How to fight cisplatin side effects like nausea & fatigue?

I think the toxic effects can be minimized from reading numerous trials and studies on HPV + head and neck cancers.
Had my 2nd cycle of chemo 1 week ago for the same HPV+ but tonsil cancer in my case .
It was a rough week compared to the 1st week . Had many different complications including a spell of nausea and vomiting, constipation, and headache , urinary tract dysfunction to name a few. This old body (67) isn't as tough as it use to be
I think I am done with chemo and have a meeting with the oncologist tomorrow. But like you said everyone and their specific case is different.
That said the chemo was offered as a adjuvant therapy or a helpful addition to radiation but seems some people
just go with the radiation alone which is where I am heading and in a lot of cases end up with similar results.
Although it may take less radiation treatments with a couple rounds of chemo so there is that potential tradeoff.
I've seen stats like 3-5 less radiation treatments per chemo treatment.
Good luck with whatever you choose to do. Lots of research at your fingertips .

It's a difficult battle. Not impossible but very difficult just the same. Likely it may be the hardest thing you have or ever will do. But it must be done and somehow we get through this.
On the plus side, we get a second chance. We reacquaint ourselves with all the world has to offer. We might become more human. We might worry less about our own mortality.
Don't hesitate to ask your care team for any medications which might help you cope better with the side effects of your treatments. I certainly wish I had spoken up more and certainly now I would be more in charge of my own care and treatments than I was at that time.
Know that you are not alone. If you want to vent, that is OK too. You can do this. Courage.

Perhaps there is a clinical trial nearby? My husband was in one at MSK, on day 10 he had a specific type of pet scan,it che ks for hypoxia. After results came back he had treatments shortened. Instead of 7 weeks he had 3 and instead of 3 chemo sessions he had 2. Doctor gave him lots of meds for nausea as well as a steroid which helped. It is a horrible disease and treatment is rough but worth it . Take any and all meds that are offered. Ask lots of questions. You will get through this!

Hi Lizzy I am really interested in your husband's treatment plan because its basically the same
as what or close to what I am planning on. so thanks for sharing that.
Although my treatment center seems to be bound by the standard of care 7 chemo/35 radiation which is way overkill for most all of us P16 + patients., I'm planning on quitting radiation around the 1/2 way point .
I am aware of the hypoxic and non hypoxic cancer scan but that isn't being offered to me however with the
remarkable progress I am seeing at 2 chemo cycles and 9 radiation treatments am pretty certain I would be a candidate for the MSK trial that your husband had, lucky him to have that plan.
So could you tell me a little about your husband's case ? Tumor location and size ?, # lymph nodes if any ?, stage ?
I am all ears when it comes to limiting the toxic and long term side effects. Can't do anymore chemo so already have the 2 under my belt.
Thanks,

@woodsy1
Hi. I’m currently in this study as well. This study is designed for a very specific subset of head and neck cancer patients. Not everyone with throat cancer qualifies.

Patients typically must have:

1. HPV-positive oropharyngeal cancer
-Usually tonsil or base-of-tongue cancer
-Confirmed p16 / HPV-positive
-This is important because HPV-positive cancers respond differently (and often better) to treatment

2. Non-metastatic disease
-Cancer confined to the head and neck region
-No distant spread (lungs, liver, bone, etc.)

3. Imaging that allows accurate staging
-MRI / CT and PET scans suitable for planning
-The trial relies on high-quality imaging to assess risk

4. No prior radiation to the head and neck
-Previous radiation would change tissue tolerance and risk

5. Medically fit for standard treatment
-Able to receive radiation (and chemotherapy if indicated)
-Adequate kidney function, hearing, and overall performance status

Trial-Specific Eligibility (Key Part)

After initial screening, eligibility hinges on tumor biology, not just stage.
-Patients undergo a special FMISO PET scan
-This scan measures tumor hypoxia (low oxygen levels)

Based on that scan:
-Low-hypoxia (“good-risk”) tumors → eligible for possible radiation de-escalation
-Higher-hypoxia tumors → treated with standard-of-care radiation

Importantly: Patients are not excluded from treatment if they don’t qualify for de-escalation—they simply receive standard therapy.

Who Is Usually Not Eligible

Patients are generally not eligible if they have:
-Distant metastatic disease
-Prior head & neck radiation
-Very advanced local disease where de-escalation would be unsafe
-Medical conditions that prevent safe radiation or chemotherapy

The trial is intentionally selective because:
-The goal is not to “do less treatment”
-The goal is to identify who can safely do less without lowering cure rates
-Tight eligibility protects patient safety and study integrity

Hope that helps!

Thank you Lizzy. That was a lot of typing.
If I hadn't already started treatment and wasn't a 8 hours drive away I would be
knocking on MSKs door to sign up.
The criteria is perfect for my case.
But I am glad to see some of these larger cancer centers are starting to offer this approach to HPV P16+ oropharyngeal patients.
I've seen HPV+ studies and trials going back 10 years or more and a large % (85) of these cancers are non hypoxic.
The hypoxic tumors are more difficult to treat.
Looks like I'll start my own trial , stop radiation after 15-18 treatments and see where I end up after a few months .
Good luck to you ! How long has your husband been out of treatment ? Remission results yet ?

Thank you justwow for your post above. I see now I was mistaken who posted it.
Think I'm still coming down from all the dexamethasone I had over the course of 2 weeks in chemo so bare with me.
Plus I'm new here still getting use to the forum navigation with a few different threads running on head and neck issues.

@woodsy1
No need to apologize:)

The part I’m still weighing is the chemotherapy component if I’m randomized to the standard/long-arm treatment.

In that arm, chemotherapy is given as high-dose (bolus) cisplatin every three weeks during a 6–7 week course of radiation. This approach has strong evidence for cure, but it also carries a higher risk of acute side effects for some patients.

Outside the trial, another commonly used option is weekly lower-dose cisplatin given alongside the same standard 6–7 weeks of radiation. Many centers use this to improve tolerability, even though the long-term outcome data are somewhat less definitive than for the bolus schedule.

My decision isn’t about avoiding treatment—it’s about whether I’m comfortable accepting the possibility of being randomized to the high-dose cisplatin schedule, versus choosing the weekly approach upfront with standard radiation.

I’m trying to balance proven effectiveness with quality-of-life considerations, and that’s the part I’m actively thinking through right now.

Best to you!!!

@woodsy1 My husband had the tonsil with tumor removed but cancer had spread to nearby neck lymph node,right side for both. We weren't told size, just that as tumor was removed he was accepted into the clinical trial. His cancer was hpv +16. He did fine until last radiation as he had both chemo and radiation for 2 days. They gave him cisplatin 100mg split over 2 days twice, both split over 2 days. We say chemo dr and apparently for 3 weeks he is in the chemo cycle. Watch for low sugar symptoms, my husband had 2 bouts of double vision, gave him 4 glucose tablets and this helped, he isn't diabetic. So in all he had 15 radiation treatments and 2 chemo sessions with lots of hydration infusions. If I can answer any more questions please let me know. The worst symptom he had was loss of taste,he's still not eating a whole lot but trying different things. His last treatment was 12/31/25.

@justwow
Sounds like you are on the right path doing the research and weighing best options.
We can certainly learn a lot from other people's past experiences with different treatment plans and outcomes so am thankful for this forum and people willing to contribute already.

If you haven't seen the excellent links roblem posted on the other thread titled "HPV Tonsil cancer: I'm very nervous about chemo and radiation" do read through ALL of those.

I was diagnosed Oct 2 2025, T1 N1 M0 HPV P16+. Right tonsil, right node. Stage 1. the tonsil tumor was 3,5 cm and node was 1.5 cm . By the time treatments started the tonsil was probably 4.5 cm. Took almost 3 months for treatment to get lined up with all the tests, scans, consultations and scheduling so that all made me a bit anxious.
Am now 11 radiation treatments and 2 chemos in.
Done with chemo that cesplatin 74 mg dose per cycle 1 week apart really wreaked havoc on my body, immune system and digestive tract.
A shingles outbreak and minor cuts or abrasions became infected.
Noticed blood work showing low RBC red blood cell count after 2nd week chemo. Other blood tests showing changes as well all heading in the wrong direction.
Anyway long winded today getting excited about finishing radiation next week . I am dropping out at 16 radiation treatments. The tumor is hardly visible anymore. My call based on compelling research data, trials and studies.

Let the dust settle while I still have some quality of life left and see what a pet scan shows in 3 mos. and go from there. My years here are growing slim anyway so I'm ok with my choices. I've had a good run. Best of luck to you and whatever you choose to do. Keep up the fight.
Just my opinion but the standard of care 35 radiation treatments and 7 chemo cycles seems like an antiquated plan for most any P16+ oropharyngeal cancer patients today . Keep researching and I bet you will come to the same conclusion.