Sorry for your diagnosis, but welcome, Nancy. There are many mono and combination chemo treatments, but Cisplatin is the gold standard with chemoradiation, but alternatives are used if the patient already had it, has kidney damage, can't tolerate it, etc, and carboplatin is used frequently as an alternate to Cisplatin with less toxicities, and almost as good results. Weekly Cisplatin infusions are better tolerated than the large 3 bag method, as well as other chemo's. There is also Induction Chemo Therapy, usually 2 or 3 times, 5 day infusions three weeks apart with high dose Taxotere, Cispatin and 5-FU as neoadjunt treatment, before the standard 7 weeks of chemoradiation, but is controversial with some doctors, has high toxicities, but studies show it responds well with HPV, and is organ preserving instead of having surgery. Erbitux, a monoclonal antibody, is popular, as well as controversial, but studies are not complete comparing it to Cisplatin, and read a recent article from MSKCC, that mybe it should not replace Cisplatin anytime soon as the gold standard, and recommendation from them it not be used as mono treatment. Being HPV positive is a good thing for this type of cancer, which responds well to chemoradiation, and Induction Chemo, but chemo alone is not curative for our cancer.

There are several things to consider for a peg tube, and I'm for it. If you can't afford to lose 20 lbs maybe one should be be considered. If you loose too much weight, usually more than 10 percent of your body weight, doctors get concerned, 20 percent, and radiation may need be interupted to make a new mask. You do not want to stop radiation once it starts, which reduces its effectivenss, and how one does during treatment health wise, completing full treatment as prescribed, maintaining current weight, has an effect on your prognosis, and overall survival. Chemoradiation at the same time is like adding two additional Grays (Gy), measurement of radiation dosage, to you total radiation. You may get radiation bilaterally, depending in involvement, tumor grade, and mine included BOT, Valleculla, which will make eating, and swallowing more difficult than having it on one side. If enternal feeding, like g-tube or j-tube is needed during treatment, it may be stopped, and surgery runs the risk of infection with a lowered immune system from the chemo, although a nasal tube can be used, but I heard it's very uncomfortable.

There are more answers to your questions, and others may contribute, but hope you find this helpful.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs