Rahul, thanks for posting back. Good that you were able to visit and get opinion from Tata Memorial. Since your brother is an intern, always take him along (if possible) whenever you visit the oncologist.

Get that biopsy done quickly, well still hoping that the hotspot is from healing rather than the disease!

All the best.

Hi All

Frozen section/Biopsy done at TATA MEMORIAL Mumbai confirmed that this is case of recurrance. Doc at TATA MEMORIAL Mumabi advised to have chemothearpy at pune or mumbai and then they will check whether surgery is possible or not.

We decided to have chemothearpy at Ruby Hall Pune. Doc at Ruby Hall Pune suggested to have 3 chemo PFC regimen( Paclitaxel + 5 Flurauracil + Cisplatin). Most probaly getting admiited to Ruby Hall today.

Here are specific updates from PET SCAN report:
ILL DEFINED LESION MEASURING 2.5X4.7X4.3 CM IS SEEN IN LEFT HALF OF MID AND POSTERIOR TOUNGE WITH EXTENSION TO INVOLVE LEFT TONSICULAR FOSSA AND LEFT LATERAL OROPHARYNGEAL WALL(A RECURRENT LESION).


Kindly advise.

Hi Rahul, your father is having chemotherapy, which in US is known as TPF. You need to take absolute care of your father and specially after 7 days of chemo as he'll be approaching Nadir (low white cells and low immunity). This link will give you some info: http://www.christie.nhs.uk/booklets/568.pdf

Take care of diet, discuss with a nutritionist to help him out. Just a piece of advice, ask the doctor to have a review MRI after completing of second cycle of PFC. If the tumor is shrinking and your father had positive benefits, then only progress with 3rd cycle.

Take good care of your father, it will be a very difficult time for him and your family. All the best.

Hi Eshwar
Thanks for your valuable reply!

Actually on first day withing first half hour of chemo dose PFC regimen( Paclitaxel + 5 Flurauracil + Cisplatin), My father had reaction (low blood pressure). He was shifted to NTU for one day.
After this doc decide to continue this cycle with 5 Flurauracil + Cisplatin only.

He told in next cycle he will change Paclitaxel to Docetaxel.

Kindly help to advise on this.

Paclitaxel and Docetaxel (Taxotere) both are Taxane category of chemotherapy agent and they mitotic inhibitors (prevents cell divisions). Paclitaxel can sometimes cause a temporary slowing of the heart rate known as bradycardia, usually harmless. Let this cycle be completed with 5FU + Cisplatin, you would still need to take lot of care.

All the best for the treatment, do remember to have review MRI before third-cycle. Go for it only if 2 cycles have helped.

Hi Team
Chemo Cycle 2 is started for my father today. The doc decided to give Docetaxel(instead of Paclitaxel) + 5 Flurauracil + Cisplatin.

But my father is still complaining in left side of the tongue, Also in left shoulder/neck area. Currently doc given some painkillers.

Kindly advise on same.

Okay I looked back and reread part of this (so forgive me if I missed any information) - You're dad's cancer will likely not be cured by chemo. If there is NO REASON why he can't be operated on (the fact that he was already radiated and this can cause issues with healing - might be one of them), surgery should be the preferred form of treatment. Since it has not metastasized, it is a good thing to get it now before it does. Unless the surgery will strip away his quality of life, then I would push for that. I must say 2.5 x4.5 is a large tumor... not huge but big enough. Mine was 1.5 x 2.5 and that cost me a third of my tongue. A tumor that size will likely not respond to chemo. Of if it does, it will only be minimal.
I am not sure of the details of your dad's tumor and the structures around it that may be effected, but really, unless there is really good reason not to operate (again the radiation he's had may be an issue with healing - but a few people here have had salvage surgery after rads and they are okay), then as I said, surgery should be his treatment. I can't say anything for certain of course as I am not a dr. but from what I know about this type of cancer, the chemo is palliative not curative. Someone else will correct me if I am wrong - I am sure - but this that's pretty much common knowledge around here.
best of luck... PS tongue cancer can be very painful, this is normal.

Cheryl, I do not believe the induction chemotherapy is with curative intent - the oncologist are probably trying to control the tumor growth and salvage as much as possible. Most likely it will be followed by surgery and radiotherapy.

Hopefully, but if it isn't shrinking the tumor then they're wasting time.

That is why I suggested followup MRI after second cycle and before third one.