thankyou,will have a lool

Mandy,

I'm surprised your medical team didn't recommend chemotherapy combined with radiotherapy in Feb 2014 - seems standard treatment in this part of the world (just my opinion). Maybe your oncologist can provide answers.

Hope everything goes smooth for your first chemotherapy treatment next week.

Karen

hi karen,it seems in australia its not that common to combine the two unless you are in a advanced stage.ive had it 4 times in 2 years and this is the first time chemo has been offered

Mandy, I wish you the best in 2016, and with your treatment.

I had Erbitux and Taxotere, along with radiation in 2012. Erbitux or Cetuximab is actually not a chemo, but is a targeted therapy, a monoclonal antibody that works on the epidermal growth factor receptors (EGFR). It's also really an early immunotherapy drug, but I also refer to it as Chemo for simpler explanation.

I believe that Cisplatin is usually the preferred chemo, but Erbitux is now approved for first line, recurrent and metatastic treatment for head and neck cancer. A number of factors can be used in consideration for Erbitux use, other chemo for that matter, including patient co-morbities, kidney function, extent of disease, etc. Actually, Erbitux was said to be the least toxic of all when I was initially going through treatment in 2009, and the worst being the notorious facial rash, which was allegedly indicative that its working, which such thought has somewhat changed over the years. When I did mine, I found it not as easy as purported, but was doable, and recently, it is found that some toxicities, besides rash, such as mucocitus, is worse than Cisplatin.

As mentioned, pretty much the NCCN guidelines are used by the doctors, but are not set in stone. Chemo or targeted therapy can be used as a radio sensitizer to make radiation work better, and there have been quite a few studies on its efficiency by adding it to radiation, namely Dr Bonner, if you care to read further, in addition, there are quite a few discussions here about Erbitux if you look in the search feature.

Erbitux can be combined with other chemo's, as Induction Chemo, Palliative Chemo, as mono-therapy, but some reports I read mentioned disappointing findings when combined with Cisplatin or other platinum based drugs. Mine was with Taxotere, and recent reports show positive results with that, but I did have a recurrence a year later, so apparently it didn't work.

Erbitux was said not to work in about 5% of head and neck cancers, and there was no assay to test that in head and neck cancer patients, unlike colorectal patients, where they test the KRAS mutation since it doesn't work in 40% of those patients, so if they don't have the mutation they don't get Erbitux. There is a new drug given to help with EGFR resistance, and not sure if they do any new assays particularly for head and neck cancer, but I haven't heard of any, others, yes.

That said, the first week is usually the loading dose, 400mg, and every week thereafter, 250mg, along with a corticosteroid to help with allergic reaction. There are two black box warnings that your medical team will be on the lookout, which rarely occur, and usually during the first or 2nd infusion, and that is a severe allergic relation, and heart attack. Any unusual symptoms should be repeated immediately, and all such is usually explained.

The others are the notorious rash, which is indictive of an EGFR inhibitor, and us not to be used as findings the drug is working or not. The other was the mucocitus, hand and foot syndrome, dehydration, and I also needed a blood transfusion midway through. The rash may occur 1-3 weeks after starting, mine was after a week, which mine was controlled by minocycline, and there may be different ones at this time, and for the extent of rash, as mine was mild. The worst part, was the itching postures, especially on the arms, legs, back, scalp. I was told to use head and shoulders for dry scalp, dove soft soap for sensitive skin, as well as the aquaphor or cetaphil cream after radiation.

http://www.cancernetwork.com/head-n...inked-high-toxicity-head-and-neck-cancer

http://www.ascopost.com/issues/november-1,-2014/adding-cetuximab-to-chemoradiation-did-not-benefit-patients-with-advanced-head-and-neck-cancer-what-were-the-reasons.aspx

http://www.cancernetwork.com/head-neck-cancer/docetaxel-regimen-tops-cisplatin-head-and-neck-cancer

I hope this helps, and if you have any questions, just ask, if I can help.

Yo. Paul. Happy New Year. you stuff off PM, send me a contact email. Don

I didn't realize that, Don, so I just updated it. Happy New Year!

ive had 2 doses of certuxamab so far,rash is starting to appear on my chin,headache and stomache cramps,but dont feel to bad,started radiation again today as well,i was meant to be having 35 rads but im only having 21,dont know why as dont see my oncologist til friday??. they cut the face out of my mask which made it alot easier,very quick 7 beams only 20 seconds each

Glad the rads are going well. Without the face part pressing down it would be a lot more comfortable.

Best wishes.

7 rads left and 2 certuxamab left,going well,rash annoying and suffer headaches but so far so good,havent needed a feeding tube yet either,i hope this works

Hang in there, Mandy! Sounds like you are doing pretty good with everything. Usually its about this point where it gets pretty rough. Keep pushing to take in enough daily calories and water to help you get past these last few days. Take it day by day and soon you will be past the hardest part. We are here to lean on, good luck!