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Need info on suggested treatment - Base of tongue - 1 lymph node - Stage III

Tim6003's picture
Tim6003
Posts: 1490
Joined: Nov 2011

Hi all.

I am 3 months out from my treaments, but I have some questions. I went to the MSTI Clinic in Boise Idaho (great people, great experience) but I keep reading where many people seem to have had two things I did not have (if I am correct). So my question is what do you all think??

I was diagnosed with Stage III base of tongue primary tumor with 1 lymph node involved (my left side).

The treatments were: loading dose of Erbitux ...then I began radiatino (37 treatments of radiation) ...each week on Thursday I would have another round of Erbitux (I had a total of 6 Erbitux treatments).

My reaction to the Erbitux was quite severe. I had "acne" from the top of my head all the way down my face and back. Very painful. At one point I had to stop the Erbitux for a week.

The discussion of surgery to remove the lypmh node was never really talked about, just that if the lymph node shrinks, that is good enough. The talk of tongue surgery was spoken about but was not really an option unless radiation did not shrink the tumor.

I see so many people who had surgery to remove lymph node(s) and I see people who had chemotherapy with three neamed drugs I never had.

I was told the Erbitux is a form of chemo ...but I wonder if I understood it correctly. Does Erbitux track down and kill the cancer cells throughout the body or does Erbitux just sensitize the cancer cells for the radiation to better kill them. My concern was if I have cancer cells say in my legs, or lungs and I was only getting radiation in the neck area...how do we kill the cancer cells roaming around my body? One doctor told me Erbitux does kill cancer cells...but I could not find that in my research ...it seemed to say Erbitux just "sensitized" the cancer cells and kept them from splitting / spreading.

And so all will know, my cancer was HPV related. I began to feel bad in August 2011 and was diagnosed October 2011 and began treatments November 2011.

I go for my first PET / CT scan of my neck and entire body May 7th 2012 (just around the corner). Keep me in your prayers on that as well if I may ask.

Thank you all....I love this site and I appreaciate all comments!

Tim / McCall, Idaho

Tim6003's picture
Tim6003
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Joined: Nov 2011

...I meant to say I am three months out from my last treatment ...and I go for my first CT / PET Scan after treatments ...obviously I had a CT / PET scan to stage my cancer and to determine treatments. Sorry I was not clear on that.

ditto1
Posts: 630
Joined: Mar 2012

Do not have answers for your question, but Im sure someone on the site will. Just thought I would let you know I can handle the prayer part. Consider it done, I will be looking for the answers as well because knowledge is power. Good Luck

Tim6003's picture
Tim6003
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Joined: Nov 2011

Ditto1.

Thank you for those prayers. I keep a list by my bedside of people and things to pray for ..and it grows more each week with my new friends on this board.

Those prayers mean the world to me. :)

longtermsurvivor's picture
longtermsurvivor
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Joined: Mar 2010

thisbis one of a number of approved treatments for the disease and stage that u had. Erbitux is not technically chemotherapy, that is correct. It is an epithelial growth factor inhibitor. It works well to shrink SCC and as such is increasingly used as an adjunct to traditional rads. I also had a huge reaction to erbitux. I took 14 out of a planned 18 weeks. It had to be stopped finally, as my face was sloughing off. Do your follow up like recommended, and enjoy feeling better.

Pat

PS. one of the big problems with scc is that no chemotherapy has yet bee found that will cure it. Fortunately, for most of us anyway, throat cancer tends to spread locally, not by distant metastases. If it escapes to elsewhere in the body, it takes a huge chunk of luck to get a cure.

jtl's picture
jtl
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I was thinking about Proton (charged particle beam) therapy and wondered if you ever considered this for re-radiation instead of IMRT. I wonder if it has less side effects. Hopefully, I will not need to consider it but it never hurts to think ahead given the statistics for recurrence.
John

jtl's picture
jtl
Posts: 419
Joined: Sep 2011

Pat pretty much summed up Erbitux. I actually had same treatment as you, loading dose and weekly thereafter during the rads. Unlike Pat and yourself I did not have the severe reaction but I did have acne like a teenager for a couple of weeks. Antibotics and some topical hydrocortisone took care of it but it was not fun having the mask on during rads with the irration. My med onc nurses refer to Erbitux as a "biological" not a "chemo" drug. It is selective in that it only targets certain cells instead of being somewhat indiscriminate. Only time will tell if it is as effective as the platinum drugs, but there is a head to head trial going on. In my case I chose Erbitux because I was concerned about the long term consequences of Cisplatin, by long term I mean many years out, although at my age maybe that was too optimistic. I can just about guarantee that your scan next week will be perfect.
John

Tim6003's picture
Tim6003
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Joined: Nov 2011

Thanks guys.

I thought the same thing....I still wonder why not traditional chemo? Not that I wanted to go through any more than I did ...but just in case there were a free racial running around somewhere ...you know what I mean?

If the cancer makde it to my lymph node...I kind of felt we should have done the traidtional chemo and not just the Erbitux bc of that very reason.

Well, I get my post treatment scan on May 7th ....jtl ...I like your optimism :)

Anybody else have a comment ...please continue to post. They say my cancer has a 30 - 50% chance of coming back in less than 2 years. Just seems high to me.

I'm eatintg better and taking vitamin e as suggested by my onc ..he said 1,000 mg a day would be a good place to start with the vitamin e.

Thanks my friends.

Tim / McCall, Idaho

Skiffin16's picture
Skiffin16
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Joined: Sep 2009

I'm not really a percentages guy....

Reason being, there are just way to many variables and factors that can influence the results in favor of an agenda.

Everyone is different going in, age, genetics, overall health, diet and bad habit history, etc....

A percentage just lumps everyone into one big bucket. Most of the studies were several years ago, and HPV wasn't as big a factor in the equation at that time either.

I am one of those that was STGIII Tonsils with a lymphnode, and also HPV+.

I too had the three big chemo drugs Cisplatin, Taxotere and 5FU...also adding in weekly Carboplatin during concurrent radiation.

I haven't really heard reference to supplementing Vitamin E before.

Best,
John

jtl's picture
jtl
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Joined: Sep 2011

I really doubt if the chance is 30-50% in 2 years. I did not have my scc on the tonsil(s) but regardless the disease is the same. My ENT doc who has seen a lot of this thinks this is an easy cancer to beat, but the cure is one of the worst. He thinks if someone did not have a "mass" or large tumor it is even curable. You will be fine, just enjoy life and don't worry too much. Don't fret about the type of chemo, Erbitux is cutting edge without the potential long term damage to major organs. If the new head to head trial is successful it may well be the new "gold standard", whatever that really means. In any event even rads alone may have taken care of the problem since it was local. I had melanoma 40 years ago and only had surgery, no chemo. Unless the cancer has metastasized maybe the chemo is not needed although big pharma may convince people otherwise.
John

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jim and i
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Joined: May 2011

My husband had stage 4 base of tongue with two lymph nodes involved. He did not have surgery as the base of tongue helps keep the food and drink from going down the airway and directs it to the esophogus. I am not a doctor but this is what our ENT told us. If the tumor passes midline of the tongue they do not like to do surgery as it increase the aspiration chances. We were told the same thing about the lyph nodes. Luckily the lymph nodes were the first to shrink. Jim finished treatment August of last year. First PET was not clear but Rad Doc said not to worry. 6 months PET showed no cancer in tongue or lymph nodes, they won't give all clear because of a very small spot on the lung but we are happy the tumor is clear. Next PET is in 3 weeks

Praying you get an all clear the first PET out from treatment.

Blessings
Debbie

Tim6003's picture
Tim6003
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Joined: Nov 2011

Keep me posted on that spot on your husbands lung .....I have added him to my prayer list as well. I am assuming his name is Jim.

I also want to tell you how encouraged I was with your husbands PET scan since he was Stage IV and i was Stage III. May I ask if your husbands cancer was HPV related ???

Thank you Debbie. Tell your husband I said hello.

Tim

LeoS2323
Posts: 143
Joined: Mar 2012

Just to add to what others have said, with just 1 node involved chances of spread elsewhere are apparently next to nothing. H&N generally spreads locally first and I was told that it would have to be fairly widespread in your nodes before going anywhere else.

This is probably why they did not think traditional chemo necessary at this stage. Although I don't know why surgery for the node wasn't considered?

All the very best for the scan.

Leo

Tim6003's picture
Tim6003
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Joined: Nov 2011

Thank you all for responding ....It is so great to hear people with experience. To all a special thanks...and to the ones who offered prayers...thank you too for that. We are a praying family and take those prayers to heart.

My wife has been unreal in her determination to take care of me along with our five chidren...I trul don't konw how she has done it .....

May 7th is my first follow-up PET ....I will be sure and post resutls if you all wish...thank you again.

Tim & Jennifer / Idaho

LeoS2323
Posts: 143
Joined: Mar 2012

With the PET scan Tim, hoping its good news coming your way

All the best

Leo

phrannie51's picture
phrannie51
Posts: 3601
Joined: Mar 2012

a pocket filled with prayers and positive thoughts on your PET.........

p

PS....I consider Idahoians as my neighbors, since I'm in Montana and just across the border.....so howdy, neighbor :)

Tim6003's picture
Tim6003
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Joined: Nov 2011

Thank you Phrannie ......

I appreciate those prayers. And hello to you to neighbor ...we live north of Boise 109 miles ...McCall .... :)

Tim

Tim6003's picture
Tim6003
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Hey all,

Looking at Jim & I's post by Debbie above ...I can see why I was not really offered surgery ...but after really taking a good look at everything while recovering from my treatments....here is what I was wondering / thinking ....

I had stage III base of tongue - HPV 16 positive ..no surgery ...Radiation and Erbitux treatments only. (I still think I should have had traditional chemo looking back) ...

..I think I should ask the Doctor when I see him (on the 7th for a full body PET scan and a CT scan of the neck) why should I not have surgery to remove the one lymph node. The lymph node has now shrunk to almost nothing (I can still feel it but it is very small compared to what it was which was 3 cm in size). The docs say this is most likely scar tissue..

...anyway ....why shouldn't I ask to have the lymph node removed????

I also am encouraged by the post above which states that my cancer and stage was highly likely to NOT have spread any further (of course the PET / CT scan will show us anything) ....

. So bottom line is I think traditional chemo and surgery to remove the lymph node should have been done and as of now at least still have the surgery to remove the lymph node ...

but to be honest ...you all know better than anyone I am probably reacting that way bc I just want the cancer out ..and I do not want it to come bace.

The ENT in Boise did tell me the chance of recurrence was 30-50% ..but he also keeps saying my 5 year survival rate is 50% yet I keep reading a stage III local mts with one lymph node that is HPV positive my 5 year survival rate increases to 60% (one of the MSTI clinic docs even said 67% ..but I can't find that stat anywhere).

Okay all ..thanks for your feedback.. The 7th is fast approaching and boy I tell you we have so many of our church friends over the years we have met (I moved every two years for 10 years while employed with Hilton Hotels, so we have lots of church's we attended)who have put us on their church prayer lists ......so I'm looking for a good news. But no matter what ..I have to say I am a blessed man with the family I have.

Thanks again all ...most of you have no idea how helpful you have been to me .. :)

LeoS2323
Posts: 143
Joined: Mar 2012

Like skiffin said on another thread - I'm not a percentages guy either. Those figures are just figures but we are all different and all individuals. People beat tiny odds, it's all subjective and doesn't take into account age, strength (both mental and physical), motivation etc.

If you were to look at a percentage for a particular cancer and stage it lumps you in with all the 90 year old people who get it when they are very frail. I would forget about those kinds of numbers Tim, those are for scientific studies not people; just believe and you will beat it.

Tell your ENT to keep his 50% and flush it down the toilet because that's what's going to happen.

All the very best for the scan

Leo

ratface's picture
ratface
Posts: 1231
Joined: Aug 2009

Hi Tim, this may be a little confusing to readers because you asked me about this post in the, "Bride to be Diet" Post, which currently appears right below this one. You asked me a poignant question regarding your treatment plan and surgery. I originally chose not to comment in this thread because I strongly disagree with a wait and see attitude by doctors regarding neck dissections. This is a support forum and you were getting some great support. But you persisted and asked me directly, so here it goes, It's strictly my personal opinion, and I'm just an average guy in a basement in Chicago. For comparison's sake our diagnosis and staging were somewhat similar with the exception that your primary tumor was much bigger and you were HPV positive. I was treated at a small local hospital with an exceptional onco radiation doctor and chemo doctor. My ENT left much to be desired and I eventually moved myself to the University of Chicago seeking a neck dissection against the advice of my original ENT. My decision was based on my own personal research, which pretty much boiled down to the fact, that the wait and see attitude, is a 1 out of 4 roll of the dice, for recurrence, from something missed in a lymph node. It gets complicated, but there is something known as "skip" metastasis, where the cancer can actually skip over lymph glands and wind up further down the road. My personal conclusion was that head and neck cancer, with lymph node involvement has a 22% chance of being missed in the lymph node after chemo and radiation. I simply could not take that chance, my personal risk tolerance would not allow it. I self referred myself to the University of Chicago and got a neck dissection where they removed seven lymph nodes. The neck dissection itself has it's own set of risks attached which must be weighed. The end result of this is that all the nodes came back clear and the pathology was negative. Was there one cancer cell in there, perhaps? Did the radiation and chemo do their job, probably. Did I need the neck dissection, probably not. Tim, it really is your call, and generally the doctors get it right.

The erbitux decision is an interesting one. I challenged my chemo doctor on her prescription of cisplatin. I thought so highly of erbitux as the new gold standard that I requested she use it. She flat out denied me, saying she had gone back and discussed it with her colleagues and cisplatin was still the gold standard and I backed down. Personally, I think it will emerge as the new gold standard, (at least for HPV derived cases) and your doctors are ahead of the curve. Best of luck in your decision making.

jtl's picture
jtl
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Joined: Sep 2011

I also had an infected lymph node, in fact that is how I discovered that I had cancer. There were no other symptoms and the primary was just a small spot on the back of my throat. My lymph node (2.5 cm) was removed in order to do a biopsy since my ENT felt that a needle biopsy would be too inconclusive. Since he only removed the suspect node I don't know for sure if that was only one that had cancer but he did not see anything else that looked suspicious. At this point I would wonder if removing the remains of your affected lymph node would be necessary. Assuming your treatment was successful, and you have no reason to believe it was not, the cancer should be gone so why have invasive surgery.

LeoS2323
Posts: 143
Joined: Mar 2012

I have just had one less than 2 weeks ago - selective, 35 nodes all clean. It's no walk in the park, but I had a tonsil out and a tongue biopsy at the same time and those are significantly more painful.

In my case the aim of the dissection was to try to avoid treatment. My MEC first turned up in a node in my neck. It was removed in the mistaken belief it was a cyst, so instead of giving me radiotherapy to where it was he took all the rest out and as it was all clean I don't need treatment.

So that was a good decision for me. Dissection seems a good plan to me in general though - it takes away the highway to the rest of our body for an HNC, cleans away anything thats in there and we can live without one side.

My feeling is surgery, even quite major surgery if possible is better than treatment. Not everyone is fit for major surgery though - mine took 6 hours which is a lot of strain on the body and heart, but I'm only 34 and in reasonable shape.

I think anyone who is deemed fit for surgery though should be given the option of dissection ahead of rads to the nodes. I think it's safer personally, but again everyone's circumstances are different. For example in Tim's case he has already had the treatment.

Out of interest ratface why wouldn't your other ENT give you a dissection?

All the best

Leo

jtl's picture
jtl
Posts: 419
Joined: Sep 2011

There are certainly lots of options but in my totally unprofessional opinion I think some RT/chemo/biological is still a safe bet. Like my rad onc likes to say, I kill what you can't see, I guess the same could be said for the med onc. I am not sure about scchn not spreading after removing the suspect nodes. Having said that, many years ago I had melanoma on my foot. It scared the crap out of the docs, they removed it and surrounding tissue to get good margins and also took out all of the lymph nodes in my groin on that side. No chemo, no rads and it never came back. Someone like Pat would know a lot more than me so maybe he will chime in.
John

ratface's picture
ratface
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Joined: Aug 2009

My ENT's philosophy makes sense from a physician's point of view as the odds are then roughly 75-25 in his favor. That's why the final decision would optimally belong to the one with the most risk?

LeoS2323
Posts: 143
Joined: Mar 2012

Yeah I think you are right - my onc professor said that SCC is 'a completely different kettle of fish' to a lower grade MEC which is what I have. This is the difficult thing relating our experiences and preferences, all our cases are a little (or a lot) different.

I think the preferred route for my onc has been surgery because it's safe to treat me that way, and because he is a brilliant surgeon so has put it in his own hands. Whereas other cases and other forms of H&N will be quite different and need rads / chemo.

I guess we all have to trust the experts ultimately, but it's good to try to stay informed and have second opinions.

All the best

Leo

Tim6003's picture
Tim6003
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Joined: Nov 2011

Ratface...thank youfor stepping out and "telling me your opinion". I realize this is a support board and we all want to be ecouraging but too I am the type that likes to chew on the meat even if it is tough sometimes (I live in Idaho, so you will have to forgive the things I say at times :))

I'm very mucy like you. I have a wife and five kids (kids are ages 21 months to 13 years old) and 1 in 4 is not something I think I want chance. Before you post I had just made an appt with my ENT in Boise to discuss just such an operation. I will see how he responds, but I'm sure his suggestion will be against it. Mine is for.

I will say this to be clear. The MSTI Clinic here in Boise (Mountain State Tumor Institute) has been wonderful. My ENT (I asked this of the scheduler today)who is cordial, sees 50 - 70 patients A DAY!!! Wow. That's crazy. He comes highly recommened in our area is why I chose him...but like I told my wife ..."honey, that's just too many patients to give me the attention I want right now"...and that's not to fault him, it's just my comfort level personally.

So thanks all for your comments. Ratface...thanks for stepping out there for me. I can't say it enough ...but this board and all of you who share make a great difference!!

Thanks!

ratface's picture
ratface
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Joined: Aug 2009

You've made a particularly crappy day for me much better. Your comments have swelled my head so much that I can't fit through the doorways anymore. If you need further help with the disection PM me. FYI you can watch several disection versions on YOu-tube.

HelpingDad
Posts: 4
Joined: Apr 2012

Hi Tim - I look forward to hearing the results of your PET scan.

I've been reviewing some of the support cases to learn more about the side effects of Erbitux. I am providing care to my 79 yr old father who has Stage IV SCC H&N that is theorized to have initiated with HPV (he has never been specifically tested). His initial tumor was on his tongue and was originally diagnosed as benign in 2007. I recurred in 2008, still benign and again Jun 2009 when SCC was detected with SCC detected in 6 of 25 cells extracted from lymph and thyroid nodules. Each time, dad had the growth surgically removed. After SCC discovery, chemo and rad were recommended. But Dad elected to roll the dice since, due to the large amount of metal in his teeth, they were going to pull them for the rad. He didn't want that quality of life.

Dad's Treatment Phase 1: Radical Neck Dissection (Surgery)

By Nov 2009, tumors began appearing in his neck and thyroid and growing quite rapidly. In Dec 2009, Dad underwent his first radical neck dissection with ENT recommendation to begin chemo/rad. At Feb 2010 follow-up, he declines treatment again. By Jun 2011, SCC tumors recur in the neck. In Aug 2011, had second radical lymph nodes dissection in his neck, but tumors now in 2 places of his chest.

Though Dad now planned to do recommended chemo treatment, he procrastinated too long and tumors in neck return. He attempts to get surgery, they tell him chemo is his only chance. So, he finally starts chemo in Dec 2011.

This procrastination may seem strange to many of you, but my father had just decided he'd prefer to die. Unfortunately, he learned that the quality of life dying of SCC is not much better than the treatments for it...

----> Point 1: *surgery* alone may be too risky ----

Dad's Treatment Phase 2: Taxotere and Carboplatin (6 planned, one every 3 weeks)
Dad still not up for radiation due to fear of losing his teeth. Plus, due to SCC spread to chest and near arm pit, Med Onc indicates that treating chemo for now is best approach. (having read more on this site how, not sure I agree in retrospect).

Dad faired okay for the first 3 infusions. Though, he was mostly bed-ridden and for periods was prone to blacking out and falling (due to dehydration). Fortunately, no serious injuries. The tumors had really been knocked down with no signs in the neck and chest. The large one near his armpit, though, seemed unphased. During the 4th and 5th, the peripheral neuropathy started hitting him hard. His legs were unsteady/wobbly, so he resisted walking and started using a rolling chair to get to his bathroom. He also had more issues with his stomach - complaining of motility issues in addition to lack of appetite, diminished taste, and feeling full. So, he (and I agreed) refused the 6th round feeling encouraged that if necessary, surgery or radiation would resolve the remaining tumor.

Two weeks following his scheduled 6th round, tumors in the neck came back with a vengeance. The med onc indicated that the cancer had likely become resistant to the drugs and skipping the last infusion would not have changed the outcome.

One pertinent conversation we had with the med onc was whether dad should have surgery again to remove the tumors before starting the next treatment. Logic would suggest that less cancer cells would mean better/faster results with the drugs (less work to do). But, the med onc says that 'theory' is just that. He offers that this is the most challenging part of cancer research - theories often don't pan out in clinical studies. That in fact, clinical studies indicate that surgery does not help the results of a follow up drug therapy. Interesting...

----> Point 2: Surgery before drug treatments may not make any difference

----> Point 3: platinum chemo drugs have huge side effects and, at best (from other postings I've read), gain patient additional time, but cancer may not be eradicated ----

Dad's Treatment Phase 3: Radiation (5xweek, 5-7 wks) with Erbitux (weekly)

With the results of two phases of treatment, I start researching more and trusting less. When I read about Erbitux, I got very excited and hopeful that Dad can tolerate this treatment better. The side effects sound as though they will be less toxic to his body. [I'm still worried whether Dad will regain his motor skills (since dancing and bowling are what motivates him).] I'm encouraged by the first visit with the Rad Onc, he feels that since there are no tongue or mouth tumors, he can avoid the damage to the teeth and mouth. He will be using VMAT rad technology. This seems better than IRMT, but perhaps more invasive than Photon, but I could not find any definitive indicated that Photon was better than VMAT. I am guessing that since Dad's original Rad appointment in 2009, targeted treatment in this area has greatly improved.

Dad had his first Erbitux infusion this past Thr and it has already inhibited the growth of the tumors (if not actually reduced their size) - at least from what is humanly visible. So far, no side effects - but not sure how long before they start - will need to do more research and continue to seek info from other postings.

----> Point 4: As one other poster commented, Erbitux may be becoming the gold standard for H&N SCC treatment. I'm hopeful this is the case.

----> Point 5: You may have been lucky not to have had to go through treatments 1 and 2...

Best wishes to you!
-Laura

longtermsurvivor's picture
longtermsurvivor
Posts: 1755
Joined: Mar 2010

Your father is well suited to erbitux therapy. He is being treated for SCC as a chronic disease, and ideally needs therapy that doesnt further compromise his quality of life. Sine erbitux is not chemotherapy, it lacks the potential to further compromise his neurologic or erythropoetic systems. And it has the potential to arrest his disease for a considerable length of time. There are people similar to your father who have posted on this board with remissions as long as 9 years that I have seen. Your father is lucky to have you as an advocate.

Best

Pat

Tim6003's picture
Tim6003
Posts: 1490
Joined: Nov 2011

Hi Laura,

Let me first start by saying I am amazed by the description of your father. He just sounds like a tough and practical man! He apparently is also very fortunate to have you on his team.

Obviously I can only give my experience and opinion, and you sound as if you have a solid team of doctors who you are watching closely :)

I did only have Erbitux ...and I did have a severe reaction to it in the way of an acne like rash that went from the top of my head to the lower part of my back...quite pronounced and it was painful, but not a pain of level 7 or above. To make you feel better, that was my only reaction and the doctor quite frankly said mine was one of the worst he has ever seen, most have a much milder reaction to the Erbitux.

Also, I am blessed (I tell my friends it's an answer to prayer) that the radiation and Erbitux did the job. My PET Scan May 7th revealed NO CANCER! NO CANCER!

So Luara, you sound like you have a great handle on this and I know there is sooooo much iformation to digest, I think you will do great!

The recovery from radiation is tough, no doubt about it. But if your dad is bowling at 79.....I'm just wish he lived closer to me because I declare I would love to meet that man and bowl a game with him. Wow.

If you don't mind, I will add your dad and you to my nightly prayers. And I said one for you before I finished typing this post.

I don't know how to PM somebody on this board...I wil have to figure that out ....but please keep me posted on your dad.

Prayers for you Laura,

Tim & Jennifer Cogdill
timcogdill@yahoo.com
208.630.4842 cell

Laura...I forgot one thing. Feeding tube? Did you father get one or are you considering it? I must tell you the doctors strongly suggested I get one (food is health while going thru treatments) and if I did not need it, great, but if I did much better to have it in before I got in too bad of shape. Mine was truly a life saver as I lost 70 lbs!!!! I drank Ensure Plus like it was going out of style (but it does have a lot of sugar). Just wanted to ask / add that since you did not mention a feeding tube.

Pam M's picture
Pam M
Posts: 2194
Joined: Nov 2009

Very glad I decided to read "a couple" posts before bed. Wonderful to hear of your clean PET, thanks for sharing. "A joy shared is a joy doubled." I was sitting here, nearly dozing, feeling a little sorry for myself for whatever cold/sinus/infection blah I've got, and your news will let me get into bed on a high note.

For what it's worth - my doc's desire was to NOT do a neck dissection - he said that hopefully it would not be needed after chemo rads, but if the chemo rads didn't get the job done, we'd do the dissection.

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