The Taber Family Blog

My consultation with my oncologist went well today. I’ve got some great doctors and he was one of the nicest and most informative so far.

Today we discussed the range of treatment possibilities based on the current diagnosis, but ultimately we’re waiting for two doctors to agree on the exact nature of the cancer before a final treatment plan is put into motion. The plan originally was always radiation and chemo, since the tumor was thought to be poorly differentiated. However there is some discussion between my own doctor and the chief of head and neck surgery at Stanford that the cancer may in fact be well differentiated, which would steer us toward surgically removing the tumor and possibly avoiding the chemo and radiation entirely. My pathology results have already been sent to Standford along with the slides and images so Dr. Kaplan can make a final assessment.

So my chemo doctor today told me the standard for chemo treatment is cisplatin and has been since the 70’s. However it is notorious for making you vomit frequently as is well documented in the various cancer blogs I’ve been reading. The stats collected since the 70’s indicate cisplatin and radiation working very well together for patients who are older than me and have other health risks such as alcohol and smoking. A new chemo drug on the scene is erbitux (aka Cetuximab). Stats show similar results as cisplatin, but the stats for men in my age group with no other health problems are inconclusive. Probably about the same, but the data to support this conclusion is simply not strong enough. I’ve also learned that erbitux is extremely expensive. Not sure if that has any bearing on which way I end up going or not. I guess it’s ultimately up to the doctors and my HMO. Anyway, today my doctor was honest in saying because I’m still fairly young and in good health he would probably recommend throwing the book at me, meaning moving ahead with cisplatin.

He also mentioned that cisplatin increases the effect of radiation, so heavy sores in the mouth and an almost inability to eat for a while would occur. So he said having a PEG tube installed early would help to keep my weight up during the time I’m not able to eat. Possible dental problems and dry mouth forever are highly likely. Lovely.

Nothing more for me to do here until Dr.’s Kaplan and Woolf agree on a course of action. I’m starting to root for surgery. I also have a consultation with Dr. Jones, the radiologist, on the 23rd of January. Hopefully we’ll have a final treatment plan in place by then.

So I’m in good shape, living normally and the pain in my mouth is completely manageable with Aleve. Evidently I still have some time before things begin in earnest. Yippee!

A couple good resource links I got from the doctor today.

www.nccn.org The National Comprehensive Cancer Network

www.cancer.org American Cancer Society

www.cancer.gov The National Cancer Institute

And one I found on my own, concerning clinical trials of Cetuximab

http://www.cancer.gov/clinicaltrials/results/head-neck-cetuximab0604