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First Chemo and Rad yesterday

robswife87's picture
robswife87
Posts: 184
Joined: Mar 2013

Rob had his first chemo (carboplatin and taxol) followed by his first rad. So far so good, no side effects from the chemo and feels pretty good. They filled him up with about 5 different things before chemo (Emend, Aloxi, dexamethasone, benadryl and pepcid). Made him a little sleepy but good. 

Radiation okay, he broke out is a cold sweat just getting ont he table. He just kept telling himself little kids do this so can I.

Today radiation went great, no problems getting in the mask. 

So I know we are at the beginning and things will turn but we are celebrating a good first chemo with no nausea today. He went to work after rads today and felt fine.

Now here is the question. can someone tell me the difference in p16 HPV positive but not high risk HPV. Below is the results. And what does this mean

MICROSCOPIC:
ADDENDUM REPORT FOLLOWING SPECIAL STAINS: (4/2/13)
==================================================
Immunohistochemical stains using antibodies to p16 and in-situ hybridization
for high risk HPV were performed on this squamous cell carcinoma. The tumor is
diffusely and strongly positive for p16 but is negative for high risk HPV usin
in-situ hybridization.

Thanks,

Sandy

cureitall66's picture
cureitall66
Posts: 890
Joined: Aug 2012

He will more than likely feel pretty good for a few weeks. We felt the most impact around week 4-5. This is tough, but is very doable. Tell him to keep focused on the great outcome....small price to pay to get rid of the beast.

Not sure what the report means exactly. Kreg's read the same as yours except the last sentence said positive for high risk HPV. Pat (Longtermsurvivor) would possibly help you with that. Maybe he will chime in or you could PM him.

Hang in there....he'll do fine.

~C

Loved one DX: BOT, 2 lymph nodes involved (same side), Stage IV, HPV16+

               TX: Chemo: Carboplatin & Paclitaxel, Radiation 7 weeks (no surgery)

               Diagnosed: Aug 2012     Ended Tx: Dec 2012   PET scan: Feb 2013 NED!!

longtermsurvivor's picture
longtermsurvivor
Posts: 1845
Joined: Mar 2010

P16 is a gene that is overexpressed in many cases of SCC.  It is especially overexpressed when the SCC is caused by HPV virus.  This report would tend to make you think this is important in some way, but it is really not.  The HPV analysis on your husband was negative.  OK, to further confuse things, there are tumors that test negative for HPV, but when retested from a different portion of the tumor, test positive.  

 

Honestly,  all of this is a tempest in a teapot, signifying nothing.  I wouldn't spend another second worrying about it.  I have had three throat cancers.  The first was HPV negative.  The second was HPV positive.  The third wasn't tested.  Go figureSmile  Sounds like things are going well.  Just keep plodding along sandy.   The table fear will vanish pretty quickly, and before you know it the treatments will be done.

 

Pat

Skiffin16's picture
Skiffin16
Posts: 8125
Joined: Sep 2009

Pat, there was no need to test you the third time for HPV... One negative, one positive, cancel each other, so this one would be neutral..., LOL..simple math.

Sandy, as Pat said, keep on stepping, one foot at a time, occasionally six inches back... Before you know it, you'll be jogging at a positive pace.

Best,

John

robswife87's picture
robswife87
Posts: 184
Joined: Mar 2013

We know that it will get worse. We are prepared. Already got quite a stock of stuff for when and if he needs it. Recipes galore for high calorie intake, some great ones from superthread. 

Radiation day 3 and fear is gone. It goes quick, he says about 7 minutes or so. Already friendly with the same folks every morning. 

We shall lean on you when times get real tough here. 

Sandy

Rob: left Tonsil SCC T2-3N2bM0 lymph node involvement Stage IV HPV 16+

        Carboplatin & Taxol 7 weeks and 35 Rads 

Lovethesun
Posts: 12
Joined: Apr 2013

Sandy,

 

Do I remember reading that you are going to the University of Michigan?  We are going to St. Joseph Mercy Hospital in Ann Arbor.

Husband has right tonsil cancer with lymph node involvement. HPV 16+.  Would have to look up the specifics.  Think he was a T2N3.  Has had 2 big rounds of Cisplatin and 35 radiation treatments. No surgery.  He will complete treatment on Friday.  Let the recovery begin!

 

Pam

robswife87's picture
robswife87
Posts: 184
Joined: Mar 2013

We are going to the U of M. Our fist Otolaryngologist wanted him at the U. 

Turns out a friend I have known for years through my son playing baseball is the Oto oncology nurse coordinator. Nice to know people in the business at this time.

No surgery here either. His chemo is weekly for 7 weeks, we do it on Mondays and he has rads at 6:30am Tuesday- Friday so he can head to work in Salem/Northville right after. He wants to get as much work time in til he just can't do it anymore.

The Free Masons in Brighton, Howell and Pinckney are going to have a big spaghetti dinner benefit soon to help us pay some bills. Thankfully, our 2 kids and their boyfriend and girlfriend are here to help us on this ride, so I can go to work. 

Love going to the U of M but St. Joe's Brighton cancer center would have been a lot closer for us but even their doc wanted us at the teaching hospital. I know that whatever the future holds, I know Rob is getting the best care he can get.

Glad to heare you guys are nearing the end and that all is well. Now to pray for NED in 3 months.

Sandy

phrannie51's picture
phrannie51
Posts: 3931
Joined: Mar 2012

treatment has begun...(did you start to think that would never happen?? Laughing).  I'm delighted to hear how well he is doing after his first chemo...going to work the next day?  I'm truly impressed! 

p

robswife87's picture
robswife87
Posts: 184
Joined: Mar 2013

I never thought treatment would start. Longest month ever. 

I did not sleep a wink Monday night worrying he would end up getting sick. He slept like a baby, got a great night sleep and then off to rads and work. 

Not sure there is much that makes him sick, Mr. Cast Iron stomach. But it could change next round, just happy #1 went well. 

Sandy

sassysrice's picture
sassysrice
Posts: 117
Joined: Nov 2012

That's a great beginning. Keep up the good work. Remember keep drinking and eating. Keep us posted

Thoughts are with you

Sue

CivilMatt's picture
CivilMatt
Posts: 3173
Joined: May 2012

Rob & Sandy,

 

Here is what I have learned about your addendum.  As Pat mentioned this is a “tempest in a teapot”.  After all, your treatment plan won’t change.

 

the in-situ hybridization for high risk HPV is a laboratory test that can be performed.  in situ hybridization usually means a smear of cells or dissection of tissue was used for the in situ hybridization.  the hybridization part means the labeled probes of high-risk HPVs were used to check for these HPV types.  they also used another test immunohistochemical stains using antibodies to p16 (p16 would be a protein).  they are saying that they found the p16 protein.  but that they could not officially type HPV by their method of in situ hybrization of the squamous cell carcinoma.  if the p16 protein is there.  i am not sure if the p16 protein is a cellular protein run amouk or a HPV protein (I don't think it is; but can't remember for sure).   The person would have to ask the dr what does it mean that they did not find any high risk HPV using in situ hybridization; does that mean it is not there; or does that mean we have reached the limits of that procedure?  if the patients wants more detailed information, they can ask the dr if p16 is an HPV protein and that means they found HPV in the carcinoma but were just unable to type it by their method of in situ hybrization (probably because they did not use that specific HPV probe).

 

Matt

hwt's picture
hwt
Posts: 2085
Joined: Jun 2012

Glad to hear your husband is off to a great start. I've got a feeling he's going to be one of the lucky ones with few side effects...certainly hope so.

Candi

Billie67's picture
Billie67
Posts: 834
Joined: Jul 2012

That you guys are finally on the treatment path and that it seems to be going well. Keeping my fingers crossed that it continues to be a smooth process.
Honestly I wouldn't give the whole HPV and P16 another thought, it won't change the treatment plan no matter if he tested negative or positive. My doctor said, "not that it changes anything for you regarding treatment but you're HPV is negative." he said it doesn't effect the type of treatment either way.
Anyway, so happy all is well so far. Keep us posted, looking forward to hearing more positive news!
Billie

Ruben and Jude's picture
Ruben and Jude
Posts: 155
Joined: Apr 2013

Sandy, I'm so encouraged after reading your post. Ruben starts chemo and radiation this coming Monday, April 22nd, and I've been anxious about him suffering side effects (among other things). Like you, I've got supplies, lotions and potions to deal with the possibilities, but I pray we don't need them. I'm thankful Rob is doing well.

God Bless. We're on the same journey. Take care.

Jude

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