Michele --

Too bad about the amifostine but it should be noted that Medimmune strongly recommneds it to be given by subcutaneous injection now, not IV -- there were too many serious side-effects from IV administraton (per our daughter who worked at Medimmune). It also should be given after the patient hydrating with at least 20-24 oz. of water and taking an anti-nausea drug 90 minutes before the injections, preferably one of the serotonin-uptake drugs like Zofran.

Many people cannot tolerate amifostine, even one dose, even given sub-cu, but many can take it for a while, and apparently being taken even part-way through the radiation regime can help salivary function. But it is not the main factor -- our RO (considered an expert both on salivary gland preservation and amifostine) told us that getting IMRT and having a parotid-sparring radiation plan is most important, that there is about a 10-15% improvement in salivary preservation with amifostine but that IMRT can allow him to spare 50% function. However, he emphasized that the critical issue here is this has to be balanced with the need to hit the cancer with the maximum radiation dose -- by far the most important thing! Sometimes the placement of the cancer does not allow a plan which spares the salivary glands, which may also be the case with an unknown primary. You could ask the RO about this.

So not taking Ethyol is not a crisis -- it is more important that your husband get through the radiation and chemo without becoming sick, and having to have breaks in treatment. It was worth trying the drug -- once -- but now it is time to move on. Whether the Ethyol is the only reason for his not eating -- many people on this list have had similar reactions to cisplatin alone, it is a pretty heavy-hitting drug. Be sure he has adequate anti-nausea meds and also, get some advice about what to eat and what not to eat. Is there a nutritionist on staff? We met with ours weekly and it was very helpful.

Be strong, it is a long road but it can be done...

Gail