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#1262 05-30-2003 07:38 AM
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DavidD Offline OP
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Hello everyone,
I have a question for you. As I read the postings on the site, most have had Chemo as part of their treatment program. Has anyone been told by their Doctors that Chemo does not have an effect on this type of cancer?
The reason I ask is because this is what I have been told. I am curious if this is just an opinion of Doctors in my clinic or the opinion of Doctors in Canada or is it a wide spread opinion. Any information would be greatly appreciated.
David

#1263 05-30-2003 08:26 AM
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David, we were told by our doctors that chemo, when combined with radiation, could be a "radiosensitizer". It could enhance the effectiveness of the radiation. The study that we were given to read indicated about a 2-3% improvement in recurrance rates using chemo. My husband had 4 chemo treatments during his 7 weeks of radiation. The chemo part was very hard.

Anita


Husband Dx 12/02 Stage 4 Tonsil Cancer T1N2bM0; surgery, radiation, chemo 1/03 - 4/03.
#1264 05-30-2003 09:01 AM
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Hi David, Just to let you know. My brother in law had 4 chemo treatments, once a week for 4 weeks. This while having rad once a day. His doctors said that the chemo would hopefully kill any cancer cells that broke away from the primary tumor and tried to settle somewhere else. I hope this info helps. I would also be curious to know your doctors response to this idea. By the way, my brother in law is being treated at the Cox Cancer Center at MGH in Boston. Gwenny

#1265 05-30-2003 10:17 AM
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I was told that in 1997. In 2001, there were trials for Erbitux that were no longer open that seemed to be having some success in head and neck cancers, but they didn't feel that chemo would help my cancer of the larynx, but then I could not couple it with radiation since I had already had it. Maybe some of the newer chemo drugs have a better success rate than they use to with head and neck cancers.

Eileen


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
#1266 05-30-2003 10:34 AM
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I also took chemo 4 times along with radiation. This was part of a study being conducted at MD Anderson. It is believed that the chemo when used in these situations enhances the effectiveness of the radiation in eradicating the cancer. In my case it got rid of both the base of tongue tumor and the neck nodes. That is the good news. However I still have difficulty swallowing 9 months after treatment ended, and the doctors also attribute the difficulty to the number that the chemo/radiation combination did on my throat.

Danny G.


Stage IV Base of Tongue SCC
Diagnosed July 1, 2002, chemo and radiation treatments completed beginning of Sept/02.
#1267 05-30-2003 11:17 AM
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Like Anita and Danny, we were told the chemo is used to enhance the RAD and also to clean up any errant cells. We also were told that the reason chemo isn't used alone is because chemo targets fast growing cells. Since a lot of the head and neck cancers are slow growing, chemo usually isn't effective by itself.

With Heather's recurrence, it looked like the cancer had changed and was now growing very rapidly, so there was a better chance that the chemo would work. If the tumor would have been operable, though, I think the docs would have recommended surgery. Even though the cancer was now growing fast, they still didn't hold out much hope that the chemo would work. Of course, so far it looks like it is.

So it seems that for a primary tumor, chemo is not the way to go except used in conjunction with radiation. For a recurrence, however, sometimes it is a viable choice. Good luck.

Rainbows & hugs, wink
Rosie


Was primary caregiver to my daughter Heather who had stage IV base of tongue SCC w/ primary recurrence. Original diagnosis August 21st, 2002. Primary recurrence March 18th, 2003. Died October 6th, 2003.
#1268 05-30-2003 04:30 PM
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Hi David,
There are many different types of chemo. One type that is used a lot with head and neck cancer is Cisplatin or Platinol which is a radiation enhancer. I know people with other forms of cancer that are being successfully treated with chemotherapy only. In my case I had 2 treatments
of Cisplatin (I don't think I would have lived through any more! lol) The oncologist told me that the radiation was THE tool for killing the cancer, not the chemo. In fact, the chemo only gave me a couple of percentage points of improvement in the odds. There was a recent study done that also stated the benefit of Cisplatin was marginal at best.

This site has a current listing of FDA approved oncology drugs:

http://www.fda.gov/cder/cancer/druglistframe.htm

And then there was this study from John Hopkins:

http://www.hopkinsmedicine.org/press/2002/MAY/020518.htm

Your Canadian docs may have read this.

Many times combinations of chemo agents are used and many times they are used in as an adjunct to surgery and/or radiation.

Chemo is a very complex subject and many advances in cancer treatment are being made here all the time.

Regards, Gary Allsebrook


Gary Allsebrook
***********************************
Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
________________________________________________________
"You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
#1269 05-31-2003 03:05 AM
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Hi David, I did not receive chemo either, and in fact the ENT said much the same thing about chemo not having much effect on my type of cancer. Since he is the surgeon perhaps he is not quite on top of the latest and greatist chemo options. I don't know and that was over 2 years ago. I did ask him if there were other treatment options and his said yes some minor differences but they all have similar outcomes. Based on how chemo affects people I am pretty happy I didn't get it.

It seem that cutting out as much as you can and then blasting the rest with photon torpedoes (or vice versa) is pretty normal. If your cancer was caught early then, since the cure rate is higher, the risk of chemo perhaps was too high in relation.


Gary, help me out here your link headline said "no appreciable difference" getting chemo vs just radiation alone but further down was this:

"In a preliminary analysis after two years, researchers found no significant difference between the two groups in the percentage of patients remaining cancer-free. The cancer recurred in 26 percent of patients receiving radiation alone and in 20 percent of those receiving chemotherapy and radiation. There also was no significant difference between the two groups in overall survival


Mark, 21 Year survivor, SCC right tonsil, 3 nodes positive, one with extra-capsular spread. I never asked what stage (would have scared me anyway) Right side tonsillectomy, radical neck dissection right side, maximum radiation to both sides, no chemo, no PEG, age 40 when diagnosed.
#1270 05-31-2003 04:53 AM
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Mark,
I'm with you! The study is more than a year old..lots can change in a year...but besides that...the study only focused on one radiation enhancing drug. What about the others? Moreover, I would think a 6% reduction in recurrence and a 6% increase in survivial is incrediably significant to those who fall into those groups. Given the option for an additional "insignificant" 6% chance of survival I think I prefer to decide what my standard treatment would be. Of course, I say this not having gone through this myself but faced with the fight I'd pull out all the weapons.

Also note that this was a press release and the full study review might give more information.


Amy
#1271 05-31-2003 06:30 AM
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DavidD Offline OP
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From what I have gathered from all of you so far, the chemo has pretty much been in combination with the radiation. I was not given that option or was it even talked about 8 years ago. They did not even think that I needed to have radiation. It was my surgeon that suggested I go ahead with the radiation treatments. He said if it was him he would not be taking any chances. As I have said before I trust him and his opinion. However, with this recurrence when I asked about chemo I was told it would not help. My thoughts are would it not clean up any radicals who want to find a new place to settle?
Any other thoughts on that.
David

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