Unfortunately, patients can no longer be involved personally in the Hopkins tumor board presentations (they say due to privacy issues as other cases are presented) -- however, I've been involved in plenty of proposal review boards (which operate in a somewhat similar fashion) and we just ask the involved people to come in and then leave, so not too happy with their rationale. I would really have liked to have heard all the opinions and discussion.
Having said that, the plan they proposed for Barry (stage IV SCC tonsil, some b.o.t. and 2 lymph nodes same side) follows NCCN guidelines. As with Sloan (our second opinion consult) and as I understand Anderson as well, they start with chemoradiation and try to avoid surgery because of QOL issues (primarily because of that base of tongue cancer). Hopkins and Sloan even proposed same drugs and same scheduling of them re the radiation. As Barry has posted, we were offered a trial with a new EGFr drug but he decided not to do it as it involves cisplatin and they are concerned about hearing loss with him.
He is probably going to start treatment August 8, which is about a month after the tumor board met -- could probably go a week earlier but meeting the dental onc has been delayed a bit (darned summer vacations!) Based on Hopkins' and Sloan's examinations of his CT scans from November and then last month's, his cancer has not progressed significantly so the timing is not as much of an issue as it might be with someone who had an aggressive, fast-moving tumor.
Hopefully treatments for HNC and other cancers will see a real change with the newer approaches (vaccines, drugs targeted to cancer-specific factors which do not kill normal cells, etc). I am a SPORE advocate for Bill Nelson's prostate cancer project in Hopkins Urology Dept. and it is amazing what is on the horizon -- but it's unfortuntately a long horizon. Right now we have to do with what we have --
Having said that., *I* wish we had
Erbitux available now in a clinical setting!
Gail Mackiernan
(Barry Cooper's wife)
