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My team and I have not decided on a treatment plan as yet. As I mentioned earlier I have a very large tumor on the base of my tongue. Possible two small nodes involved. But too small to know for sure. I was not happy with the first purposed treatment of Cisplatin only-with tomotherapy. Felt that I saw a lot of studies on the net that said combo drugs such as Cisplatin and 5-Fu worked better.

Doctors working hard to come up with an aggressive treatment. I'm only 55, female, and good health otherwise. Strong constitution.

I'm getting a little confused. Lots of studies of different treatments and different drug studies, but I personally don't know what has actually been PROVEN (by multiple studies) to work and increase survival rate. (I'm in a little over my head).

My comment made is that my doctor is thinking about "induction therapy." Does anyone know anything about it. It was explained to me that they use a combo of drugs (possible as many as 3) to beat up the tumor, and then what is left is radiated. Pretty aggressive. Saw one small, Stage 3,2008 study with very impressive results, but obviously, can't comment on reoccurance or long term survival.

Hope all this makes sense. Love to have any input
Thanks Sandy


Sandy 56, BOT SCC Biopsy 1/21/09 Stage 3, T3NXM0.
Finished 3 cycle induction chemotherapy 4/7/09. (Chisplatin, 5-fu and Texotere). Re-staged 4/20/09,(very successful.) Will start Carboplatin/radiation 2 Gy/5 days/7 weeks (Tomotherapy) starting May 4th. Finished 6/22/09.
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Sandy,

The real weapon is the radiation and the chemo sets the cells up to be more effectively killed adding some say 20 to 30% more in the kill rate dept. Do not put off your Tx decision to long and without a FNA to the suspected nodes no one can diagnose cancer. They will certainly target those with the radiation and in most cases that does the job.


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.
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David:
The treatment is called TIP with concurrent chemoradiotherapy (in my case tomotherapy). It is being used more often with bulkier tumors and larger nodes then mine. Used to retain organ function. ONly small studies, but using it more often

Without going into too much detail: First you get a regiment of 3 drugs (Paclitaxel, Ifosfamide and Cisplatinum)once or twice. This greatly softens and reduces tumor size. After this, then we do Cisplatin and tomotherapy.

Has shown very good results in S cell tongue cancer and same type of cancer in cervix.

Study Stage 111 August 2008. Hancock et.al.: TIP Sequential Therapy in Base of Tongue Cancer.

Thanks
Sandy


Sandy 56, BOT SCC Biopsy 1/21/09 Stage 3, T3NXM0.
Finished 3 cycle induction chemotherapy 4/7/09. (Chisplatin, 5-fu and Texotere). Re-staged 4/20/09,(very successful.) Will start Carboplatin/radiation 2 Gy/5 days/7 weeks (Tomotherapy) starting May 4th. Finished 6/22/09.
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Sandy --

There have been a few threads on induction chemo (see here and here and here). Several OCFers who had induction therapy (or their spouses) posted there -- perhaps you could contact them through PM or e-mail.


Leslie

April 2006: Husband dx by dentist with leukoplakia on tongue. Oral surgeon's biopsy 4/28/06: Moderate dysplasia; pathology report warned of possible "skip effect." ENT's excisional biopsy (got it all) 5/31/06: SCC in situ/small bit superficially invasive. Early detection saves lives.
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Hey Sandy,

I was a researcher as well....spent hours on the net looking at studies regarding the best chemotherapy drug, worrying about Cisplatin because hubby had/has hearing loss that predates his cancer. Here is what my hindsite concludes:

As David said, the radiation is the weapon that is going to do the ultimate damage to the tumor.

The chemo simply opens the door.

The biggest issue is staying healthy and capable of getting thru all your treatments. This is where the induction vs. just concurrent treatment comes to play. With each chemo, your body gets sicker. Your bloodcounts go down. You feel lousier and lousier, your mouth will have sores and your immune system is pretty compromised. All of this affects your ability to get thru daily ( in my husband's case twice daily)radiation. This does not mean that I am against induction therapy. I certainly don't have the expertise or the statistics to know what is best. I just know the ultimate goal is to complete your radiation treatments with little to no interruption.

This is something that was not on my radar screen. Just thought I would mention it.

Deb


Deb..caregiver to husband, age 63 at diagnosis, former smoker who quit in 1997.
DIAGNOSIS: 6/26/07 SCC right tonsil/BOT T4N0M0
TREATMENT START: 8/9/07 cisplatin/taxol X 7..IMRT twice daily X 31.5.
TREATMENT END: 10/1/07
PEG OUT: 1/08
PORT OUT: 4/09
FOLLOWUP: Now only annual exams. ALL CLEAR!

Passed away 1/7/17 RIP Bill
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Hey Sandy

I had the triple whammy... 3 rounds of Chemo, 5FU Taxotere & Cisplatin for the induction. This shrunk my tumor quite significantly.

Then moved on to surgery to get what was left of the primary tumor out, which we were able to do, with clear margins.

Next on to all of our favorite, radiation treatment, to do the cleanup of what stray nasties that may have been left.

Aggressive, yes, but I was determined to beat the beast.

Questions? Fire away!

Kevin


9 YEAR SURVIVOR
SCC Tongue (T3N0M0) diag 06/2006.
No evidence of disease 2010
Another PET 12-2014 pre-HBO, still N.E.D.


�Remember to look up at the stars and not down at your feet. It matters that you don't just give up.�
Stephen Hawking
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Sandy, My induction chemo was cisplatin and doxtaxel at the CCC and I brought 5FU home for 5 days, was off for 2 weeks and then repeated the process 2 more times and then did carboplatin weekly with radistion for 7 weeks and NO surgery, I am now 1 year clear of canceer!! Hope this helps a little.. Semper-Fi Bob


Bob age 57, non smoker,non drinker, ended treatment on 11 Nov 2007 and started back to work on 29 Nov 2007. Veterans Day 2012 the Battle was lowered, folded, Taps was played and the Flag buried as I am know a 5 year survivor. Semper-FI !!!
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I had 6 weeks of induction chemo
I had a large tonsil into the base of tongue tumor plus a lymphnode the size of a lemon.
I had Erbitux Carboplatin and Placlitaxel once a week for 6 weeks
Then a 2 week rest
Then i had 7 weeks of radiation with doubles on fridays
Plus Cisplatin chemo daily on weeks 1,4 and 7
Then a 3 week rest
Then a neck disection on Oct 30 last year
I feel great right now
I love my peg tube. I pour some great stuff down me.
My sweet taste buds are not working to good. A bummer but good for me.
Saliva isnt to good but not a bad as most ive read here
I got some nuerapothy in a few fingers and toes.
I wanted them to hit me with everything they could



Tonsil into base of tongue 3to4cm tumor. Giant lemon sized 9cm lymphnode. Squamos cell carcinoma
April 5 diagnosed. June 5 started treatment. Cetuximab Carboplatin Paclitaxel once a week for 6 weeks.Then 7 weeks of radiation plus chemo cisplatin then 4 weeks rest then neck disection was Nov 7 2008
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Sandy,

My husband had a large tonsil/BOT tumor and had the same induction chemo regimen that Bob described above and then 7 weeks of radiation with concurrent cisplatin. He is doing well and is clear so far. His doctor said this regimen was due to size of tumor and might reduce the chance of metastisis.

Last edited by Sophie H.; 02-07-2009 09:23 AM.

Sophie T.

CG to husband: SCC Stage 4, T4, N1, M0; non-smoker and very light social drinker; HPV+
induction chemo begun 7/07; chemo/radiation ended 10/10, first cat scan clear; scan on 5/9/08 clear, scan on 10/08 clear; scan 1/09 clear; scan 1/10 clear; passed away July 2, 2016
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My doctor said that induction has been used for large bulker tumers with enlarged lymph nodes which is not mine. But he said that doctors are starting to use it more often.
Sandy


Sandy 56, BOT SCC Biopsy 1/21/09 Stage 3, T3NXM0.
Finished 3 cycle induction chemotherapy 4/7/09. (Chisplatin, 5-fu and Texotere). Re-staged 4/20/09,(very successful.) Will start Carboplatin/radiation 2 Gy/5 days/7 weeks (Tomotherapy) starting May 4th. Finished 6/22/09.
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