strength. Kindly let me know if this is something you have experienced or heard of - extremely conservative treatment of one a month and only 3.

Thanks to all and keep Joyce in your prayers

What exactly is her current treatment? Maybe update your Signature Line.

Hello David,
Unfortunately the only thing I know is that she had first treatment of chemotherapy November 12 and the next one was given December 13. They did not follow the 21 day treatment because her blood count was so low.

CURRENT UPDATE WITHIN THE LAST HOUR FOR SISTER-IN-LAW: Just spoke to her, she had to reschedule her appt. She is so weak, she cannot get out of bed. Her whole body aches and she cannot sleep. She also has a cold and cough, but she said that this is in her list of side effects. The appt. has been rescheduled for December 27.

They may be using chemo as maintenance chemo, palliation, pain management, not for curative intent, since it's usually not given alone for SCCHN, but they are given alone as induction chemo before treatment, as adjunct therapy, as a radiosensitizer before or during radiation, and to reduce tumor size before surgery, radiation, if any of these are planned. There are chemo's like Carboplatin that don't effect the kidneys as much as well as Erbitux, others, but don't know if these are being given. Low WBC makes you susceptible to illness, and infection, and usually give Neupogen shots to help increase WBC, but they also make the bones, and joints ache. Maybe your MIL should go to the ER to get checked out being she is so weak, and there could be a multiple of things wrong. Good luck.

Ina, so sorry to hear Joyce isnt doing very well. Best thing to do is to push the hydration as much as possible. A minimum of 48 oz daily, in her situation with kidney issues 60 oz a day probably would be much better for a minimum. Nutrition must be difficult for her right now. If she is able to take in enough nutrition and hydration she will feel a little better. The hospital should be able to get her hydrated in the chemo lab with a doctors prescription. At least thats how its done here. She would feel much better being hydrated so please pass that along to your caregiver relatives.

Best wishes with everything!!!

Hello Christine and all thanks for your reply!!

I have a question about treatment. Can my mother-in-law be treated with chemo and NOT radiation?

2010 The first time they found CA on her tongue, she had surgery and NO Chemo and NO Rad.

2012 Partial Mandibular Dissection 3 series of Chemo (once a month) for 3 months. NO RAD.

I know she is very weak and being 5'5 she only weighs 89 lbs as of Nov 12 when I was there.

My in-laws are afraid to ask the doctors about her prognosis, we are all in the dark.

I hope some can shed us some light...

Thanks in advance.

Yes. On rereading your timeline, I see your MIL had surgery in October. Besides what I mentioned above, Adjunct chemo, secondary to primary treatment, can be done also. I don't know what the weight was before, but if more than 10 percent weight loss occurs, it's a concern, and some type ot intervention is needed for cachexia or wasting syndrome, which has an effect on prognosis. She may need a peg or nasal tube for nutrition, IV fluids or TPN feedings, and other medications to help her, and not being able to get out if bed it is serious, besides other mentioned ailments, so I suggest seeing a doctor, ER ASAP. Even call an ambulance if needed. That's what I had to do for myself, and wound up collapsing and in ICU for a month, hospital for 6 months with every possible ailment. Things can go downhill quickly.

Ina what is the purpose of her chemo - ? That what you need to ask - chemo will not cure this cancer -. Take care and sorry she's still struggling.

Ina, gosh I am so sorry about what your mother in law is going thru!!! She must get nutrition and hydration!

I know you are always the last to know and with her being in another country its not very easy to help her. Its unusual to give chemo 'just because'. Since she is in such bad health right now Im wondering why she even is getting chemo at all. The usual treatment (had she been here in the US) would have been radiation to kill the cancer. Do you think the doctors didnt get clean margins or get all the cancer with her surgery? That could be the reason for the 3 months of chemo.

By itself, chemo will not cure her of cancer. Chemo is a helper that goes with radiation to help make it a more effective tool.

I would suggest to her caregivers to take this alot more seriously. Just like with everything else she has been thru, they need to understand this is a life and death disease. I know you are trying to help but it doesnt always go over that well and they dont always listen to your info you pass along. Maybe you could somehow save this thread and email it to them with all the responses. If they can see what experienced forum members are saying would it make a difference to them? Maybe, its worth a shot!

Ina, wishing you and your family Happy Holidays!!!!

My sister-in-law is going home to be with her for her final treatment in January 2013. I think it is more of being in denial. when I said that her cancer is stage 4 since it has reached the mandible they said it was so small and that is just beginning stages. Being an inlaw is not easy at all. I seem to be the bad guy. They won't read or research about oral cancer.

In reference to her lungs, they said that the chemo was a precaution to stop the spread of the cancer to her lungs. But now she has bad colds and coughing.

Thanks for all the advise and it is so nice to have all of you!!

God bless to all and have a Merry Christmas and a Prosperous New Year!! Most of all good health and long life to all members and care givers.

Here in the US it is not normal to treat something before its a problem (chemo to prevent mets to the lungs). Thats why we all have had such a hard time understanding why she was given chemo.

From what I went thru I was told, when the cancer invades the jawbone then it would automatically be a Stage IV diagnosis even if caught early. Mine was very early but it was also very fast moving and grew significantly between when I was diagnosed and 2 months later when I had the mandibulectomy.

Since your sister in law is going over to be with her, maybe you can try to get her involved with the forum or print things out to show her. I know its a difficult situation and it can so easily be taken wrong so you have to tip toe around. By talking about it clinically and not mentioning Joyce's name, avoid saying words like "I", "ME", and "YOU" it can be discussed in a different way so its not like picking sides, giving unwanted advice or scolding anyone.

There are alot of people who put their heads in the sand and put all their trust in their doctors. They dont want to know things and by not knowing it cant hurt them..... or so they think. Knowledge is power and helps to ensure Joyce gets the very best treatment where her best interests are always top priority. Boy is this difficult being around the world!

Wishing you and your family all the very best and happy holidays. Good health to all (especially Joyce) in 2013!

((HUGS))

Hello Christine and everybody,

My husband told me that the reason for the conservative treatment is due to the fact that my mother-in-law is weak. She is 5'4 and 88 pounds (lost 30 pounds since her glossectomy in 2010 and never gained weight back), she has an enlarged heart and stage 4 kidney (meaning if the health of her kidneys deteriorate she would ne dialysis). So basically there is nothing much they can do.

Her chemo is only 1 session once a month. She is usually very weak for the first 3 weeks. Originally they planned to give her chemo every 21 days but they had to delay it since she is weak.

I am not sure what they are trying to achieve with her current treatment but that is the most they could give her with her current medical condition.

I hope to hear your opinion about this. Thanks to all.

Please let me end with a quote:

"What is Christmas? It is tenderness for the past, courage for the present, hope for the future. It is a fervent wish that every cup may overflow with blessings rich and eternal, and that every path may lead to peace."
Agnes M. Pharo

Last night around midnight, we called Joyce to ask her how she is. Her last chemo was in Dec 13. Dec 27, she met with her oncologist and she is scheduled her next chemo Jan 9, 2013. Her blood count is low and she is weak. According to my sister-in-law, she is very fragile and weak to undergo radiation as of the moment. However, everything will be reevaluated after her final treatment Jan 9. My oldest sister-in-law is going to be with her for 6 weeks. Please include her in your thoughts and prayers. Thanks

You have my prayers and thoughts coming your way. Hugs and healing vibes...