Cisplatin...2 or 3 treatments

First of all, thank you to all of you for "existing" on this site. Coming here has truly helped us begin our battle with this cancer. My husband, Andy, was diagnosed with tonsil/base of tongue cancer. He had robotic surgery to remove his tumor and a neck dissection. He has completed 23(out of 30)of his radiation treatments and has had 2 treatments of chemo(cisplatin). His oncologist may recommend not completing the 3rd cisplatin treatment. We will see her on Friday and I assume her decision will be based on how his blood work looks. My question...should we "push" to get the 3rd treatment in? He doesn't want to stop short in treatment and have doubts that he didn't do all that he possibly could. Thank you for any feedback. Robinleigh

Comments

  • soccerfreaks
    soccerfreaks Member Posts: 2,788 Member
    "Pour me another cup of coffee"
    (Red Steagall reference)

    Doctors may refute me, but I have come to believe that chemotherapy is not an exact science. That said, if OncoLady wants to cut the treatment short by one session, I would hope that it is because she is confident that previous surgery and other treatments have done the job.

    In my case, following a lobectomy (right lower lung), OncoMan advised that he recommended the chemo but that it was precautionary and he would have no problem with me refusing it. I chose to go with the entire program (playing hooky only once or twice).

    If your hub wants to go the distance, it should be his choice ultimately unless OncoLady has some health issue to throw out there that might make it detrimental to complete the treatment.

    I wish your husband and his family the best, however you decide to go.

    Take care,

    Joe
  • Kimba1505
    Kimba1505 Member Posts: 557
    Hey Robinleigh..
    ...welcome. This IS an amazing site that helped me help Mark through his diagnosis, treatment and post treatment (Stage IV tonsil, SCC, HPV+ Robotic surgery, radical neck disection, 30 rads, 1 cisplatin 5 carboplatin/taxol)
    His cisplatin was pulled after the first dose due to hearing loss. Still curses the loss; but I was happy he had one dose of the "big gun". Carboplatin and taxol are also very effective chemos for what he had; but if a person can tolerate the cisplatin, I think they prefer to use it because it just must wipe out evertything in its path.
    If they take your husband off the last cisplatin, will they replace it with something else? Mark was to do cisplatin 3 doses over six weeks; but the carboplatin/taxol was every Monday.
    Hope this is helpful,
    Kim
  • robinleigh
    robinleigh Member Posts: 297

    "Pour me another cup of coffee"
    (Red Steagall reference)

    Doctors may refute me, but I have come to believe that chemotherapy is not an exact science. That said, if OncoLady wants to cut the treatment short by one session, I would hope that it is because she is confident that previous surgery and other treatments have done the job.

    In my case, following a lobectomy (right lower lung), OncoMan advised that he recommended the chemo but that it was precautionary and he would have no problem with me refusing it. I chose to go with the entire program (playing hooky only once or twice).

    If your hub wants to go the distance, it should be his choice ultimately unless OncoLady has some health issue to throw out there that might make it detrimental to complete the treatment.

    I wish your husband and his family the best, however you decide to go.

    Take care,

    Joe

    Thank you much! Ultimately,
    Thank you much! Ultimately, I think we'll have to trust the doctor's opinion (Love the OncoLady name). Appreciate the feedback very much!
    Best wishes to you, Robinleigh
  • susan0803
    susan0803 Member Posts: 90
    Kimba1505 said:

    Hey Robinleigh..
    ...welcome. This IS an amazing site that helped me help Mark through his diagnosis, treatment and post treatment (Stage IV tonsil, SCC, HPV+ Robotic surgery, radical neck disection, 30 rads, 1 cisplatin 5 carboplatin/taxol)
    His cisplatin was pulled after the first dose due to hearing loss. Still curses the loss; but I was happy he had one dose of the "big gun". Carboplatin and taxol are also very effective chemos for what he had; but if a person can tolerate the cisplatin, I think they prefer to use it because it just must wipe out evertything in its path.
    If they take your husband off the last cisplatin, will they replace it with something else? Mark was to do cisplatin 3 doses over six weeks; but the carboplatin/taxol was every Monday.
    Hope this is helpful,
    Kim

    3rd round of cisplatin
    Robinleigh,
    My husband had stage IV tonsil with 35 rads - ended treatment 11/10. He was to get the 3 rounds of cisplatin, but experienced pretty bad hearing loss and went with only the 2 rounds of cisplatin. Plus his rad onc convinced him that it was not 100% deemed necessary in his case. I had posted this same question when Joe was in the middle of treatment since I wasn't sure him skipping the last cisplatin was the right thing to do. Joe's onc said she would not substitute the cisplatin with the carboplatin or any other chemo drug but did honor his decision not to push for the 3rd cisplatin. You probably could get some more opinions on responses to my post from last fall. I think I had posted it around October 2010 timeframe.

    Hope this helps.
    Suzanne
  • robinleigh
    robinleigh Member Posts: 297
    Kimba1505 said:

    Hey Robinleigh..
    ...welcome. This IS an amazing site that helped me help Mark through his diagnosis, treatment and post treatment (Stage IV tonsil, SCC, HPV+ Robotic surgery, radical neck disection, 30 rads, 1 cisplatin 5 carboplatin/taxol)
    His cisplatin was pulled after the first dose due to hearing loss. Still curses the loss; but I was happy he had one dose of the "big gun". Carboplatin and taxol are also very effective chemos for what he had; but if a person can tolerate the cisplatin, I think they prefer to use it because it just must wipe out evertything in its path.
    If they take your husband off the last cisplatin, will they replace it with something else? Mark was to do cisplatin 3 doses over six weeks; but the carboplatin/taxol was every Monday.
    Hope this is helpful,
    Kim

    WOW! Sounds totally
    WOW! Sounds totally familiar.
    So far, no problems from the cisplatin...no hearing issues, neuropathy, and kidney functions have looked fine. I imagine that his kidney function will be assessed again on Friday. Temporary side effects have been awfully tough so I suppose we'll weigh it out with his doc. She hasn't mentioned replacing the cisplatin but that's an awfully good question. Will ask!
    Thank you for your reply so much!
    Robinleigh
  • adventurebob
    adventurebob Member Posts: 691
    Cisplatin
    Hi Robinleigh,

    If you trust your doc and she's been good to your husband so far then her recommendation would probably make the most sense. I think there is a small amount of science to how an oncologist decides how much Cisplatin to give us. Not much though. My doc gave me the options of getting a full dose or not getting any dose at all one time because my whites and platelets were low. I suggested halving the dose. He thought that was a great idea and so we did a half dose. My idea, not his. Not much science. Maybe half a dose would work for your husband. Congrats on making it this far. You're almost there.

    Bob
  • Kent Cass
    Kent Cass Member Posts: 1,898 Member

    Cisplatin
    Hi Robinleigh,

    If you trust your doc and she's been good to your husband so far then her recommendation would probably make the most sense. I think there is a small amount of science to how an oncologist decides how much Cisplatin to give us. Not much though. My doc gave me the options of getting a full dose or not getting any dose at all one time because my whites and platelets were low. I suggested halving the dose. He thought that was a great idea and so we did a half dose. My idea, not his. Not much science. Maybe half a dose would work for your husband. Congrats on making it this far. You're almost there.

    Bob

    Robinleigh
    I'd say that if your Dr. advises it, and thinks your husband's physical condition can handle it, and your husband thinks he can- go for it. Many of us have spent time in the hospital, and some of us are thankful we did what we felt we should do. It is your husband's call, but if he feels strong enough to weather a third storm, then let that storm happen.

    kcass
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    THREE for ME....
    Not much that I can add (welcome to the forum), other than encoragement and hang in there, you're on the downside of the hill....

    I also had three, but my Chemo MD, monitored me, my blood and everything else prior to each session.

    Like mentioned, if they think he can handle it and his counts are good enough, go for it. If they don't they may opt to not continue, continue after a few weeks, or something at a lower dose.

    I had Cisplatin, taxotere and 5FU for nine weeks (three week cycles), then seven weeks concurrent with radiation. Seven doses of weekly Carboplatin and 35 daily head shots of bolted to the table radiation and Amifostine Injections.

    Best,
    John
  • luv4lacrosse
    luv4lacrosse Member Posts: 1,410 Member
    CISPLATIN
    My opinion if he is not suffering any major hearing loss, finish the last treatment. The Cisplatin makes the radiation more effective.

    Mike
  • Greg53
    Greg53 Member Posts: 849

    CISPLATIN
    My opinion if he is not suffering any major hearing loss, finish the last treatment. The Cisplatin makes the radiation more effective.

    Mike

    2 out of 3 for me
    Robinleigh,

    I was scheduled for 3 but was one of the lucky ones to have my ONCO stop the last Cisplatin dose. Ok, not really so lucky as I lost 75% hearing in one ear and 30% in the other. They substituted 3 Erbitux treatments for the last Cisplatin. I agree with others who have stated that the chemotherapy appears to be a bit of a SWAG (scientific wild-**** guess). My ONCO himself said that the chemo was only about 10% of my treatment (guesstimate) and that the first 2 Cisplatin treatments accounted for 90% of the chemo effect. If my math is right that would put the last treatment at 1% of the treatment total. Of course that was just for me and "Everyone is Different". I can see both sides of the argument - Like Mike said if no hearing loss, why not go for it. But if you trust your doc and they say it's not needed......

    Good luck with your decision.

    Positive thoughts!

    Greg
  • beru1977
    beru1977 Member Posts: 3

    WOW! Sounds totally
    WOW! Sounds totally familiar.
    So far, no problems from the cisplatin...no hearing issues, neuropathy, and kidney functions have looked fine. I imagine that his kidney function will be assessed again on Friday. Temporary side effects have been awfully tough so I suppose we'll weigh it out with his doc. She hasn't mentioned replacing the cisplatin but that's an awfully good question. Will ask!
    Thank you for your reply so much!
    Robinleigh

    cisplatin
    My husband could only do two rounds of cisplatin because of ringing in his ears and potential hearing loss if he did the third. He was so upset that his treatment would not go as planned if he did not have his third chemo. His oncologist explained that the two rounds put enough toxicity in his system so the radiation could still work. He told my husband that not having the third round would not impede his cure rate. He is 14 months from his last radiation treatment. He has put on 16 pounds and is starting to eat more solid foods. Hang in there!!!
  • buzz99
    buzz99 Member Posts: 404
    Two out of three
    Our oncologist advised that Buzz skip the third dose of the TPF protocol (taxotere, platinol {cisplatin} and 5FU). He had major issues with this "cocktail". No hearing loss but kidney disfunction and neuropathy (numb fingers and toes)were problems.
  • jermain21
    jermain21 Member Posts: 15
    me 2,
    I finished all of my radiation. My doctor didn't want me to do a third dose of chemo.
  • Ron49
    Ron49 Member Posts: 91
    Only 2 for Me
    Hi Robinleigh

    My husband Ron just finished his treatment last Friday. He was diagnosed with SCC with mets to the left lymph, had the 3 cm node removed and a tonsilectomy on Jan 3, 2011. No primary tumor was located so we never officially got a stage of the cancer. He Started 3 rounds of cisplatin on Feb 15 with 33 concurrent rads. He had a peg put in the week before rads and chemo started. So we are just a little ahead of you in terms of treament. He has been so sick and has lost 30lbs. We have been in the ER or at the hospital 3 times recently. His onco did not think he could handle the 3rd chemo but she felt that the cancer was isolated to Rons head and neck and that he received lots of benefit from the 2 chemo treatments and she felt since his scan was clean all of the cancer might have been removed during surgery. Ron also has had significant hearing loss and I am now concerned as it seems from what I am reading here this may be permanent? The onco said it would be temporary. His blood counts are all low but his white blood cell count last Friday was 1.6 which is considered critically low. He was scheduled for the 3rd chemo this last Monday April 4th. I am relieved he is not having the 3rd treatment as I don't think physically he could handle it. As it is right now he is very sick. We trust the Onco's judgement and feel the 2 was the right decision. I know this is a very tough time and please know you ad Andy are in our thoughts and prayers.

    Robyn & Ron
  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    Ron49 said:

    Only 2 for Me
    Hi Robinleigh

    My husband Ron just finished his treatment last Friday. He was diagnosed with SCC with mets to the left lymph, had the 3 cm node removed and a tonsilectomy on Jan 3, 2011. No primary tumor was located so we never officially got a stage of the cancer. He Started 3 rounds of cisplatin on Feb 15 with 33 concurrent rads. He had a peg put in the week before rads and chemo started. So we are just a little ahead of you in terms of treament. He has been so sick and has lost 30lbs. We have been in the ER or at the hospital 3 times recently. His onco did not think he could handle the 3rd chemo but she felt that the cancer was isolated to Rons head and neck and that he received lots of benefit from the 2 chemo treatments and she felt since his scan was clean all of the cancer might have been removed during surgery. Ron also has had significant hearing loss and I am now concerned as it seems from what I am reading here this may be permanent? The onco said it would be temporary. His blood counts are all low but his white blood cell count last Friday was 1.6 which is considered critically low. He was scheduled for the 3rd chemo this last Monday April 4th. I am relieved he is not having the 3rd treatment as I don't think physically he could handle it. As it is right now he is very sick. We trust the Onco's judgement and feel the 2 was the right decision. I know this is a very tough time and please know you ad Andy are in our thoughts and prayers.

    Robyn & Ron

    Neulasta
    I believe my counts were below 2.0 also, 1.8 if I remember correctly.

    Each week following the Cisplatin, Taxotere and 5FU,I'd get an injection of Neulasta. It's pretty pricey as I recall somewhere between $2,000 - 5,000. It's main purpose is to regenerate the blood cells within the bone marrow. I know that in about 2-3 days, my major bones (back,legs, arms) would ache really bad, like a bad flu coming on.

    It took 8-12 months post treatment before all of my blood counts came back within normal ranges.

    Thoughts & Prayers,
    John
  • DrMary
    DrMary Member Posts: 531 Member
    Skiffin16 said:

    Neulasta
    I believe my counts were below 2.0 also, 1.8 if I remember correctly.

    Each week following the Cisplatin, Taxotere and 5FU,I'd get an injection of Neulasta. It's pretty pricey as I recall somewhere between $2,000 - 5,000. It's main purpose is to regenerate the blood cells within the bone marrow. I know that in about 2-3 days, my major bones (back,legs, arms) would ache really bad, like a bad flu coming on.

    It took 8-12 months post treatment before all of my blood counts came back within normal ranges.

    Thoughts & Prayers,
    John

    2 is the new 3
    Our chemodoc said that studies were leaning toward 2 cisplatin treatments for HPV-caused tonsil cancer, at least. This was good news, as Doug was not going to make it through a third dose (his nausea and vomiting went way beyond the expected 7-10 days).

    As everyone else has said, however, you have to trust your doctor - I was glad he wanted to stop at 2.
  • robinleigh
    robinleigh Member Posts: 297
    Ron49 said:

    Only 2 for Me
    Hi Robinleigh

    My husband Ron just finished his treatment last Friday. He was diagnosed with SCC with mets to the left lymph, had the 3 cm node removed and a tonsilectomy on Jan 3, 2011. No primary tumor was located so we never officially got a stage of the cancer. He Started 3 rounds of cisplatin on Feb 15 with 33 concurrent rads. He had a peg put in the week before rads and chemo started. So we are just a little ahead of you in terms of treament. He has been so sick and has lost 30lbs. We have been in the ER or at the hospital 3 times recently. His onco did not think he could handle the 3rd chemo but she felt that the cancer was isolated to Rons head and neck and that he received lots of benefit from the 2 chemo treatments and she felt since his scan was clean all of the cancer might have been removed during surgery. Ron also has had significant hearing loss and I am now concerned as it seems from what I am reading here this may be permanent? The onco said it would be temporary. His blood counts are all low but his white blood cell count last Friday was 1.6 which is considered critically low. He was scheduled for the 3rd chemo this last Monday April 4th. I am relieved he is not having the 3rd treatment as I don't think physically he could handle it. As it is right now he is very sick. We trust the Onco's judgement and feel the 2 was the right decision. I know this is a very tough time and please know you ad Andy are in our thoughts and prayers.

    Robyn & Ron

    It's amazing to be able to
    It's amazing to be able to chat with people going through the same battle.
    We saw the oncologist today and haven't determined yet whether Andy will do the 3rd round of cisplatin. It will depend on his blood work next week.
    Andy did not get a PEG tube prior to treatment but since swallowing has gotten so difficult he's getting one on Tuesday. I hope it will be a relief for us both because he's been getting fluids quite often because of dehydration and has quite a time getting his medications down.
    Robyn....I was wondering why Ron has lost so much weight when he has the PEG?
    My best wishes to all of you!
    Hoping is Coping!
    Robinleigh
  • sweetblood22
    sweetblood22 Member Posts: 3,228

    It's amazing to be able to
    It's amazing to be able to chat with people going through the same battle.
    We saw the oncologist today and haven't determined yet whether Andy will do the 3rd round of cisplatin. It will depend on his blood work next week.
    Andy did not get a PEG tube prior to treatment but since swallowing has gotten so difficult he's getting one on Tuesday. I hope it will be a relief for us both because he's been getting fluids quite often because of dehydration and has quite a time getting his medications down.
    Robyn....I was wondering why Ron has lost so much weight when he has the PEG?
    My best wishes to all of you!
    Hoping is Coping!
    Robinleigh

    Still lost weight with Peg tube.
    I'm not Ron, but I still lost 40 lbs with my tube. I did ok with my weight during treatment and then a couple weeks after all hell broke loose and I couldn't keep any liquid nutrition in me. Severe vomiting. I was down to 87 lbs. Finally I got a pump for overnight which delivered my cans of food extremely slowly. One can took three hours.

    A few of us have had these issues after rads and have to weather that dreaded 'j' curve.
  • KristynRuth86
    KristynRuth86 Member Posts: 140

    Still lost weight with Peg tube.
    I'm not Ron, but I still lost 40 lbs with my tube. I did ok with my weight during treatment and then a couple weeks after all hell broke loose and I couldn't keep any liquid nutrition in me. Severe vomiting. I was down to 87 lbs. Finally I got a pump for overnight which delivered my cans of food extremely slowly. One can took three hours.

    A few of us have had these issues after rads and have to weather that dreaded 'j' curve.

    I didn't complete 3
    I was scheduled to have 3 done, and I can't remember why, but the 2nd one got rescheduled for a week later, so when it was time to go for number 3 they told me there wasn't a need since my rad trtmnt was almost over and the 2 go hand and hand.
  • Army_Guy
    Army_Guy Member Posts: 53
    ...2 or 3 Treatments
    Here's my 2 cents. Each one of our bodies are different. I had a very aggressive treatment for an S3, T4, M0 HPV-based tumor in my throat. Radiation twice daily for 6 weeks; chemo (Cisplatin) once per week for 6 weeks. I finished on August 12, 2010;PET in November 2010 showed my bod to be cancer-free. PEG removed Sep 28th; chemo port removed April 6, 2011 (last Wednesday). Minimal side effects: dry mouth, some ringing in my ears but no hearing loss; major weight loss (83 lbs...but I was overweight) but weight has been stable for about 6-7 weeks. Thyroid problems being treated with meds. All in all I fared pretty well for an old guy. My point is, you have to hope your doctor knows YOU and understands your particular case well enough to work with you and make informed decisions. The outcome is in the medical oncologists and the "Big Guy's" hands...Dave