My husband is in his 7th week now. He received 2 Chemo (Cisplatin)treatments, but they have found that his red blood cell count is down and they are considering not giving him a 3rd chemo treatment because of this. Does anyone know the pros and cons to receiving 2 chemo treatments verses 3 chemo treatments? When completed he will receive 35 radiation treatments. At this point we are not sure about the surgery issue and if surgery is required. Carol...

Mom,

It's probably impossible to answer that question with any certainty but when my MO was considering eliminating my 3rd Cis he reminded me that the chemo does not by itself kill the cancer. It assists the rad by setting the cells up to be killed more effectively, i.e. the chemo enhances the kill rate. He had told me at the beginning that adding chemo to the Tx would enhance the kill rate of the rad by 20 - 30%. Now that ESTIMATE was with 3 so what would the ESTIMATE be with 2 ? .... 13.333% - 20% ? I have never heard that ESTIMATE but there are probably soooo many variables that it would be impossible to know except one thinking 3 must be better than 2.

Carol-
All I can add is my experience since I am also a Stage IV tonsil survivor. I had 4 chemo treatments. Two during radiation and 2 more each 3 weeks down the road. One of which was postponed a week due to low red blood cell count. It was aggressive and made me sicker than a dog, but I am now a 5 year survivor! Hang in as long as you possible can with treatment. - Kris

Thank you David for your reply. It is a difficult question, but I wondered what some of the people here in the forum thought. My understanding from a lay persons view is that it kills all the good and bad cells in the body not really sure of the details either. When you think of it... what cells?? I also believe it works with the radiation, killing the cancerous cells and takes good cells with it. I would like to know what other people think on this subject. Thank you again. Carol...

Kris thank you for you reply also, I did not see it until I had posted. That maybe the alternative if needed and they will do it. Thanks again. Carol...

Actually the existing researcyh I've read and heard about shows there's not much difference between two and three rounds of cisplatin in terms of later recurrence. I was only able to have two treatments myself since after the second both my white and red blood cell count were way way low. From what I understood from my doctor at the time, somewhere between 30 and 40% of people receiving this treatment only end up being able to take two of the three chemos, so it isn't that unusual.

Nelie

I had 2 out of three and I am almost 5 years out now. The added toxicity may have caused other problems anyway. The data I have read suggests about 13% improvement in survival odds (that's in addition to radiation by itself) with concurrent Cisplatin and radiation, I have never seen a number as high as 20-30%. I have also read reports that 2 Cisplatin treatments are as efficacious as 3 and in some cases maybe even more so.

Carol, I think the only thing that matters is what Ken is physically able to tolerate. What difference if 3 treatments are better than 2 if he can't have it.

There's so many variables at work including how advanced the cancer was to begin with, is there lymph node involvment, it is contained in situ or extracapsular, is there metastasis, are there microscopic cancer cells that are hiding, what other health problems exist. All these things influence results.

When Jack was in treatment I chased every statistic I could find because I didn't want to believe that in the end we would just have to wait and see. I think the true challenge of being a survivor is accepting that no one can promise results. We all go thru this horrific experience, it should at least come with a money back guarantee.

I hope the blood counts come up but if not don't make yourself nuts about it. It is what it is.

Regard JoAnne

Well put JoAnne, Thanks Lee

Here is a new swing?? My husband was scheduled for his 3rd chemo today. He was admitted but his radiation doctor decided to propose it until June 5th his original date for chemo, then the chemo doctor said there was no advantage to having it then and scheduled it for June 18th. The chemo doctor said the premium days for chemo were not lining up because of a date error with the second chemo??? At this point in time they are setting up the chemo. I think it was proposed because of his low red blood cells count. Any thoughts??? Carol...

Hi Carol;

I believe my diagnosis was almost exactly the same as your husband, as was the primary site, the 35 radiation treatments and the 3 Cisplatin treatments.

Just before my 3rd chemo tx, my weight fell below a threshhold number I had negotiated with my radiation oncologist (I had refused a G-Tube on the basis I wouldn't fall below a certain weight; if I did, I would agree to the tube's insertion.) It fell so far in fact, she threatened to cancel my 3rd treatment altogether. I strongly objected, signed myself into Surrey Memorial Hospital, had the G-Tube inserted and managed to halt any further weight loss. I pressured them into keeping my last date with Cisplatin.

I set only one goal when I started treatment, and that was to survive my 3rd chemo treatment. I had heard a significant percentage of patients are not able to handle the 3rd treatment for an assortment of reasons, and I wanted full measure of any and all treatments prescribed for me, if humanly possible.

My simple mind reasoned at the time that 2 thirds chemo treatment meant only 2 thirds of the cancer would be killed. I know that it isn't as simple as that, but I had to psyche myself up somehow if I was to achieve my goal.

From what I have heard and read on the topic, if they prescribed 3 treatments as part of the overall treatment plan, then do everything possible to receive those 3 treatments, stopping just short of harming yourself of course.

From another perspective, I don't how I would cope in the event of a recurrence and for whatever reason I had failed to take the 3rd of 3 chemo treatments, or had missed 1 or 2 of the radiation treatments; and let me assure you, I had more than ample justification for missing a couple of those when a chunk of one of my ears fell off....

... but we must battle on regardless of the setbacks or disappointments or the pain.

Whatever course your decision takes, I wish you and your husband every success in the pursuit of a full cure !

JT2

Our cancers are very much the same. Because of his case being an emergency, we were thrown into the treatment plan. (not that I didnot appreciate it) ASAP was a necessity. The dates for the chemo and radiation were all changed from the original plan. His red blood cell counts was low on 2 occasions. His 3rd and final chemo would have been very close to his second chemo. There was a date error. I am not sure what is going on now. I must talk to my husband, he arrives home for good today. I just wondered what are PREMIUM days for chemo. I really feel good about his cancer (thanks to this forum and its support) I think he will be cured. They are marveled at the size of his tonsil now, stating it is almost back to normal. His lymph node has shrunk so much he can hardly find it now. Thank you for your reply. Take care. Carol...

Carol,

I have never heard the term Premium Dates for chemo but I, like many others, received my 1st chemo my 1st day of rad (before my rad) and my 2nd one 3 weeks later and my last one on my last day of rad (before my rad) meaning all chemos were 3 weeks apart.

Some people have received weekly chemo txs and some have been hooked up to an infusion tube where the chemo is constant.

Hope this helps.

Carol,

I was one that could only take 2 treatment of the Cisplatin. From what I have been told it is OK. If you can do 3 wonderful. I also understand that maybe a different Chemo can be used. Maybe look into that and see if that is possible or necessary.

Take care,
Diane

Carboplatin is often used as a substitute to cisplatin.

Thank you all for the replies. I really cant imagine this date error happening when my husband was in the hospital and their lodge for 7 weeks, although we were thrown into this thing from the start. We have did everything to fight this disease and now find this problem. My husband is finding the treatment very difficult now, but 1 more radiation Monday, Tuesday the trach comes out and now they have scheduled the final chemo for June 18th. We will ask his doctor what is sufficient doses to have and what can be done now. Thanks for mentioning carboplatin, I had forgotten this substitute. Thanks again. I continue to believe he will recover and be cured, thanks to this forum, I remain POSITIVE... Carol...