Gail - when you get these in the future, please send the original url to Sheldon Sax so that he can add them to the news section of the web site. We'd like to keep it as current as possible and between the two of us we don't always catch everything, there are so many journals to review.

As an aside- can you address the use of chemo[carboplatin\cistplatin] in recurrances;ie NOT in conjunction with radiation. There are some of us who are experiencing chemotherapy long past radiation therapy. Amy

I guess I'd want to know the sample size for that study before concluding that the no statistical difference they found between cisplatin and carboplat was not just a lack of power.

I was treated at Moffitt and my MO never mentioned Carbo until the end. He made Cisplatin sound like the state of the art chemo. I am meeting with him next Tues and I plan to let him read Gails post. I want his comments and I will share them with the group.

Nelie makes a good point (re sample size) and I tred to find the references in the Moffitt article but they were not listed. The general feeling from all the MOs I've spoken to is that there is little difference in outcome -- several told me cis is used because it has the "longest history" -- there have been some studies on ovarian cancer where a platinoid was the *sole* therapy (no radiation) and cis showed a slight advantage over carbo. One has to wonder, however, if the chemo adds only an estmated 10-15% to the radiation how much difference a slight advantage would be (e.g. 5-10% of 10-15%, is 0.5 to 1.5% added control) in light of the much more significant toxicities associated with cisplatin.

In any case, planty of people getting carboplatin are having complete clinical responses to their therapy so it certainly works.

I too would be interested in Moffitt's response in light of their 2002 article. Perhaps that MO is the only one using carboplatin but if so, why was he asked to write an article espousing it's use. Possibly in the intervening years Moffitt has fond out something we should know about the relative efficacy.

Gail

I met with my MO at Moffitt today and asked him about the 2002 article. He was familiar with the doctor and said he is committed to his preferred treatment but he said that there still has not been a large scale head to head comparison of cis to carb and Moffitt's TX protocol for my type of cancer remains Cisplatin concurrent with IMRT radiation. He also said that if the patient presents a medical history of hearing problems or experiences hearing problems with cis during Tx, they switch to carbo.

Oh well, I'm finished Tx and I just received my first all clear CAT results today so I'm releaved.

Hi David,

For what it's worth, Cisplatin was recommended to us by Sloan Kettering, among others, for Jack. It's their protocol but was also based on how aggressive his cancer was and the extracapsular lymph node invovlement. Sometimes you just have to go with to each his own and realize that opinions in medicine will continue to vary.

The good news is that you've finished your treatments and the CT scan was clear. Everything else is a side effect to be dealt with, being alive is the victory. Congratulations.

May you continue to be well and get good news.
Regards JoAnne

Thanks JoAnne, the docs want to give you their best shot and they go with the most agressive treatment they think you can handle. They can always back off a bit. Their goal, like ours, is to kill all the cancer the first time. Unfortunately sometimes they come close to killing the host!

Now to the next phase, whatever that is.

Hey David great news!

As for cisplatin; when I read thru my notes I see the RO resident dr said that if cisplatin effects the hearing then they will switch to something else. However I recall the chemo dr saying at the time when my Dad told him about his hearing; that there is nothing else to switch to. My Dad; already hard of hearing due to meniers was told most likely his hearing would be effected. And yes the cisplatin did effect his hearing but he did all 3 cisplatin anyhow.

I'm just wondering if there is a study on how effective cisplatin is; are there less re-occurances?

Again congratulations David!

LisaB, I was told that Cisplatin does the best job of assisting the radiation in disrupting the cancer cell. Carboplatin is often used as a switch to chemo when cisplatin proves to rough.

Thanks for your comments.