First time poster, joined today, like very much what I see in the board.

Male, 57, California, in good health, no other issues
DX: BOT SCC Stage 4a, HPV+, multiple nodes

Spring 2012 Felt tiny "gland" underneath chin, at back of throat. Thought it was simple sore throat. PCP took a look, prescribed antibiotic. Two weeks - no change, prescribed second round of antibiotic and directed to ENT if not gone. Did not go away and did not go to ENT. Zero pain or discomfort, only symptom is visible lump getting larger along side of neck. Surely must be some gland just building up some infection associated with regular sinus area congestion.

Nov. 30 - Dec. 3, 2012 Finally went to PCP after admitting lump in neck is not going to go away on its own. Immediately told it was cancer and referred to CT, labs and ENT. Went to get blood drawn and next day got CT of neck area and chest then saw ENT who did endoscopy and reviewed radiology report and declared hypopharyngeal cancer. Created a series of orders for more tests.

December 2012 ENT referred me to Head Neck Cancer Surgeon, trained at Sloane-Kettering. More tests PET-CT, MRI, In-office FNA results had lots of inflammation cells so a bit uncertain with remaining tissue cells. General operation to do a series of DX procedures and biopsy several areas. PET-CT shows inconclusive spots on lungs, one on right and on left. Could be inflammation, something else, or maybe cancer; so, staged M0.

Final DX of BOT SCC Stage 4a/b, multiple nodes. Suggests likely treatment is concurrent chemo and radiation, the standard protocol. Key takeaway from HNC surgeon is to choose the most aggressive option as I am young and fit and better to strive to kill all potential distant cancers now and and reduce chance of recurrence.

January 2013 Initial appointments with MO and RO. MO suggests, in addition to standard chemo-radiation regime, an induction chemo therapy be done since the PET-CT shows possible cancer and there may be microscopic cancers not yet detectable. The dreaded TPF with 5-FU is suggested.

Next day, initial consult with RO who feels induction chemotherapy is probably not needed as no definitive studies have shown induction improves overall survivability. However, he speaks with the MO and I hear him say he would go along either way.

My case goes to tumor board next week so I have some time to get informed on induction therapy as the standard chem-radio therapy seems pretty well established and agreed. What is the general experience here and are there any studies showing improved efficacy with induction chemo sequential with chemo-radiation?

Thanks in advance and look forward to being active here.

Don

I will post elsewhere going forward but would love some opinions