About to Start Rads and Chemo

ToBeGolden

I had radiation only in 2010 for laryngeal cancer. Unfortunately, it has returned; and I have undergone total laryngectomy. But the operation was unable to get all of the tumor. So I will be receiving radiation plus chemo come the first of the year.

The chemo will be designed to sensitize cells to the effects of radiation. My oncologist said it would be a "gentler" type of chemo, without massive hair loss or massive vomiting. But I have found that oncologists tend to be overly optimistic.

What has been your experience with chemo designed to augment radiation? Did you have mild nausia or did you vomit your guts out? The oncologist is talking about cisplatnum OR some drug I haven't heard of. Rick.

RogerRN43

Cisplatin
I think many of us has had Cisplatin to sensitize cells to radiation.
It is probably dose dependent and individual to the person in terms of side effects, which listed are many, the serious ones are very rare, the most common being nausea/vomitting. Some people get tinnitus (ear ringing) and peripheral neuropathy (pins, numbness fingers), let them know if that happens as they can progress to longterm, not common though.

I got 3 big doses, it made me a little nauseated but my major side effect was hiccups. They prescribed Largactyl and it helped.
They should also be prescribing you a cocktail of anti-nausea drugs prior to your dose taken for a few days. You should also receive hydration therapy for a few days to help your kidneys, it's all standard that goes with giving Cisplatin.

The side effects are usually not immediate, start a few days afterward, and after a week, 2 weeks at the most subside and it's out of your system.

Hoping it's minimal for you.

Skiffin16

Concurrent
Rick, while I initially had three cycles of the stronger chemo (cisplatin, taxotere and 5FU). Those all being just one dose each every per three week cycle. I also had seven weeks of concurrent chemo/rads... Seven weeks of carboplatin weekly and 35 daily rads each of those weeks.

The carboplatin even being weekly was not nearly as bad as the large cycle doses. I didn't get sick or nauseaous at all, Zofran to curve any just incase, but never used it.

I also actually started growing back any hair that I had loss during the intial doses of chemo, so that wasn't a factor either.

As for taste and saliva, I can't really say. During he intial three big doses, I would get taste back that last week before starting again.

Of course having both the carboplatin/rads weekly/daily, around week 3 - 4 I lost pretty much both until several weeks/months.

But now going on close to three years post, I have regained nearly 100% taste and 95% saliva.

So, for me, the concurrent with the lower (more gentle), LOL...chemo, was not nearly as hard on me. But having the rads, definitely adds to the pucker factor.

Carboplatin is basically a more refined form of Cisplatin, from my understanding.

"Carboplatin is sometimes called a “second generation” platinum drug. The first generation consisted of the drug cisplatin, which came to prominence in the 1970s. Carboplatin was designed and planned as an improvement – a drug that worked in largely the same way with the same chemical mechanism, but with better biochemical properties that would not produce such nasty side effects. The idea was that with a lesser side effect profile, higher dosages could be given and the "pow" to the cancer cells could be increased.

Carboplatin differs chemically from cisplatin by being a bigger molecule, with a dicarboxylate ligand. This slows the metabolic breakdown of the agent (it stays in the body longer) and reduces the rate of formation of toxic by-products."



Best,
John

longtermsurvivor

It may not always be fun
but you'll survive it. I had carboplatin/taxotere in a q three week cycle for 4 doses, and Erbitux every week. The erbitux will continue throughout radiation. I was also treated routinely with zophran and emend for nausea. Even so, I had queasy stomach and loss of apetite, beginning about day 4, lasting longer each treatment cycle, until this last one it was about 10 days long. I actually gained weight during treatment.

I found this to be pretty tolerable. And I had a great tumor response to the drugs.

Best to you.

Skiffin16

longtermsurvivor said:

It may not always be fun
but you'll survive it. I had carboplatin/taxotere in a q three week cycle for 4 doses, and Erbitux every week. The erbitux will continue throughout radiation. I was also treated routinely with zophran and emend for nausea. Even so, I had queasy stomach and loss of apetite, beginning about day 4, lasting longer each treatment cycle, until this last one it was about 10 days long. I actually gained weight during treatment.

I found this to be pretty tolerable. And I had a great tumor response to the drugs.

Best to you.

Tumor
The secondary tumor (lymphnode), actually dissolved completely away during the three sessions of Cisplatin, Taxotere and 5FU..

This was confirmed with a CT, before I even started the additional seven weeks of concurrent weekly Carboplatin and daily rads.

I only had the EMEND the first three days of each of the three cycles...zofran or phenigren as needed for any addional nauseau.

I only felt sick (nauseaous) once during the sixteen weeks. That was when someone kept asking me questions about chemo and wouldn't shutup....so basically, I threw up on them...mostly just water though, LOL....

JG

Bigfuzzydoug

low-dose Cisplatin
It was explained heavily to me as an option that we thought for the longest time I would need. It's quite common to augment and improve the effects of the radiation. It's also to ensure that any malignant cells that may have metasticized are also destroyed when not in range of the radiation.

You may not feel any side effects from it. "I doubt you'll even lose your hair," my Oncologist said to me. "Certainly even if their are side effects to the low-dose Cisplatin, you won't even notice it compared to the radiation which will be a challenging ordeal." I'll admit that radiation to the throat and larynx is far more brutal. It's what you need to get better and you have to soldier through it. But if they want to give you low-dose chemo as well, I would go for it. You won't notice it much at all compared to the radiation. You'll just have to deal with the port for several weeks.

Good luck!

ToBeGolden

Thanks
Thank you once again for all the advice and encouragement. I will opt for the adjunct chemo. Glad to learn that this chemo will not be among the most brutal of chemos.

My treatment plan is still evolving. I learned that the docs will place a shunt in the esophagus; a minor surgical procedure before radiation is started. The purpose is to separate the walls of the esophagus to lessen the chance that radiation in the area will scar the walls together. However, the shunt will force the use of a nasal-gastric tube for feeding. Not bad in itself, but I will miss eating real food, for the six weeks of radiation treatment. I will be allowed to swallow liquids.

Worst part of the shunt is that I will not be able to use the treacheoesphageal shunt as a voice prosthesis. So I go back to writing to communicate. I have an electro larynx, but it's understandability is limited. Perhaps, I will get better with practice.

It will be a challenging couple of months. I will keep you posted. Rick.

longtermsurvivor

ToBeGolden said:

Thanks
Thank you once again for all the advice and encouragement. I will opt for the adjunct chemo. Glad to learn that this chemo will not be among the most brutal of chemos.

My treatment plan is still evolving. I learned that the docs will place a shunt in the esophagus; a minor surgical procedure before radiation is started. The purpose is to separate the walls of the esophagus to lessen the chance that radiation in the area will scar the walls together. However, the shunt will force the use of a nasal-gastric tube for feeding. Not bad in itself, but I will miss eating real food, for the six weeks of radiation treatment. I will be allowed to swallow liquids.

Worst part of the shunt is that I will not be able to use the treacheoesphageal shunt as a voice prosthesis. So I go back to writing to communicate. I have an electro larynx, but it's understandability is limited. Perhaps, I will get better with practice.

It will be a challenging couple of months. I will keep you posted. Rick.

Rick
My hat is off to you for your continuedd positive attitude. I've spent a few days writing for communication, so I know what a PIA it is. Personally I have a positive feeling toward your treatment. It is going to be a challenge, but I think it is going to work. Positive thoughts toward you.

Pat

jtl

ToBeGolden said:

Thanks
Thank you once again for all the advice and encouragement. I will opt for the adjunct chemo. Glad to learn that this chemo will not be among the most brutal of chemos.

My treatment plan is still evolving. I learned that the docs will place a shunt in the esophagus; a minor surgical procedure before radiation is started. The purpose is to separate the walls of the esophagus to lessen the chance that radiation in the area will scar the walls together. However, the shunt will force the use of a nasal-gastric tube for feeding. Not bad in itself, but I will miss eating real food, for the six weeks of radiation treatment. I will be allowed to swallow liquids.

Worst part of the shunt is that I will not be able to use the treacheoesphageal shunt as a voice prosthesis. So I go back to writing to communicate. I have an electro larynx, but it's understandability is limited. Perhaps, I will get better with practice.

It will be a challenging couple of months. I will keep you posted. Rick.

Best Wishes
Rick,
Just look at the face of a Golden and you know you are loved.
John

Kyle Gilmore

Hi...So sorry for your need
Hi...So sorry for your need to go another round with your c....I hope you get thru it with no problems.

I had NPC and had concurant cisplatin with rads. My tumor was pretty big and my rad doc was amazed at how quickly it went away with the chemo and rad concurant approach.

I t was a lower dose but and I had it for 5 weeks, sometimes i felt really loopy but i think it was due more to the steroids then the chemo. A few times I got some crazy hiccups also.

Good luck and stay strong

D Lewis

ToBeGolden said:

Thanks
Thank you once again for all the advice and encouragement. I will opt for the adjunct chemo. Glad to learn that this chemo will not be among the most brutal of chemos.

My treatment plan is still evolving. I learned that the docs will place a shunt in the esophagus; a minor surgical procedure before radiation is started. The purpose is to separate the walls of the esophagus to lessen the chance that radiation in the area will scar the walls together. However, the shunt will force the use of a nasal-gastric tube for feeding. Not bad in itself, but I will miss eating real food, for the six weeks of radiation treatment. I will be allowed to swallow liquids.

Worst part of the shunt is that I will not be able to use the treacheoesphageal shunt as a voice prosthesis. So I go back to writing to communicate. I have an electro larynx, but it's understandability is limited. Perhaps, I will get better with practice.

It will be a challenging couple of months. I will keep you posted. Rick.

Stay strong, Rick
You can get through this. It's just another bump in the road. I will be holding healing thoughts for you.

I had high-dose Cisplatin. Didn't lose my hair, didn't get sick even once. My doctor placed me on three different anti-nausea meds, with a fourth for backup. Emend, Zofran, Compazine and I forget... Plus something else with a long name that began with 'd' that came in through the chemo IV.

Deb

ToBeGolden

Goldens
Once again, thanks for your kind advice. The two months of upcoming treatment look unbearably long when at the start. But I know next year, the treatment will be a thing of the past. The most difficult thing will be not being able to speak. The docs are putting a tube to dilate the esophagus. This is to help prevent the esophagus being fused together by the rads. However the tube will prevent the esophagus from vibrating, which is the source of my new prosthetic esophageal speech. I will get by communicating with Word Pad. I also have an electro larynx, but I have not mastered that device well enough to be generally understood. I will have plenty of time to practice.

Golden Retrievers have the perfect personality. Peanut, pictured, died earlier this year at the age of 14. All my previous Goldens died at that age. I always walked her off leash, and she went up to everybody. Would just block people, even strangers, and demand to be petted. Never picked on cats, squirrels or smaller animals. Acted tough to animals that she was afraid of, but would never fight. An ardent swimmer, she actually could dive and swim under water. My user name is ToBeGolden because I wish I could have her personality and outlook. Rick.

Skiffin16

ToBeGolden said:

Goldens
Once again, thanks for your kind advice. The two months of upcoming treatment look unbearably long when at the start. But I know next year, the treatment will be a thing of the past. The most difficult thing will be not being able to speak. The docs are putting a tube to dilate the esophagus. This is to help prevent the esophagus being fused together by the rads. However the tube will prevent the esophagus from vibrating, which is the source of my new prosthetic esophageal speech. I will get by communicating with Word Pad. I also have an electro larynx, but I have not mastered that device well enough to be generally understood. I will have plenty of time to practice.

Golden Retrievers have the perfect personality. Peanut, pictured, died earlier this year at the age of 14. All my previous Goldens died at that age. I always walked her off leash, and she went up to everybody. Would just block people, even strangers, and demand to be petted. Never picked on cats, squirrels or smaller animals. Acted tough to animals that she was afraid of, but would never fight. An ardent swimmer, she actually could dive and swim under water. My user name is ToBeGolden because I wish I could have her personality and outlook. Rick.

Peanut
So sorry for the loss of your friend, companion and family member.... My two chocolate lab sisters, Kali and Jasmine (Jazzy), were/are my caregivers...of course with my lovely wife Shelley.

We also had a black female lab, Ebony...she was 13 when she passed...always in our hearts, and never forgotten.

They can offer we mere humans, so much in the way of living life to the fullest.

Happy Holidays, and kick butt....

Best,
John