Has anyone had radiation to their head and neck area TWICE?

MJG1
MJG1 Member Posts: 137 Member

My husband had head and neck cancer 5 years ago and had chemo and 35 radiations.  The cancer is traveled to the other side and now we don't know if he will even qualify to get radiation in the opposide side.  Please share if you have had an experienc like this.  Thank you,

Comments

  • LitlCJdoll
    LitlCJdoll Member Posts: 245 Member
    Yes, depending on specifics---

    To answer Margi,

    Yes, I have known a few men who have had radiation twice, head / neck.  On this forum, on the Inspire forum, and 2 in person at my surgeon's clinic.

    There are lots if factors that go into the decision by the treatment team.  Its not something the patient can "request".  They have to weigh many consequences of radiating twice.  Its a Risk versus benefit scenario.

    When I asked for a second round, just to target a New Primary tumor that came up 9 months after my first radiation treatments ( 66 Gy), my R O stated an emphatic No. He said it would Rupture my Carotid artery, and I would have a bleed out.  

    These guys know our Anatomy, the problems we had with the first round, etc. So, I implicitly trusted his answer.

     

    Because I am in the Cancer Center hospital, I need sleep because the doctors will be Rounding early in the morn. Nighty night.

    Crystal

    P.S. I'm curious what Dennis thinks of --- asking about a second round?  What is his input?  I'm always interested to hear from a fellow patient/ survivor.

  • wbcgaruss
    wbcgaruss Member Posts: 2,482 Member
    edited August 2021 #3
    Yes I Have Had

    Radiation a second time in H&N area.
    Here is an excerpt from my CSN page--

    Hello again just to update-Hershey Medical is recommending radiation follow-up to my lymph node operation. Since I had throat cancer in 2013 this radiation would be right around a previously radiated area. Rather than go the distance to Hershey we have had my records transferred down to the local Cancer clinic to the doctor that did my previous radiation. I am starting radiation treatments Monday, December 30th, 2019 and if I don’t miss any I will be done on Feb. 7th, 2020. I am getting a total of 30 treatments.
    They are avoiding as much as possible my old radiation areas and my throat, spine, mandible, etc., and just trying to do what is absolutely necessary to give me a good outcome and not cause any unnecessary damage, and hopefully, I will not lose my swallowing ability. I am not looking forward to it but they tell me it is a high probability of cancer coming back with no treatment. I am to get 30 treatments with the cyberknife. Take Care-God Bless

    So I had the cyberknife at the cancer center near me.
    They originally wanted me to go to Philadelphia for proton therapy which is many times the best for the head and neck because it damages less surrounding tissue but I really didn't feel up to the travel every day so my local cancer center felt the cyberknife would work out for me. Our local cancer center is excellent and my radiation doctor and his team are super.
    Everything went well and so far (knock on wood) Actually praise God and give him the Glory I am cancer-free.
    Please check out Proton Therapy and actually here is a page from Memorial Sloan Kettering Cancer Center that explains the many types of radiation.
    https://www.mskcc.org/cancer-care/types/head-neck/treatment/radiation-therapy

    Proton Therapy

    Proton therapy is a form of radiation that uses proton beams instead of photon beams. Unlike photons, protons do not penetrate beyond the tumor. That’s why proton therapy reduces the likelihood of side effects caused by damage to normal tissue. Because there could be fewer side effects, proton therapy allows us to use a higher radiation dose on the tumor, maximizing the chance of destroying it.

    Proton therapy is extremely helpful for many people. At present, it is most commonly used for head and neck cancer that has come back after prior treatment.

    Memorial Sloan Kettering is one of a limited number of centers nationwide that offer proton therapy.

    Wishing You The Best-Take Care-God Bless-Russ

  • Ag123
    Ag123 Member Posts: 54 Member
    It sounds like your husband

    It sounds like your husband did hit the 5 year bench mark. Sorry it had decided to appear again. 
    If it makes you feel any different, I have read many case reports and stories on patients getting re-irradiated after a recurrence. I have rotated in oncology department for a while myself as a student. It's not uncommon. Many seem to be doing fine if they can tolerate the effects. The last time I checked survival studies (2 year survival and even 5 year survival) looked promising if the tumor is small or if it's been a long time since their last radiation (enough to recover), their last and current dose, etc. I'm sure a lot of factors have to be considered and weighed our carefully especially when there is an option to do surgery (endoscopic or not) and try out newer less toxic therapies.

    On the flip side I've know some folks who had to opt out of surgery after their cancer was determined enough to show up for the 3rd time because the region was basically too damaged to handle it. So I can understand why some oncologists approach that decision cautiously.

     

    I would get multiple expert opinions on this. 

    but as you can see there's definitely hope!

    Best of luck to your husband.

  • johnsonbl
    johnsonbl Member Posts: 266 Member
    It is possible but depends on how much...

    radiation you already received to the location you now need to treat.  The calculations are all quite complicated...but it is possible.  Your radiation oncologists will figure it out for you.

  • LitlCJdoll
    LitlCJdoll Member Posts: 245 Member
    edited September 2021 #6
    Ag123 said:

    It sounds like your husband

    It sounds like your husband did hit the 5 year bench mark. Sorry it had decided to appear again. 
    If it makes you feel any different, I have read many case reports and stories on patients getting re-irradiated after a recurrence. I have rotated in oncology department for a while myself as a student. It's not uncommon. Many seem to be doing fine if they can tolerate the effects. The last time I checked survival studies (2 year survival and even 5 year survival) looked promising if the tumor is small or if it's been a long time since their last radiation (enough to recover), their last and current dose, etc. I'm sure a lot of factors have to be considered and weighed our carefully especially when there is an option to do surgery (endoscopic or not) and try out newer less toxic therapies.

    On the flip side I've know some folks who had to opt out of surgery after their cancer was determined enough to show up for the 3rd time because the region was basically too damaged to handle it. So I can understand why some oncologists approach that decision cautiously.

     

    I would get multiple expert opinions on this. 

    but as you can see there's definitely hope!

    Best of luck to your husband.

    Brandon is correct

    As Brandon just wrote, his Radiation Oncologist will be the One to decide.

    You don't get " multiple" doctors giving input on something as specific as radiation.... There is a Dossimetrist involved and the Radiation Oncologist.

    Neither my oncology head & neck surgeon nor my Medical Oncologist would weigh in on this isdue----- The expert in both the Subject, and in his very specific case, is the Radiation Oncologist.  

    So, he knows best on this matter, all things Radiation!!

    Myself, I literally begged for a second round, because I had a New Primary come up only 9 months after radiation treatments. So invasive and fast growing it took 2 more surgeries.

    My R O said No Way, Crystal.  He told me it would rupture my carotid artery....

    I 100% trust him ( and he is also a great friend too !).  ?

     

  • Duggie88
    Duggie88 Member Posts: 760 Member
    edited September 2021 #7
    wbcgaruss said:

    Yes I Have Had

    Radiation a second time in H&N area.
    Here is an excerpt from my CSN page--

    Hello again just to update-Hershey Medical is recommending radiation follow-up to my lymph node operation. Since I had throat cancer in 2013 this radiation would be right around a previously radiated area. Rather than go the distance to Hershey we have had my records transferred down to the local Cancer clinic to the doctor that did my previous radiation. I am starting radiation treatments Monday, December 30th, 2019 and if I don’t miss any I will be done on Feb. 7th, 2020. I am getting a total of 30 treatments.
    They are avoiding as much as possible my old radiation areas and my throat, spine, mandible, etc., and just trying to do what is absolutely necessary to give me a good outcome and not cause any unnecessary damage, and hopefully, I will not lose my swallowing ability. I am not looking forward to it but they tell me it is a high probability of cancer coming back with no treatment. I am to get 30 treatments with the cyberknife. Take Care-God Bless

    So I had the cyberknife at the cancer center near me.
    They originally wanted me to go to Philadelphia for proton therapy which is many times the best for the head and neck because it damages less surrounding tissue but I really didn't feel up to the travel every day so my local cancer center felt the cyberknife would work out for me. Our local cancer center is excellent and my radiation doctor and his team are super.
    Everything went well and so far (knock on wood) Actually praise God and give him the Glory I am cancer-free.
    Please check out Proton Therapy and actually here is a page from Memorial Sloan Kettering Cancer Center that explains the many types of radiation.
    https://www.mskcc.org/cancer-care/types/head-neck/treatment/radiation-therapy

    Proton Therapy

    Proton therapy is a form of radiation that uses proton beams instead of photon beams. Unlike photons, protons do not penetrate beyond the tumor. That’s why proton therapy reduces the likelihood of side effects caused by damage to normal tissue. Because there could be fewer side effects, proton therapy allows us to use a higher radiation dose on the tumor, maximizing the chance of destroying it.

    Proton therapy is extremely helpful for many people. At present, it is most commonly used for head and neck cancer that has come back after prior treatment.

    Memorial Sloan Kettering is one of a limited number of centers nationwide that offer proton therapy.

    Wishing You The Best-Take Care-God Bless-Russ

    Russ

    Russ

    Perlman Center (part of the Hospital at the University of Pennsylvania) has Proton. I just had regula radiation there because I think they were just setting it up when I was going there back in 2010. I live 74 miles north west of Philly and drove back and forth every day for my treatments which wasn't a good idea

     

    Jeff

  • MJG1
    MJG1 Member Posts: 137 Member
    wbcgaruss said:

    Yes I Have Had

    Radiation a second time in H&N area.
    Here is an excerpt from my CSN page--

    Hello again just to update-Hershey Medical is recommending radiation follow-up to my lymph node operation. Since I had throat cancer in 2013 this radiation would be right around a previously radiated area. Rather than go the distance to Hershey we have had my records transferred down to the local Cancer clinic to the doctor that did my previous radiation. I am starting radiation treatments Monday, December 30th, 2019 and if I don’t miss any I will be done on Feb. 7th, 2020. I am getting a total of 30 treatments.
    They are avoiding as much as possible my old radiation areas and my throat, spine, mandible, etc., and just trying to do what is absolutely necessary to give me a good outcome and not cause any unnecessary damage, and hopefully, I will not lose my swallowing ability. I am not looking forward to it but they tell me it is a high probability of cancer coming back with no treatment. I am to get 30 treatments with the cyberknife. Take Care-God Bless

    So I had the cyberknife at the cancer center near me.
    They originally wanted me to go to Philadelphia for proton therapy which is many times the best for the head and neck because it damages less surrounding tissue but I really didn't feel up to the travel every day so my local cancer center felt the cyberknife would work out for me. Our local cancer center is excellent and my radiation doctor and his team are super.
    Everything went well and so far (knock on wood) Actually praise God and give him the Glory I am cancer-free.
    Please check out Proton Therapy and actually here is a page from Memorial Sloan Kettering Cancer Center that explains the many types of radiation.
    https://www.mskcc.org/cancer-care/types/head-neck/treatment/radiation-therapy

    Proton Therapy

    Proton therapy is a form of radiation that uses proton beams instead of photon beams. Unlike photons, protons do not penetrate beyond the tumor. That’s why proton therapy reduces the likelihood of side effects caused by damage to normal tissue. Because there could be fewer side effects, proton therapy allows us to use a higher radiation dose on the tumor, maximizing the chance of destroying it.

    Proton therapy is extremely helpful for many people. At present, it is most commonly used for head and neck cancer that has come back after prior treatment.

    Memorial Sloan Kettering is one of a limited number of centers nationwide that offer proton therapy.

    Wishing You The Best-Take Care-God Bless-Russ

    Proton Therapy

    Russ, You are very helpful and give me hope.  YES, we're looking into Proton Therapy with the Drs.  There is some concern that insurance will fight, but we shall see.  I totally understand your desire for treatment within your home comfort zone.  

    May I ask you if you are able to swallow at this time?  

    Thank you,

    Margi

  • MJG1
    MJG1 Member Posts: 137 Member
    edited September 2021 #9
    Ag123 said:

    It sounds like your husband

    It sounds like your husband did hit the 5 year bench mark. Sorry it had decided to appear again. 
    If it makes you feel any different, I have read many case reports and stories on patients getting re-irradiated after a recurrence. I have rotated in oncology department for a while myself as a student. It's not uncommon. Many seem to be doing fine if they can tolerate the effects. The last time I checked survival studies (2 year survival and even 5 year survival) looked promising if the tumor is small or if it's been a long time since their last radiation (enough to recover), their last and current dose, etc. I'm sure a lot of factors have to be considered and weighed our carefully especially when there is an option to do surgery (endoscopic or not) and try out newer less toxic therapies.

    On the flip side I've know some folks who had to opt out of surgery after their cancer was determined enough to show up for the 3rd time because the region was basically too damaged to handle it. So I can understand why some oncologists approach that decision cautiously.

     

    I would get multiple expert opinions on this. 

    but as you can see there's definitely hope!

    Best of luck to your husband.

    5 year

    Ag123...He did almost make 5 years cancer free.  Tongue cancer showed up as a sore...Was removed and came back again. ct on sept 8 showed NOTHING...Cancer was already growing, but not showing...PEt showed the tongue tumor plus another new tumor in his throat.  That was a heart breaker.  We know we have an up hill battle and are letting our team at Siteman put it together to present to us and then we'll decide how to proceed.  Since none of us knows the health of others outside this stupid cancer it's very alarming to me to put numbers of years on it etc.  One day at a time trying to get rid of the tumor and stay healthy is what we plan to do. Cancer, hopefully, will be a blip on the radar .  Praying for that for sure

  • wbcgaruss
    wbcgaruss Member Posts: 2,482 Member
    edited September 2021 #10
    MJG1 said:

    Proton Therapy

    Russ, You are very helpful and give me hope.  YES, we're looking into Proton Therapy with the Drs.  There is some concern that insurance will fight, but we shall see.  I totally understand your desire for treatment within your home comfort zone.  

    May I ask you if you are able to swallow at this time?  

    Thank you,

    Margi

    Yes To The Affirmative

    I can swallow and certainly give full credit to my radiation doctor and his team.
    In fact a shout out to Dr. Kenneth G. Berkenstock & his team at Lancaster General Hospital Radiation Oncology.
    However, each case is different and unique as per the patient.
    I think some of it depends on total radiation and the areas received.
    I am pretty sure that is my last chance to have radiation as an option.
    And hopefully, I don't need any more chances for treatment options because I would like cancer to take a hike and leave me alone-Amen
    Through all my 3 cancers I can still swallow and eat most anything but I can't swallow as well as pre-treatment.
    It takes me twice as long to eat a meal as it does my wife.
    Depending on the food it takes awhile.
    No quick meals for me anymore.
    And in swallowing sometimes things just sort of get where they don't go down so you push it back in your mouth
    and chew it some more and add water or soda whatever you like with your meal.
    I also quit swallowing pills as there is too much problem and risk with them getting stuck.
    I take all my meds now with applesauce I just open the capsules and have a little hand grinder for the hard pills.
    After my first cancer back in 2013 I had swallowing issues and food getting stuck so I had 4 dilations to open my throat more.
    So not perfect but dealing with my situation and thankful for where I am at, Praise God.
    Watching your situation and hoping all works out well for you-Take Care-God Bless-Russ

  • Ladylacy
    Ladylacy Member Posts: 773 Member
    Radiation

    My husband had his first round of radiation for laryngeal cancer in 2010 (35 radiation treatments) then he had his second round of 35 radiation treaments one year later when his cancer spread to the cervical of his esophagus.  Second round really did damage and he was on a feeding tube for the last 4 years of his life.  He needed a third round when it was discovered that the cancer had returned but my husband said no more.

  • LitlCJdoll
    LitlCJdoll Member Posts: 245 Member
    Ladylacy said:

    Radiation

    My husband had his first round of radiation for laryngeal cancer in 2010 (35 radiation treatments) then he had his second round of 35 radiation treaments one year later when his cancer spread to the cervical of his esophagus.  Second round really did damage and he was on a feeding tube for the last 4 years of his life.  He needed a third round when it was discovered that the cancer had returned but my husband said no more.

    When its too much

    Dear Ladylacy,

     

    I went through this for the past years,  with Randal my boyfriend. May 18th he passed away, after finally putting in a DNR order at the hospital, the week before.     Back in January this year, it would have happened but then he had Full Code orders, and they brought him back.  He very much regretted that they revived him, in January....

    Randal had Radiation twice. He had Immunotherapy agents twice. And he had 9 YEARS of many different chemotherapy agents.

    Before his Head & Neck cancer, he had CLL Leukemia Stage IV.   They got it into Remission with chemo, and they took out  his feeding tube.

    A few months later, a CT scan found he had Base of Tongue SqCC, and it was HPV Positive .  He was immediately started on Cisplatin and his 35 . radiation treatments. However, his Metastasized to his Liver, spine vertebrae, right hip bone and also surrounded his gall bladder.  His SqCC metastasized very quickly, even though it was an HPV cancer.  

    6 tumors in the liver.  Keytruda, ....Opdivo ...Carboplatin,  Taxol,... Gemzar,...Xeloda ,.....  Some of these would shrink the tumors some, but just months later the tumors came roaring back.

    He actually had a 3rd Radiation, and that was done for Palliative measures to the right hip Bone tumor, to kill the pain.  He was Falling so much and at 6'2" tall, a fall was like a tree falling.  It was really hard to get him back up, in the later months....

    With the last chemotherapy, it was so very harsh that it stripped him of All quality of life.  ( things like Blistered hands and feet. His skin cracked open and bled. He could not longer use a syringe, nor open a pill bottle.... Etc.)  His s voice completely disappeared, in January. Not a word uttered, ever again.  .  He was in constant pain. Sleep, when he could get it, was his only peace.

    He decided 9 Years was a long enough Fight.  Keep in mind, there was No  respite between his 2 Stage IV cancers. None.   He got the second PEG tube years ago, and the Tracheostomy in  October 2019. Actually, he and I were in the Emergency dept at the same time, different reasons.  Both of us admitted then.

    Randal was only 60.  His father died of cancer at age 58, and Randal spoke his Eulogy. .

    He put up one he!! of a fight though.  He didnt go into Hospice, he stayed on  treatments.

    .He chronicled much of it on Quora, if anyone here reads that online Digest.  He wrote his autobiography as well.

    So, he had 3 courses of Radiation...

    Sorry, to write this, but  I just lost him on May 18th, at 3:15 am.  Its still on my mind.  Very strong fighter.  He liked that about me, as well,----- that I've kept going in spite of it all.

    ?

    crystal

  • wbcgaruss
    wbcgaruss Member Posts: 2,482 Member
    edited September 2021 #13

    When its too much

    Dear Ladylacy,

     

    I went through this for the past years,  with Randal my boyfriend. May 18th he passed away, after finally putting in a DNR order at the hospital, the week before.     Back in January this year, it would have happened but then he had Full Code orders, and they brought him back.  He very much regretted that they revived him, in January....

    Randal had Radiation twice. He had Immunotherapy agents twice. And he had 9 YEARS of many different chemotherapy agents.

    Before his Head & Neck cancer, he had CLL Leukemia Stage IV.   They got it into Remission with chemo, and they took out  his feeding tube.

    A few months later, a CT scan found he had Base of Tongue SqCC, and it was HPV Positive .  He was immediately started on Cisplatin and his 35 . radiation treatments. However, his Metastasized to his Liver, spine vertebrae, right hip bone and also surrounded his gall bladder.  His SqCC metastasized very quickly, even though it was an HPV cancer.  

    6 tumors in the liver.  Keytruda, ....Opdivo ...Carboplatin,  Taxol,... Gemzar,...Xeloda ,.....  Some of these would shrink the tumors some, but just months later the tumors came roaring back.

    He actually had a 3rd Radiation, and that was done for Palliative measures to the right hip Bone tumor, to kill the pain.  He was Falling so much and at 6'2" tall, a fall was like a tree falling.  It was really hard to get him back up, in the later months....

    With the last chemotherapy, it was so very harsh that it stripped him of All quality of life.  ( things like Blistered hands and feet. His skin cracked open and bled. He could not longer use a syringe, nor open a pill bottle.... Etc.)  His s voice completely disappeared, in January. Not a word uttered, ever again.  .  He was in constant pain. Sleep, when he could get it, was his only peace.

    He decided 9 Years was a long enough Fight.  Keep in mind, there was No  respite between his 2 Stage IV cancers. None.   He got the second PEG tube years ago, and the Tracheostomy in  October 2019. Actually, he and I were in the Emergency dept at the same time, different reasons.  Both of us admitted then.

    Randal was only 60.  His father died of cancer at age 58, and Randal spoke his Eulogy. .

    He put up one he!! of a fight though.  He didnt go into Hospice, he stayed on  treatments.

    .He chronicled much of it on Quora, if anyone here reads that online Digest.  He wrote his autobiography as well.

    So, he had 3 courses of Radiation...

    Sorry, to write this, but  I just lost him on May 18th, at 3:15 am.  Its still on my mind.  Very strong fighter.  He liked that about me, as well,----- that I've kept going in spite of it all.

    ?

    crystal

    Dear Crystal You Can

    Never forget one you love so much.
    It is good to share his story and his fight, good for the heart and good for the mind.
    Thank you for telling his story and relaying to us what a fighter he was.
    He certainly tried to beat this disease but it was relentless on him.
    His fight and struggle gives us all hope to not give in but to fight to the next day.
    I am glad Dear Crystal that you have such memories of Randal.
    You have my deepest condolences and support.
    I pray you will find peace as you continue your own battle.
    Wishing You The Best-Take Care-God Bless-Your Friend Russ

  • LitlCJdoll
    LitlCJdoll Member Posts: 245 Member
    edited September 2021 #14
    wbcgaruss said:

    Dear Crystal You Can

    Never forget one you love so much.
    It is good to share his story and his fight, good for the heart and good for the mind.
    Thank you for telling his story and relaying to us what a fighter he was.
    He certainly tried to beat this disease but it was relentless on him.
    His fight and struggle gives us all hope to not give in but to fight to the next day.
    I am glad Dear Crystal that you have such memories of Randal.
    You have my deepest condolences and support.
    I pray you will find peace as you continue your own battle.
    Wishing You The Best-Take Care-God Bless-Your Friend Russ

    Thank uou, dear Russell,...

    Thank uou, dear Russell,....but now I cannot stop sobbing...

  • josh r.
    josh r. Member Posts: 264 Member
    edited September 2021 #15
    Twice saved with rads and chemo

    Hello to you all,

    I have been treated twice with chemo and radiation, first in 1991 for larynx stage 3 cancer, and again last year for stage 3 esophageal cancer. In 1991 this simultaneas treatment was relatively new and as my present radiologist says "that was the stone age". Similar symtoms that I had in 1990-91 began again in April-May of last year and the esophageal cancer was confirmed on July 1st of last year. While surgery was suggested by my ENT and then "my team" at Stanford Med Center, it was with hesitation due to my history, age, nearly 75, I declined. 

    My wife had just had her second anniversary of NED for breast cancer so I went to her oncologist and radiologist where we live on the Central Coast of California and asked for their input.Their staff tried to get my prior history but were not able to get much after 30 years. Fortunately they agreed to treat me, again simultaneasly with nealy 30 radiation treatments along with chemotheropy at one treatment a week. 

    Thanks to God, my wife, daughter, family, and friends along with all the medical brothers and sisters I am doing fine. My last PET Scan, labs etc. in June were clear and normal. I feel that I am pretty much back to my "normal" spiritual, mental and physical balance. I am so grateful and wish you all the best of health. josh

  • MJG1
    MJG1 Member Posts: 137 Member
    edited September 2021 #16
    josh r. said:

    Twice saved with rads and chemo

    Hello to you all,

    I have been treated twice with chemo and radiation, first in 1991 for larynx stage 3 cancer, and again last year for stage 3 esophageal cancer. In 1991 this simultaneas treatment was relatively new and as my present radiologist says "that was the stone age". Similar symtoms that I had in 1990-91 began again in April-May of last year and the esophageal cancer was confirmed on July 1st of last year. While surgery was suggested by my ENT and then "my team" at Stanford Med Center, it was with hesitation due to my history, age, nearly 75, I declined. 

    My wife had just had her second anniversary of NED for breast cancer so I went to her oncologist and radiologist where we live on the Central Coast of California and asked for their input.Their staff tried to get my prior history but were not able to get much after 30 years. Fortunately they agreed to treat me, again simultaneasly with nealy 30 radiation treatments along with chemotheropy at one treatment a week. 

    Thanks to God, my wife, daughter, family, and friends along with all the medical brothers and sisters I am doing fine. My last PET Scan, labs etc. in June were clear and normal. I feel that I am pretty much back to my "normal" spiritual, mental and physical balance. I am so grateful and wish you all the best of health. josh

    Thanks for the response, Josh!

    Congratulations on things working out for you!  I hope you live many more healthy years.