#37375 05-12-2004 08:32 AM | Joined: Aug 2002 Posts: 76 Supporting Member (50+ posts) | OP Supporting Member (50+ posts) Joined: Aug 2002 Posts: 76 | This was in Tuesdays Detroit Free Press. The doctor in this is Dan's Oncologist. I thought it great that it was in our paper. This is the first time I have ever seen anything related to Oral Cancer printed in the Detroit area.
"Patients with advanced head and neck cancers do better if chemotherapy is added to the radiation and surgery they now receive, two new studies suggest. The findings shuld change the standard of care for people with such high risk tumors, said Dr John Ensley, pare of a team that piloted the combination treatment in the 1980's at Barbara Ann Karmanos cancer Institute and its affiliate Wayne State University School of Medicine. It has also become the accepted treatment for several other types of cancers, including nasopharyngeal tumors in the region that connects the mouth and nose to the esophagus. The regimen gives 6-8 weeks of radiation treatmens and high doses of chemotherapy on the first, 22nd, and 43rd days of radiation. This particular regimen has hit a home run every time said Ensley, head of oncology for the Karmanos head andneck cancer team. It comes at a cost. Complications included four deaths about 2 percent of patients in one study. One in four had side effets, including mouth sores and stomach problems. About 5 percent had such severe mouth sores that they will need feeding tubes for a lifetime. (Dan got treatment for his mouth sores and was fine) The research was reported in the May 6th issue of the New England Journal of Medicine. Head and neck cancers include tumors of the tongue, mouth,nose and throat. They are the 6th most common type of cancer worldwide. About 37,000 cases are diagnosed in the United States each year. They are among the more difficult to eradicate. They often recur despite surgery and radiation and kill more than half the patients diagnosed with them within 5 years said Dr.Bruce campbell a Milwaukee doctor who helped conduct one of the studies. The new research involves advanced squamous cell tumors, which originate in cells lining structures in the head and neck and often spread to nearby lymph nodes. Smoking and other tocacco use accounts for 85 percent of the cases. One study involved more than 400 AMerican patients, half of whom got radiation and the others radiation plus the drug "cisplatin" between 1995-2000. After 2 years 82 percent of those who got chemo had their cancer controlled, compared to 72 percent who got radiation alone. There was no difference in overall survival perhaps researchers say, because of high rates of deather from other diseases related to smoking and alcohol ue, also common among people with head and neck tumors. The second study found chemotherapy improved survival. It was done in Europe and involved more than 300 patients. Five year survial was 53 percent in those who got chmeotherapy and 40 percent for those who got radiation alone. Ensley and others expect that the longer studies are conducted more survival benefit will be apparent.
Sherrie wife to Dan, Tonsil cancer survivor, Stage IV diagnosed July/2001
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#37376 05-12-2004 08:33 AM | Joined: Aug 2002 Posts: 76 Supporting Member (50+ posts) | OP Supporting Member (50+ posts) Joined: Aug 2002 Posts: 76 | Sorry about the typos, I have RA and have a hard time typing, but I should have been better with re-reading my errors!!
Sherrie wife to Dan, Tonsil cancer survivor, Stage IV diagnosed July/2001
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#37377 05-12-2004 08:52 AM | Joined: Feb 2004 Posts: 372 "Above & Beyond" Member (300+ posts) | "Above & Beyond" Member (300+ posts) Joined: Feb 2004 Posts: 372 | Sherrie Lynn, Thanks so much for the information. It's helpful to know that hopefully the chemo will add to the success of some of our treatments! God Bless, Debbie
Debbie - Caregiver for husband, Dan, diagnosed with tongue cancer 7/03. Partial gloss., mod. neck dissections, graft. Recurrence neck tumor 12/03. Radical left neck dissection 12/24/03-unable to get all the tumor. 8 weeks chemo/rad beginning 1/12/04.
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#37378 05-12-2004 11:22 AM | Joined: Dec 2003 Posts: 2,606 Likes: 2 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Dec 2003 Posts: 2,606 Likes: 2 | Sherrie,
Thanks for the article. It sure put a little pep in my step to know I had this treatment plus a few extra weeks of radiation.
Ed
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
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#37379 05-12-2004 12:35 PM | Joined: May 2003 Posts: 928 "Above & Beyond" Member (500+ posts) | "Above & Beyond" Member (500+ posts) Joined: May 2003 Posts: 928 | Sherrie, Thank you for taking the time to type all this . It must have been painful for you with the RA. My husband also received this protocol , he is doing absolutely wonderful. This has given us an extra little bit of hope. Cheers Marica
Caregiver to husband Pete, Dx 4/03 SCC Base of Tongue Stage IV. Chemo /Rad no surgery. Treatment finished 8/03. Doing great!
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#37380 05-12-2004 12:36 PM | Joined: Dec 2003 Posts: 116 Gold Member (100+ posts) | Gold Member (100+ posts) Joined: Dec 2003 Posts: 116 | Thanks for the info but the % indicated can vary depending on the area of cancer. These appear to be general % but will vary by type.
SCC R-Tonsil T2 NO MO Dec 2003. Completed IMRT Radiation only to tonsils(72Gy) and neck(55Gy)March 04. Detected at age 50.
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#37381 05-12-2004 12:43 PM | Joined: May 2004 Posts: 218 Gold Member (200+ posts) | Gold Member (200+ posts) Joined: May 2004 Posts: 218 | Sherrie Lynn,
Great stuff. Wonderful. Glad to hear that the medical community is publishing this in local papers.
I wish I could shout it from the roof tops.
I talk to so many people that still receive surgurey and radiation alone.
Why cant the medical profession as a whole agree that this is the benchmark protocol to this point? Arent they all on the same team?
Just my two cents.
Thanks, Robert
SCC 1.6cm Right Tonsil 10/3/03, 1 Node 3cm, T1N2AM0, Tonsil Removed, Selective Neck Disection, 4 Wks Induction Chemo (Taxol,Cisplatin), 8 Weeks Chemo/Radiation (5FU,Hydroxyurea,Iressa), IMRT x 40, Treatment Complete 2/13/04. 41 Years Old At Diagnosis
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#37382 05-12-2004 01:10 PM | Joined: Nov 2002 Posts: 3,552 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Nov 2002 Posts: 3,552 | This is a definite improvement in the numbers since the last study which put the benefit of chemo at only 6% (combined with radiation) or so (the chemo they are talking about is Cisplatin).
The studies were originally printed in the New England Journal of Medicine.
I forwarded transcripts of the original report to Brian last week.
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)
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#37383 05-12-2004 02:15 PM | Joined: Jul 2003 Posts: 1,163 Patient Advocate (1000+ posts) | Patient Advocate (1000+ posts) Joined: Jul 2003 Posts: 1,163 | Gary,
All the good news about using chemo along with and during radiation makes me wonder why it was never mentioned to me. I made my decision in July to have the surgery followed by radiation based on what my ENT and the tumor board suggested. Chemo was never mentioned. It's easy to look back and say I should have done this,or that. Even though I was a stage 4, tonsil tumor without node involement. After having a 15 hour surgery and the resulting quality of life issues I do wonder about my decision. You did so well without surgery it makes me wonder. I'm sure your quality of life issues pale compared to those who had major surgery. Each swallow is a thought out process, each drink of milk is done over a towel. It takes me 45 minutes to eat what I used to eat in 15. My choices of food are based on if I can eat it and how long will it take, I'm having my second Pet/Cat scan next Wed the 19th. I am dreading the results. I almost feel like cancelling it and only go back if I think "It's Back".
I like hearing about survival improvements however I don't feel it will effect my odds.
Dan
Daniel Bogan DX 7/16/03 Right tonsil,SCC T4NOMO. right side neck disection, IMRT Radiation x 33.
Recurrance in June 05 in right tonsil area. Now receiving palliative chemo (Erbitux) starting 3/9/06
Our good friend and loved member of the forum has passed away RIP Dannyboy 7-16-2006
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#37384 05-12-2004 04:07 PM | Joined: Aug 2003 Posts: 1,627 Patient Advocate (1000+ posts) | Patient Advocate (1000+ posts) Joined: Aug 2003 Posts: 1,627 | My team decided against chemo. They said my one lymphnode was contained and that the chemo would be to take care of any distant mets which they didn't feel I had. Also that my tumor was well-differentiated and would respond well to radiation. Not sure if I'm saying this correctly. I do know that if I were NOT having surgery that I would want the chemo. I trusted the choice my doctors made at the time and still do.
SCC Left Mandible. Jaw replaced with bone from leg. Neck disection, 37 radiation treatments. Recurrence 8-28-07, stage 2, tongue. One third of tongue removed 10-4-07. 5-23-08 chemo started for tumor behind swallowing passage, Our good friend and much loved OCF member Minnie has been lost to the disease (RIP 10-29-08). We will all miss her greatly.
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