Cisplatin 3X or Weekly

Hello everyone,

i am am really happy to have found this board, my level of anxiety has dropped a bit!  I was diagnosed with Stage 4 HPV+ first week of September with lymph node extensions.  I had robotic surgery on September 15 to take the base of tongue tumor out and dual neck surgeries to remove impacted lymph nodes.  The surgery was successful and now heading into chemo and radiation.  I will be getting 6 weeks of radiation and the decision I now face is if Cisplating should be 3 big doses of 100 mg/m2  or 6 weekly low doses of 40mg/m2.

has anyone here done surgery like mine followed by therapy and if so has anyone done the lower dose week.y.  I hear the side effects are less but want to make sure survival is not compromised.  Any info you can provide would be great.

thanks

Comments

  • phrannie51
    phrannie51 Member Posts: 4,716
    Everybody seems to get one or the other....

    ....either a weekly dose of Cisplatin, or the 3 big ones.....usually the Dr. decides how they think it should be done.  I've heard that the 3 big doses are harder on the patient, tho I don't have a way to compare it.....I did have the three large doses.  My body seemed to cope with it pretty well.  I would be kind of sick for about 5 days afterwards....not all day, but have nausea on and off during the day.  My Oncologist was a stickler about anti-nausea meds.....his big rule was never to wait till I got sick to take them.  He had a absolute schedule for nausea meds and I followed it to a T.  One thing, no matter how you end up doing the chemo, seems one way is just as effective as the other....so don't take that into consideration.

    Anyway....BIG welcome to the club nobody wants to join.  Having all these smart and kind  (and very positive people) to talk to when going through treatment is the only way to go. 

    p

  • wmc
    wmc Member Posts: 1,804
    Welcome to the H&N

    I'll say welcome to the group no one wants to be at, and sorry you need to be here. With it being HPV+ you have really great winning numbers. I'll let outhers advise on Chemo and RAD, as I never had them, only surgery. I didn't know the doctors gave you a choice, but if they did it must not really matter as far as treatment goes. Sounds like only side effects will be differant. Keep strong as you will beat this. It is a bumpy road to go down, but so many have and came out ok, as will you.

    Bill

  • CivilMatt
    CivilMatt Member Posts: 4,721 Member
    welcome

    Survivor1996,

    Welcome to the H&N forum, so sorry you qualify.  I was stage IVa, scc, bot, 1 lymph node & hpv+ (surgery, rads & Erbitux) and I am 2y6m post treatment and doing well.

    If you haven’t visited the Superthread, feel free to browse it for information.

    While my surgery was similar to yours, I had Erbitux in place of traditional chemo treatment (like yours).  P51’s  advice about anti-nausea meds is spot on.  The easiest and best advice I received from the H&N gurus, was to drink lots of water and swallow often.

    The task for you is to learn to work with your body when the side effects show (and they will).  You will figure it out.

    We are always open to ANY question.

    Good luck,

    Matt

  • Ladylacy
    Ladylacy Member Posts: 773 Member
    Cisplatin

    When my husband was diagnosed with laryngeal cancer, he underwent radiation and chemo first.  His chemo was Cisplatin 3 big doses (one dose every 3 weeks).  He didn't have much nausea (nor did he lose his hair, thinned a bit though) with the chemo, but then his doctor put him on Emend to be taken before the chemo and then for 3 days after and it helped with the nausea.  The main problem he had was that he didn't stay hydrated and ended up having to have fluids several times and his second dose was divided into 2 because his blood count dropped very low.  He never got the third dose.  Then 5 months later he had to have a complete laryngectomy, partial neck dissection and reconstruction of his throat due to the radiation. 

    Wishing you the best -- Sharon 

  • Hondo
    Hondo Member Posts: 6,636 Member
    Hi Survivor

    Glad you found us and happy to have you here. There are a lot of different H&N cancer survivors here, I am NPC so will not be much help to you, but from looks of things many others have already answered your questions. So for now welcome to the site.

     

    Tim Hondo

  • phrannie51
    phrannie51 Member Posts: 4,716
    Ladylacy said:

    Cisplatin

    When my husband was diagnosed with laryngeal cancer, he underwent radiation and chemo first.  His chemo was Cisplatin 3 big doses (one dose every 3 weeks).  He didn't have much nausea (nor did he lose his hair, thinned a bit though) with the chemo, but then his doctor put him on Emend to be taken before the chemo and then for 3 days after and it helped with the nausea.  The main problem he had was that he didn't stay hydrated and ended up having to have fluids several times and his second dose was divided into 2 because his blood count dropped very low.  He never got the third dose.  Then 5 months later he had to have a complete laryngectomy, partial neck dissection and reconstruction of his throat due to the radiation. 

    Wishing you the best -- Sharon 

    Emend here, too.....

    My Dr. had me on Emend during the chemo treatment, and for three days after, also.....it's a "big gun" for nausea.  Ask your Oncologist about it.

    p

  • Crazymom
    Crazymom Member Posts: 339 Member
    welcome

    glad you are here.  you have a tough road ahead of you, but it is doable.  I am 2 years and 9 months out and am feeling great and enjoying life.  Good luck.   Ann

  • Shell_7801
    Shell_7801 Member Posts: 71
    Crazymom said:

    welcome

    glad you are here.  you have a tough road ahead of you, but it is doable.  I am 2 years and 9 months out and am feeling great and enjoying life.  Good luck.   Ann

    My 2-cents

    I'm receiving cisplatan at the lower dose weekly for 7 weeks.  I was not given a choice though.  What I know about it is that it takes 5 hours when I'm there weekly and I return on another day of the week where I do not receive the cisplatan, just a flushing of my system which takes 3 hours.  Without the flushing I feel extremely worn down.

    Diagnosed 8/15/2014 SSC Stave IV, primary site tonsil, 4 lymph nodes involved,  not HPV-16, radical tonsillectomy and modified neck dissection to date with 7 weeks radiation and chemo.  

    This makes me a 1 month/12 day survivor.....yipee!!!

    M

  • SASH
    SASH Member Posts: 421 Member
    Dosages

    I did the weekly lower dosage to try and minimize the side effects.  I had carboplatin not cisplatin but they are really similar.  While getting chemo I was also doing 10 weeks of radiation.  I was scheduled to have 10 weekly chemos, but there were times that chemo had to be put off a week or more based upon white blood cell counts being too low.  This didn't stop the radiation, just the chemo.  I did all my radiation and finished my chemo a few months later for a total of 10 chemos where the final was a big dose, or three times what I was getting weekly.  This was because I was supposed to have a total of 12 rounds total but to save time, they gave me more on my last one. 

    I was never sick but did have my hair thin and it really thinned about 2 weeks after my last chemo. 

    You can talk to doctor about options and if you can ask him if you start on the weekly regiment but find it is too hard on you, would you be able to switch to the 3 week apart dosage later on.  Just another question that should be answered by your doctor.

  • debbiejeanne
    debbiejeanne Member Posts: 3,102 Member
    Survivor, I never had chemo

    Survivor, I never had chemo but wanted to wish the best in making your decision.  Praying which ever tx you get that it will go smoothly and you will get through without hitting too many pot holes.

    God bless you,

    dj

  • Survivor1966
    Survivor1966 Member Posts: 5
    Thank you

    Hello all,

    thank you so much for you support.  I elected to go with the weekly Cisplatin at 40mg/m2 to complement the 6 weeks of radiation and bracing for the side effects during and after.  Your insights are very much appreciated and I will be checking in as often as I can to provide feedback.

    thank you all.

  • Roar
    Roar Member Posts: 269 Member
    I had the three big doses

    I was not offered an option- knowing what I know now I think I would have chosen the lower doses if it was offered to me and my team thought it best.I am not going to lie- the cisplatin days were the worst. I was able to deal with the rads. my advise is in addition to the IV hydration you will receive before the cisplatin keep drinking water during the administration period and days afterwards- as much as you can tolerate to wash it out of your system. You must keep fighting and stay positive - most of us here have surmised what you are about to undertake

    good luck fellow survivor 

    Ralph

  • Survivor1966
    Survivor1966 Member Posts: 5
    Thanks

    Hello everyone,

    looks ms like my earlier comment did not get posted.  I wanted to thank you all your support and the information provided.  I will be starting treatment Monday with 60Gy of radiation over 6 weeks and weekly Cisplatin at 40 mg/m2.  I am confident in beating this and enjoying many more years with my family.  I met with a naturopath today in preparation and some of the other things he recommended aside from L-Glutamine were vitamin D, whey powder and niacinamide as well as Reishi mushroom.

    thanks

  • Shell_7801
    Shell_7801 Member Posts: 71

    Thanks

    Hello everyone,

    looks ms like my earlier comment did not get posted.  I wanted to thank you all your support and the information provided.  I will be starting treatment Monday with 60Gy of radiation over 6 weeks and weekly Cisplatin at 40 mg/m2.  I am confident in beating this and enjoying many more years with my family.  I met with a naturopath today in preparation and some of the other things he recommended aside from L-Glutamine were vitamin D, whey powder and niacinamide as well as Reishi mushroom.

    thanks

    Cisplatan and Sex

    My doctors did not tell me until I asked.  On the day of chemo and for 2 days after no sex without a condom.  Your body including all of its vital fluids are full of poisen.

    Not that you'll be in the mood for it but all people are different, especially in the beginning.

    Much luck to you!

    Michelle