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Stage IV Head and Neck Cancer

mfacnason
Posts: 4
Joined: Feb 2004

My brother in law has two large tumors on both sides of his neck along with growth in the front.  Radical surgery in Nov 2012 removed a very large mass in his throat, however, it has all grown back. The chemo did not work and they put off radiation because of a fistula from the surgery. Now he is starting radiation tomorrow and I have to wonder if the side effects are going to be worth it. They are telling us radiation is only for pain control and not cure.  He has some nodules in his lungs, but the VA wont do a PET Scan so we do not know if it is cancer in his lungs. They are 80% sure it is, but they refuse to do the PET. Wondering if anyone else has seen such an aggressive head and neck cancer and what are we to expect.  How fast does this cancer kill when it is not being treated?

Ladylacy
Posts: 516
Joined: Apr 2012

While my husband's cancer is different from your BIL, radiation is one of the worse for head and neck patients.  We are told this up front.  My husband has been thru 35 rounds of radiation twice, once in late 2010 and the other just finished up in July 2012.  We were told up front that if he didn't have surgery to remove his larynx, he would have a year at the most which he did have in March 2011.  This time because it has reoccurred (treatment was the 2nd round of radiation and chemo) for the second primary at the cervical of his esophagus and spread to his right lung, the only thing he was offered was chemo and we were told no cure.  He elected quality over quantity and all of his doctors said they didn't know how long he has.  Only the man upstairs knows that. 

Personally after seeing what my husband has suffered thru I would take pain medication to control the pain if it is only offered for pain and not cure.  Radiation will only cause more pain and more problems.  My husband's lung cancer was diagnosed thru a PET/CT scan and then a biopsy.  The recurrence at the cervical of his esophagus was shown only on the PET/CT scan, which was quite large and spread further down his esophagus) no biopsy was done because the specialist said it wasn't necessary.

Wishing you and your family the best -- Sharon

fishmanpa's picture
fishmanpa
Posts: 1131
Joined: Jan 2013

I've not heard of radiation being used to control pain or for pallative care. I know chemo is used to help shrink tumors and thus lessen pain but rads? All I know is the rads I received tore me up. I was on pain meds to control the pain from the rads in my mouth and throat. 

I don't know enough about it to comment definitively.

"T"

 

longtermsurvivor's picture
longtermsurvivor
Posts: 1836
Joined: Mar 2010

One that does not have a single good answer.  20% of deaths from throat cancer have metastatic disease at the time of death, but the metastasis is generally not the cause of death.  Death tends to be from the effects of local recurrance.  I can see why they may not want to pursue the lung problem, as doing so doesn't really help his situation, it just adds another dimension to what is already a nearly impossible problem.  Yes, radiation can be used to do local palliation.  If the tumor is large, it will not cure, but will reduce the size of tumor, and prolong life.  Now, the quality of life being offered is likely not going to be very good.  So of course, the radiatio should have been offered with this understanding, and given as an offer only, not a dictate on the part of the treatment team.  How long until death is a hard question to answer.  There are a few around this board that are alive with disease as many as 8 years down the road.  but realistically, what you describe are fast growing cancers, and the life expectancy is likely to be  a few months, probably not more than six.  This depends, of course, on a number of factors, like how aggressively he is supported.  If he has a PEG in place for nutrition and fluids, that would be entirely different than without assisted intake.

I hope this helps in some way.

 

Pat

 

ToBeGolden's picture
ToBeGolden
Posts: 697
Joined: Aug 2010

I have throat cancer that has matastesized to the lungs (and some bones). A PET is not diagnostic for cancer. I had a lung biopsy to confirm lung cancer in my case. PET's are used to scan large areas looking for "hot spots", when areas of possible metastesis are unknown. The areas  in the lungs will certainly be "hot", but this could be due to cancer or infections. Patients who get PETs are generally those patients with no known active cancer sites (having a cancer site previously successfully treated.)

Any chemo directed at the throat cancer will likely attack any cancer in the lungs. I hope this helps explain things a little and not add to your confusion. Rick.

HobbsDoggy
Posts: 165
Joined: Feb 2013

My radiation was rough.  If I was told little or no hope would I go through it knowing what I know now, I just am not sure.  My first reaction is no way I would want my time left to be as "free" as possible.  The more I thought about it would I say do it as I would have a secret hope that it would cure or in some way stop the cancer, I might.  The side effec of radiation are difficult.  Have the doctors laied out all the side effects?  I would as them very specifficaly to list them and what they think is likely to be the best and worst case situation.  If they have not given your brother in law a clear picture of the side effects that would seem very strange to me as I think that would be essential.

Best of luck

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