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Chemotherapy for Neck Cancer Treatment

Posts: 19
Joined: Feb 2011

On Tuesday, 02-22-2011, I met with a Otorhinolaryngology (head & neck Surgeon) at the Mayo Clinic in Phoenix, Arizona. Besides being scheduled for surgery, I was told by him that I also would be doing radiation as part of the treatment. I was relieved when he told me that I would not be undergoing any chemotherapy. The doc explained to me that chemo is only to be used with any forms of cancer from the neck down and not from the neck up.

As I read the posting in the Head & Neck Cancer section I can see that plenty of you have had chemotherapy when you were diagnosed with neck cancer. So at this point I am confused but grateful that I will not have to undergo chemo.

Did I misunderstand him when he said "no" chemo for me or is chemo reserved for more serious cases of neck cancer?

RushFan's picture
Posts: 223
Joined: Aug 2010

I was diagnosed with squamous cell carcinoma with an unknown primary. Surgery to remove a suspicious lymph node revealed extra-capsular extentions...and landed me at stage IV.

The option was mine to have Cisplatin chemotherapy...the Cisplatin would enhance the IMRT radiation treatment. The phrase "if you want to throw the kitchen sink at it"...and that's what I decided to do. My doctors told me at the time they were concerned that it might be over treating...but had every confidence I was young and strong enough to handle it very well.

They were right on. So far, I have had three CT Scans with no evidence of disease. I'll have my fourth in about six weeks.

I would ask for detailed clarification. Mayo is top-notch.
All the best to you and your upcoming treatments.


Posts: 19
Joined: Feb 2011

Hey Chuck, thanks for getting back with me. I too have a squamous cell carcinoma in the form of a tumor. Like you, the scans and the doc(s) cannot determine origin. This Monday for my presurgery check I will be seeing a Mayo dermatologist in hopes of locating the squamous cell spot (possibly somewhere on the top of my head). I was told by the surgeon that if the dermatologist cannot find the origin of the squamous cell they would remove my tonsils as part of my surgery

Thanks for your advice and thoughts....


Jimbo55's picture
Posts: 576
Joined: Jun 2010

I was treated with the rads/chemo combination for base of tongue scc stage 4. As Rush said, "The option was mine to have Cisplatin chemotherapy...the Cisplatin would enhance the IMRT radiation treatment". It was stated exactly the same by my MD's.

If you're not sure of anything related to your treatment, ask them to go over it again, and again if necessary, until you have a firm understanding of this. Cheers


Ron49's picture
Posts: 91
Joined: Dec 2010

It was my choice also to have chemo. I also have scc with a metastasized tumor in my left lymph gland (about 3 cm) which was removed Jan 3 along with my tonsils. No primary tumor located for me either however the cells in the tumor were differentiated or poorly formed and considered aggressive. We asked every Dr we know including our primary Head and Neck as well as the Chemo Oncologist and a surgeon we have in the family and all said because of my age if it were them they would take as much treatment as was available. The choice was ours to make. I don't want to minimize this decision as it was I believe the hardest thing my wife and I ever had to do. It is a personal choice for me and my wife as I knew that the lump in my neck had been there for at least 5 months and in my lymphatic system before being diagnosed. None of the docs could answer our question about the chances of the cancer traveling from Ron's lymph gland to another location. This gave us reason to pause and think if maybe it had than we should go for the chemo treatment. It may be over treatment however because I am 49 I am hopeful to never go through this again. I am scheduled for 3 (1x every 3 weeks) IV 6 hour infusions of cisplatin concurrent with 34 IMRT treatments. Yesterday I finished my 8th radiation treatment and have had 1 chemo treatment. So far the chemo has not been too bad. I know I have a long road ahead but I feel good about this decision.

So sorry to hear another person is going through this. I wish you nothing but the best my friend.


sweetblood22's picture
Posts: 3228
Joined: Jan 2010

"The doc explained to me that chemo is only to be used with any forms of cancer from the neck down and not from the neck up."

I don't think this is the prevailing thought by any of the doctors I went to. They wanted me to do Erbitux and I refused. Chemo recommendation may have to do with what stage you are and any metastasis but i think that above statement is inaccurate.

PS. I should add in that I had a neck dissection with clean margins but also an unknown primary. I had radiation only.

Scambuster's picture
Posts: 973
Joined: Nov 2009


The docs have protocols to follow that they share within the industry, but they have various reasons for how and why they recommend a particular line of treatment. Not being informed yourself makes you rely heavily on the doctors choices. (Don't panic, we were mostly all in the same boat) Don't be afraid to seek a second opinion, and definitely ask your doctors why they recommend what they intend to do.

I had minor surgery, then Erbitux which is a target therapy, and the effects are very mild compared to some other Chemo's. I also had IMRT (70 rounds - twice a day for 35 days) and that is what knocked me around. (SCC to left tonsil)

If they are very convinced the tumor is localized with no spread at all, they probably feel comfortable not to use Chemo. Picture Radiation like pulling visible obvious weeds from the garden, and Chemo to spray all over the get the little ones you can't quite see yet. Hope that helps.


buzz99's picture
Posts: 404
Joined: Sep 2010

It is odd that a Mayo doc said no chemo for above the neck cancer. We consulted with three Mayo docs last August and all three mentioned treatment with chemo and radiation should we choose to not have surgery. Buzz had two rounds of Taxotere, Cisplatin, and 5FU followed by Erbutux and concurrent radiation (33 treatments) as recommended by Mayo but done in our home town. Your paticular case may not warrant chemo but you should ask why.

Kent Cass
Posts: 1898
Joined: Nov 2009

I am Nasopharyngeal, as are a number of others here. Nasal, as in nasal cavity, and pharynx as in the back of the mouth. I was not presented with a choice, according to my ENT and Onco, with the apparent blessing of the University of Iowa- got both chemo and radiation at the same time. ENT told me that ONLY RADIATION WAS THE WAY IT USED TO BE TREATED, but now it's standard, at least for H&N that has shown to have spread, to get both the chemo and rads. Chemo is what aces the C everywhere it might be, whereas the rads ace the C where the rads are applied. Not as simple as that, but I think that's a good overview. And, chemo is definitely used for Cs that are above the neck, as many here will testify.

Your C Dr. may have specific reasons for advising that chemo isn't needed, and the reasons might be justification, but this does seem a bit peculiar. Mayos?! One would think any Dr. affiliated directly with Mayo's is top-notch, and correct in the treatment plan. Might wanna ask this Dr. for at least one specific reason why chemo isn't in the cards. As you say, though, you are getting surgery done, so that just may factor into this in a way that makes your Dr.'s plan correct.


I should have noted in the above post that the reoccurance factor is part of the chemo and rads combo treatment. Personally know of a case that was tongue, and only rads were done. Within two years it was back so severe that one of those 16-hour Ops was necessary at the U of Iowa, and took a great physical toll on the patient. Drs. at the U of Iowa told him he should have had both chemo and rads- not just the rads.

DominicM's picture
Posts: 18
Joined: Nov 2010

Although docs told me it was my choice, here was their criteria for recommending chemo + rads + surgery for my SCC, BOT, met to lymph node in neck.
I saw several local docs and was also evaluated at Dana Farber Institute in Boston as well as seeing a genetic counsilor for further testing and recommendations....they all agreed that chemo would not offer a lot of benefits and that radiation was the mainstay of treatment....BUT...due to my age (43) and health (excellent) and the fact that it had metastasized to lymph nodes, everyone agreed that I should hit it with everything as I could most likely easily tolerate the treatment.

Skiffin16's picture
Posts: 8286
Joined: Sep 2009

For me (having tonsil cancer and a tumor) STG III SCC HPV+), there was no choice. I was advised basically that there are three protocols, surgery, radiation and chemo. The best plan at present was a combination usually of the three.

In my case it was surgery for the tonsils, nine weeks of chemo in three week cycles (Cisplatin, Taxotere and 5FU), then seven weeks of concurrent weekly chemo/35 daily rads. Like mentioned the weekly chemo was Carboplatin (a lesser version of Cisplatin), which reacts well with the rads.

I might opt for a second opinion. Historically on this forum, the majority have had both radiation and chemo, and a lot with some form of surgery.


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