head & neck cancer in lungs, liver - 1248615

dsc1forever
Posts:2

8/10/10 diag head&neck cancer, origin base of tongue, 8/16/10 treatment radiation full neck 43 days chemo 6 days/1per week, released to return to work 7/6/11, 3/10/12 diag head&neck cancer in left lung treatment 5 cyborknife, 7/6/12 diag head&neck cancer 'widely metastasized to both lungs' chemo carboplatin 1/3wks, erbutix 1/wk for 3 sets = 9weeks, 9/26/12 diag additional spreading in both lungs and new tumor in liver chemo taxotere 1/3wks 3 sets = 9weeks

my question is can this be contained and or eradicated - would like to converse with others who have been thru this

Forums

catdander
Posts:

Hello Duke, Welcome to Grace. I'm so sorry you are going through this. We do have a great set of blog/posts and expert specialist input on head and neck cancer but at this time we don't have a patient group that discusses head and neck cancer. That's only because the head and neck cancer portion of the site is fairly new and just hasn't happened. Hopefully that will change. It may sound a odd but along with a great amount of knowledge I have also received a great deal of comfort discussing lung cancer with others.

Below is a quote and link to a blog post discussing treatment for head and neck cancer that starts with,
"The first question to ask when addressing incurable SCCHN is to be sure that the cancer really is incurable. When SCCHN recurs, it often recurs locally, at or near the site of the original cancer. For this reason, local salvage therapies such as surgery, radiation, chemoradiation or even repeat chemoradiation can sometimes elicit a cure for the patient with a local or local-regional recurrence. These topics are important and will likely be the subject of future posts on GRACE. The rest of this post will assume that the patient truly is incurable, either because local maneuvers are no longer possible, the cancer has spread to distant sites, or the patient has made a choice to not receive further surgeries or radiation."

http://cancergrace.org/hnscc/2010/05/18/chemotherapy-for-incurable-scch…

Dr. Weiss is very fond of reminding us that he has 2 reasons for treating incurable cancer, to extend life and increase or maintian a good quality of life.

This next blog post is an introduction to head and neck cancer.
http://cancergrace.org/hnscc/2010/05/10/intro-to-scchn/#more-1092

I hope this helps and I hope others will read this and join the conversation.

Janine
forum moderator

Dr West
Posts: 4735

I'm afraid it can't be eradicated, and the goal here would be to prolong your survival as long as possible, while trying to minimize both cancer-related symptoms and treatment-related side effects. There are some other treatments that can potentially be tried, the main focus being on chemo to try to treat cancer throughout your body, since it has spread beyond where it started.

Good luck.

-Dr. West

dr. weiss
Posts: 206

Dear Duke,

I'm sorry to hear that you're in this situation. Unfortunately, as Dr. West notes, once head/neck cancer has spread outside of the head/neck region, it is not curable. While the "C" word of "cure" is not possible, there is real hope for the other "C" word -- "control." As Catdander notes, control can extend duration and quality of life. Generally, if a treatment is working, we continue it. I personally define, "working" as two conditions being met: 1) Cancer is not growing (doctor defined) 2)Side effects are limitted or at least acceptable (patient defined). So, if docetaxel is working, the standard of care would be to continue it.

If docetaxel is failing, or it fails in the future, there are multiple options available to you:

*Clinical trial
*Methotrexate
*Xeloda or 5FU
*Focus all efforts on comfort (hospice)

Within the realm of clinical trials, there's plenty of promising stuff out there. Locally, I would offer a patient in your situation a clinical trial involving A041-03, a drug that inhibits the blood vessel growth to cancers. It's given as a shot every three weeks. If you haven't done so already, you may wish to be seen by a medical oncologist with specialized expertise in head/neck cancer to see if any promising trials are availabel near you.

catdander
Posts:

Thank you Dr. Weiss for your input. It's good to see you on the boards. Wow, I didn't know there were so many "C" words, I counted 8 in your post. I like the take on it.

control, what we all want
continue, if it works don't fix it
curable, we wish but too often must move forward
clinical, that's where our great doctors are making us feel better and moving medical science forward
catdander, that's me!
comfort, we all need that
cancer, of course
conditions, it always depends

Duke, I hope you find what will give you the best for a long time to come. Let us know how things go and how we can help

Janine

dsc1forever
Posts: 2

hi - since i last wrote i have been on taxoterre, i did have a pet scan that the chemo dr said was 'stable' no spreading but no decrease, so we continued the taxo until 3 weeks ago when the latest pet scan showed no new tumors but the tumors in my lungs and liver had grown, today i rec my new chemo xeloda which i will take 6 500mg tabs 2x day = 6000 mg day for 14 days then a week off then 14 more days then a new pet scan i have been in chemo since the begining of july 2012 my best hope is that this new chemo slows the growth of all these tumors i do have a couple of questions what are the odds that the xeloda contains what other chemo drugs could we use so far my side effects from the chemo have been min, i do spend 2-4 days in bed, am on prozac, have some pain in my left lung, memory loss, dizziness, hard to breath when i stand up too quick (they say there is fluid under my left lung)

catdander
Posts:

Hi Duke, It's good to hear from you. I'm glad you've done so well on taxotere. I understand the side effects can be quite difficult for some people.

I'll ask Dr. Weiss, our head and neck specialist to comment on your questions.

In the meantime I'm sure you've seen this section but want to make sure you know we have a growing section in our expert commentary on head and neck cancer. I hope you do well on your next treatment for a very long while. http://cancergrace.org/hnscc/

Janine
forum moderator

dr. weiss
Posts: 206

Xeloda has been studied in a phase II trial of patients whose cancer had previously progressed on platinum-containing regimens. The response rate was 22.5%. However, it's worth reviewing how "response" is defined in clincial studies since it's a little funny. "Response" means at least 30% shrinkage of tumor. Patients whose cancer shrunk less than 30% or whose cancer was stopped growing for a time might have also achieved benefit not captured by this measure.

The most common side effects from xeloda, when used alone for head/neck cancer, are low blood counts (like all chemo) hand/foot syndrome (red burning hands and feet) and sores in the mouth and throat.

There are many drugs that have been shown to have some activity in head/neck cancer. After the drugs you've already mentioned, a clinical trial or methotrexate might be considered most standard.