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#81021 09-23-2008 10:53 PM
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marma Offline OP
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My father in law has been on 4 cycles of Erbitux and 16/30 IMRT sessions. In the last few days the ulcers on his lips have become large and white in color and his lips are swollen. The medical oncologist said that this is mucositis and that because of this he is stopping the Erbitux for now. I am concerned that stopping will have even more harm than the mucostitis and wanted to know if anyone shares a similar experience or knowledge of this issue?

I have much more to share but will do so in another post about what I have learned about oral tongue cancer.



FIL completed treatment 10/08. CG to father in Law in india who had SCC oral tongue T2N2M0. FIL underwent surgery, neck dissection, IMRT, and erbitux without losing weight or getting nauseated. Completed October 2008. SO far so good.
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During my treatment, I missed a week of chemotherapy (cisplatin & Erbitux) since I was having my PEG tube put in and the docs wanted me to avoid any nausea for the procedure. I was also concerned, but the docs explained that Erbitux has a very long half-life and stays in the body long after the dose is administered. Because of this, they were willing to skip a week.

After my treatment ended, I'd say it took a full four weeks for the side effects of the Erbitux (the rash and cracking skin) to clear.

Hope this helps.

- Margaret


Stage IV SCC lt lateral tongue, surgery 5/19/08 (partial gloss/upper neck dissection left side/radial free flap reconstruction) IMRT w/weekly Cisplatin & Erbitux 6/30/08, PEG 1 6/12/08 - out 7/14 (in abdominal wall, not stomach), PEG 2 7/23/08 - out 11/20/08, Tx done 8/18/08
Second SCC tumor, Stage 1, rt mobile tongue, removed 10/18/2016, right neck dissection 12/9/2016
Third SCC tumor, diagnosed, 4/19/2108, rt submandibular mass, HPV-, IMRT w/ weekly Cisplatin, 5/9 - 6/25/2018, PEG 3 5/31/2018
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marma Offline OP
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Thanks Margaret. My FIL has the rash also but no cracking that I know of. I hope his Erbitux is resumed.


FIL completed treatment 10/08. CG to father in Law in india who had SCC oral tongue T2N2M0. FIL underwent surgery, neck dissection, IMRT, and erbitux without losing weight or getting nauseated. Completed October 2008. SO far so good.
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Different chemo but missed one dose picked up a couple of weeks later. Make sure they are doing all they can for him to get better.

Every day is different,
Cray

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Marma,

The most important treatment is the radiation so if he has to give up the Erbitux so be it as far as I'm concerned.


David

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
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marma Offline OP
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Papa has recovered form the mucositis and will be on his Erbitux again starting tomorrow:-)


FIL completed treatment 10/08. CG to father in Law in india who had SCC oral tongue T2N2M0. FIL underwent surgery, neck dissection, IMRT, and erbitux without losing weight or getting nauseated. Completed October 2008. SO far so good.
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I just read some interesting information on how Erbitux works. When used in conjunction with radiation, it "...makes the cells less likely to recover after radiation".

Evidently the researchers have found that RT on certain cancer stem cells "may actuate a signaling pathway that alerts the cancer stem cells to start repairing themselves" (this was discovered in a study on breast cancer so I do not know how applicable this is to H&N cancer) but the article goes on to say that ""it (Erbitux) has been especially helpful in lung and head and neck cancers".

To summarize the article, multimodality treatment protocols can "maximize the chance that we'll win"

The research was done at UCLA by Dr. Hak Choy.
Cure Magazine, Special Issue, Volume 7, 2008, page37

Last edited by Gary; 11-21-2008 09:20 AM.

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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Marma

Good to hear that your father in law is back on the Erbitux. While dropping Cisplatin treatments may be no big deal ( I never took it, but David did and his post speaks for itself)- that's not what I was told about Erbitux as a single agent My RO was insistent that even with the thrush, mucositis, etc in my mouth, my best chance for a cure was to have all 8 of my Erbitux treatments done each week. He was open to postponing the last one for one week -based on the half life build up but I was able to do all 8 non stop. More than a year ago, he stressed everything in Gary's post about the synergistic effect. Interestingly enough, although he was finishing up a clinical trial on Erbitux and Csyplatin combos, he recommended that I try Erbitux alone to avoid the Csyplatin long term effects on hearing etc. that he saw in his patients.


65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13
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I just started my Erbitux treatments this week and have had 7 of my 30 RT's. They are giving me RT for a second time because they feel that I have enough new tissue for it to be ok. I am seeing redness both inside my mouth and outside on my neck a lot sooner than the first time. I have just started to see what I think is the rash from the Erbitux on my face. The oncologist and the surgeon both told me this was my best chance to stay cancer free this time. I'm glad to see Gary's post from Cure article.



48
SCC Floor of Mouth 7/06
9/06 Surgery, bilateral neck dissection, 58 nodes clear PT2pN0pMx
35 rad 2006
Recurred 6/08, 1 Carboplatin, 1 Cisplatin
Surgery 9/08 - Total glossectomy, free flap from pectoral muscle, left mandible replaced using fibula
35 IMRT & Erbitux 11/08
4/15/09 recurrence
6/1/09 passed away, rest in peace

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