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#11473 07-26-2007 04:41 AM
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Trev Offline OP
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Hi All
I am about to start Cisplatin for the first time on Tuesday followed by RT on the same day, this will be followed by RT everyday (except weekends) for 7 weeks (35 episodes)with Cisplatin every Tuesday for 7 weeks.
Can someone give me a clue as to what to expect in the way of side effects for this period.
many thanks
Trev

#11474 07-26-2007 06:07 AM
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I got a rash on my face that was successfully treated with minocycline. Also I have more ringning in my ears, which is annoying. I did not get mouth sores or hair loss. Nausea was avoided with the use of zofran,reglan and decadron. I ended up with anemia at the end of treatment. The cisplatin affected my blood counts so much that my doctor lowered my dose to 75%.


Left tonsil SCC, HPV+. T2N0M0. Tonsillectomy 3-07, bilateral radiation, cisplatin 3x, Tx completed 6-06. Clear PET 4-01-2008.
Thyroidectomy 5-9-08, resulting in permanent surgically-induced hypoparathyroidism and adrenal problems. Bummer.
#11475 07-26-2007 06:35 AM
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My husband was very nauseus the 1st time. He found using Emend helped a great deal for the last 2 doses, I would recommend to keep yourself very hydrated and if they recommend a peg tube to do it. It was a life saver for my husband. Its a tough treatment but you will get through it. We are all here to help you and to keep you in our prayers. Try to eat as much as you can with high caloric intake now. He did not have any problems with his ears. Each and every person is so different as you will come to know from these post. Keep a great attitude for that is 1/2 of this battle. God Bless LJ


CG to husband 53,39 rads. 3 rds cisplastin ended 6/2/07 Tonsils removed 1.10.07 11 of 20 nodes positive- lump removed on rt. side of neck 1/26/07 cancer of nasal pharnyx TXN2MX 2nd rd. of chemo- carbo/taxol on 6/11/07
#11476 07-26-2007 06:44 AM
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I had a similar treatment protocol -- 8 weekly Cisplatin and 39 IMRT. I really had very few side effects from the Cisplatin -- a little fatigue about 36 - 48 hours after treatment, but nothing horrendous. I was given Zofran and Decadron prior to each administration, and had an Rx for Compazine. The Zofran and Compazine combined really prevented any problem with nausea. They do, however, tend to cause constipation. If they give you Decadron, be prepared to be a little hyper for the rest of that day -- it is a steroid.

Best of luck.


Jeff
SCC Right BOT Dx 3/28/2007
T2N2a M0G1,Stage IVa
Bilateral Neck Dissection 4/11/2007
39 x IMRT, 8 x Cisplatin Ended 7/11/07
Complete response to treatment so far!!
#11477 07-26-2007 09:09 AM
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My Tx was very similar - I had IMRT for 7 weeks on weekdays. I had three rounds of Cisplatin - one every two weeks. Frankly it made me quite nauseous despite all the meds that others have mentioned. My experience was that the worst period was the two or three days after getting the infusion. I never did experience vomiting - just a nagging queasy/nauseous feeling that would never really go away. After a few weeks my doc gave me Marinol and that helped to some degree.

Of course the side effects of the IMRT are well documented on this site so you probably know what you're getting into there. Try to remember on the radiation that the side effects continue for a bit after radiation ends. They say it's typical not to 'hit bottom' physically until a few weeks after radiation ends and that was my experience as well. I tell you that hoping you won't get discouraged if you don't feel immediately better after the 7 weeks of treatment.

As you can see by the replies you've gotten so far there's a wide range of reactions to the Cisplatin. I was pretty sickly but not as bad as some have had it. Hopefully you won't have to battle the nausea.

I would add also that they promised me I'd lose my hair from the Cisplatin and I really didn't. I lost some on the back of my head at the bottom of my hairline (from sleeping on a pillow I assume) but that was about it.

Stay tuned in and let us know how you do.
-Steve


Age 41 - Stage 2 SCC tongue Dx 2/06. Cisplatin x3, IMRT x35. Mets to neck node discovered 7/07. RND 40 nodes removed, margins not clear. Cisplatin, Taxotere, 5-FU Fall 07, then IMXT/Erbitux for 7 wks. Inoperable mets to both lungs and pleura Dx Oct'08. 4 cycles Carboplatin, Erbitux, 5-FU so far.
#11478 07-26-2007 11:50 AM
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Trev,

As you can see I had 3 rounds of Cis 3 weeks apart and like some, the combination of the chemo and rad produced an uncontrollable nausea. The nausea can lead to dehydration, then constipation and certainly weight loss and general weakness.

You may have some slight thinning of your hair due to Cis but loosing the hair on the back of your neck comes from the radiation exiting your body. That hair will return but you will probably never have to shave again below your chin as the rad will kill all those hair cells permanently.

The main thing to watch for with Cis is the ringing in the ears which is cell damage. I did not recognize the ringing soon enough and I have permanent high frequency hearing loss in both ears and still experience occasional ringing.

Remembering that each patient can react differtly to the same combination of Tx alternatives, you still will do yourself a tremendous favor by drinking at least 48ozs of water and 2000 calories of "food" each and every day. Believe me I know first hand that goal can be hard to attain but do your best to reach it and you will avoid many of the nasty side effects I mentioned above.


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.
#11479 07-27-2007 08:04 PM
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Trev, I too had concurrent chemo and RT with 4 rounds of cisplatin, once a week. The injection itself was not a big deal and I could still drive back home after treatment but about two days later, nausea appeared and I couldn't stand the cooking smell in the kitchen. Make sure your doctor gave you the anti-nausea drug to take before meals, or else you won't be able to eat. I remember throwing up three times during treatment. Other than that, you will feel physically and mentally weak. Watch out for depression. No loss of hair in my case. Advice in above posts is worthy of noting and I hope that you can overcome all the discomfort very soon.

Karen


Karen stage 4B (T3N3M0)tonsil cancer diagnosed in 9/2001.Concurrent chemo-radiation treatment ( XRT x 48 /Cisplatin x 4) ended in 12/01. Have been in remission ever since.
#11480 07-27-2007 09:35 PM
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Trev Offline OP
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Thank you All,
I appreciaye the replies and will follow up on your advices, I am very uptight about the start of my treatment as it is only 2 days away, and at this moment I am feeling VERY tense, I will keep you in touch with the treatment ,again thanks
TREV

#11481 07-27-2007 10:50 PM
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Trev
careful here! You are about to compare apple with oranges....

Of the responses that you got the majority had 3 cisplatin treatment every 3 weeks or so. This is NOT the same that they will give you.
When they give you cisplatin every 3 weeks a total of 3 times or so then this is quite different from getting is weekly. In that setting the concentration is 90-100mg/m2. If you get it weekly then the concentration that is used is 30 (typically) mg/m2. So in a weekly scenario you expect a hell of a lot less side effects. In order to compare anything you need to know the dosage and even then the reactions are individual. [I just wished that people would add the concentration information so that we can actually compare]
I had weekly cisplatin treatments (see my signature for details) and this was as far as nausea was concerned a total non event. I did not take any nausea medication at all and I was ok until day 6 (Wed) when I felt a bit queasy in the morning, Therefore I took one promethazine on Tue evening from that point on.
Nevertheless, stay hydrated and keep the nutrition up. Also, as David cautions, WATCH out for ringing, this can happen even with the weekly low cisplatin dose. 2-3 days after the first infusion I started to detect some ringing which by the time of the second infusion had abated (otherwise I would not have had it) However, then the ringing came back and we switched to carboplatin. (It is now pretty much gone)


You will probably find that the weekly chemo is the easy part.

Best Markus


Partial glossectomy (25%) anterior tongue. 4/6/07/. IMRT start @5/24/07 (3x) Erbitux start/end@ 5/24/07. IMRT wider field (30x) start 6/5/07. Weekly cisplatin (2x30mg/m2), then weekly carbo- (5x180mg/m2). End of Tx 19 July 07.
#11482 07-28-2007 02:15 PM
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Trev Offline OP
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Thanks Guys
Am not looking forward to the up coming treatment but OH well what must be must be, will keep in touch during and after treatment
Again thanks for your support
TREV

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