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#191040 10-26-2015 08:18 AM
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My question is about chemo and clinical trials. My mom has endured two hemiglossectomies, radiation, and chemo in the span of 10 months. Sadly, my sweet mom has just found out this morning that her cancer is back for the third time in as many months (I guess it never really left). It's in the area of her tongue and throat that has been removed twice, and she now has an additional spot. This is just in 3 months since her surgery in July with clear margins and nodes.

We are told at this point that surgery is not an option this time because recovery from this surgery was already very complicated. Radiation is not an option for her either, because again, she's still healing from her first go round with radiation. Chemo was difficult for her, too. We have a meeting this week to talk about chemo options to extend life. I know it's not considered curable at this point, but I'm wondering whether anyone with a "recurrence" has had any luck with chemo alone in terms of pain management and control of tumor growth? What chemo regimen?

I am also wondering if someone like my mom-in her early 70s, advanced cancer resistant to treatment, tough but been through the wringer-would be a candidate for any clinical trials. I love her so much and would miss her horribly (as would the rest of her family), but I'm not afraid of her death (I know we all die). I just want her to have some good days ahead, and I'm terrified that may not be in the cards for her. Sorry for the desperate ramblings.


Mom (beautiful soul) 12/4/14 SCC L tongue (neg. biopsy 10/14);
1/8/15 hemiglossectomy/neck dissection: T3N1, extracapsular extnsn, PNI, pseudoglandular/spindle cell, margins not clr;
2/2/15 RT/carbo/taxol;
4/15/15 CT clr;
5/15 neuropathic/trigeminal pain/headaches;
6/15 recurrence flap margins/BOT; cancer encroaching skin
7/23/15 hemiglossectomy; clr margins & nodes
10/22/15 CT: nasopharyngeal tumor, jaw, and necrotic nodes; tumor under chin/corner of mouth
11/5/15 left cancer behind




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You are such a clear thinker and so loving to your mother. She must be very proud of you. I don't know much about palliative chemo or clinical trials but others will have some idea. I hope there is something that will help her. I'm very disappointed that it came back and wish you both well. Your expression "been through the wringer" is so apt. I often think there's only so much a body can take and then something else is hurled at me but my gaps in between have been prolonged and I just wish that had been the case for your mum.


1996, ovarian cancer surgery + cisplatin and taxol.
September, 2007, SCC of left lateral tongue. Excision.
October, 2009 recurrence in scar tissue, T1NOMO. Free flap surgery from left wrist - neck dissection. 63 year old New Zealander. No chemo, no RT.
February, 2014. New primary in left buccal mucosa. Marginal mandibulectomy, neck dissection, right arm free forearm flap. T1N0M0 but third occurrence and some areas of concern: RT started 8 April and finished 19 May.
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Im so sorry your mother is going thru this again.

There are some promising trials that have been discussed on the forum. Take a look at Brian's posts to get the specifics. Hopefully one of the trials would be an option for your mom.

Best wishes with everything.


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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Thank you, Alpaca and Christine. Always comforting to hear from you. I was hoping for a larger gap, too. But here we are. Based on her really ugly CT scan, it appears she now has a nasopharyngeal tumor, as well as a spot adjacent to her jaw and two necrotic nodes-one on the left and one on the right. She will probably begin the palliative chemo assuming she can tolerate it. We'll continue to look for possible trials, but the rapid progression of this cancer is frightening. Of course we're hoping for for more quality time and a little symptom relief once the chemo starts, but given the gravity of this, we've been asking her friends and family to send her letters or cards sharing nice memories they've had with her, so that we can read them with her and then eventually share them with her grandkids. Not giving up. Just trying to be prepared. I hope you are doing well.


Mom (beautiful soul) 12/4/14 SCC L tongue (neg. biopsy 10/14);
1/8/15 hemiglossectomy/neck dissection: T3N1, extracapsular extnsn, PNI, pseudoglandular/spindle cell, margins not clr;
2/2/15 RT/carbo/taxol;
4/15/15 CT clr;
5/15 neuropathic/trigeminal pain/headaches;
6/15 recurrence flap margins/BOT; cancer encroaching skin
7/23/15 hemiglossectomy; clr margins & nodes
10/22/15 CT: nasopharyngeal tumor, jaw, and necrotic nodes; tumor under chin/corner of mouth
11/5/15 left cancer behind




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Sorry to report that my sweet mom died last Thursday. It was very hard to watch her transition from life to death over the course of two days, but we made the most of our time together. The night before she grew unresponsive, we talked about life, joyful times, favorite memories, religion, and then early the next morning she began struggling to breathe. She was never responsive again after that, and she died the next night. During those two days, she had visits from close friends who told her goodbye, we read letters from family and friends, read poems, played music, and she was surrounded by family and next to her dog when she took her last breath and left her broken body. We will miss her terribly. We learned so much from her. She was hopeful until the very end of her life. I'll be thinking about you all and wishing you good health. I think the science is coming around, and we'll have some better options soon.


Mom (beautiful soul) 12/4/14 SCC L tongue (neg. biopsy 10/14);
1/8/15 hemiglossectomy/neck dissection: T3N1, extracapsular extnsn, PNI, pseudoglandular/spindle cell, margins not clr;
2/2/15 RT/carbo/taxol;
4/15/15 CT clr;
5/15 neuropathic/trigeminal pain/headaches;
6/15 recurrence flap margins/BOT; cancer encroaching skin
7/23/15 hemiglossectomy; clr margins & nodes
10/22/15 CT: nasopharyngeal tumor, jaw, and necrotic nodes; tumor under chin/corner of mouth
11/5/15 left cancer behind




Joined: Jun 2007
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Im very sorry for your loss. May she rest in peace, free from pain and sickness.

You were a wonderful caregiver. In time the memories of happier, healthier times will bring you comfort.


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
Joined: Apr 2015
Posts: 91
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Posts: 91
I am sorry to hear about your mother. Sounds like you are a great daughter. Denise


Biopsy tongue 3/24/15
Diagnosis SCC tongue/floor of mouth
Partial glossectomy, resection and right neck dissection done
4/22/15
T2aN0M0
05/01/2015-no further treatment indicated at this time,
monthly check ups for two years
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I am so sorry you lost your mother. My heartfelt condolences to you and your circle of family and friends.


SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
Joined: Mar 2011
Posts: 1,024
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So sorry. You are indeed a Wonderful Daughter.
Tammy


Caregiver/advocate to Husband Kris age 59@ diagnosis
DX Dec '10 SCC BOT T4aN2bM0 HPV+ve.Cisplatin x3 35 IMRT.
PET 6/11 clear.
R) level 2-4 neck dissection 8/1/11 to remove residual node - necrotic with NED
Feb '12 Ca back.. 3/8/12 total glossectomy/laryngectomy/bilat neck dissection/partial pharyngectomy etc. clear margins. All nodes negative for disease. PEG in.
March 2017 - 5 years disease free. Woohoo!
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"OCF Down Under, Kiwi"
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My condolences. You painted such a lovely picture of your mother that she will stay in my mind. Much love.


1996, ovarian cancer surgery + cisplatin and taxol.
September, 2007, SCC of left lateral tongue. Excision.
October, 2009 recurrence in scar tissue, T1NOMO. Free flap surgery from left wrist - neck dissection. 63 year old New Zealander. No chemo, no RT.
February, 2014. New primary in left buccal mucosa. Marginal mandibulectomy, neck dissection, right arm free forearm flap. T1N0M0 but third occurrence and some areas of concern: RT started 8 April and finished 19 May.
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