Types of radiation therapy and chemo therapy combinations

Posted by maeono @maeono, Nov 9, 2023

Hello - my brother was just diagnosed with HPV cancer and had removal of lymphs nodes through right neck dissection and removal of right tonsil. He is 56 and otherwise healthy and very active. There was cancer in only 1 or 30 lymph nodes but it was large and the cancer was outside the lymph node (extra nodal extension). They did not find cancer in the tonsil and he is now scheduled to go back for the TORS surgery to remove the lingual tonsil. They are unsure if they will find cancer in the other tonsil and think there is chance they will not find the primary site. He is told he will need radiation for 6-7 weeks and likely chemotherapy as well.
My questions;
I've been reading about Proton therapy radiation and it seems like it is better tolerated with less side effects. He is at Dana Farber and they seem to have an excellent Head and Neck program but I don't see on their website they offer Proton therapy. What can people tell me about proton therapy vs. traditional radiation and is worth seeking out a 2nd opinion at a center with proton therapy? I've also read about DART and wondering if others have chosen that?

Chemotherapy was discussed but there was no mention of immunotherapy. Wondering if others have been offered immunotherapy? The doctor seemed to indicate that although
he was leaning towards recommending chemo that it would be reasonable for my brother to decide not to choose chemotherapy as the research is limited. My brother has hearing loss in one ear already and I've read that one of the side effects of the chemo used for HPV is hearing loss so this is of course a concern.

Thank you ahead of time for any thoughts, suggestions or recommendations to further research and discuss with his team. My best to you all!

Interested in more discussions like this? Go to the Head & Neck Cancer Support Group.

@stephenrfleury

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I had chemo and 35 radiation. There are two types of chemo. One is harsh and can cause hearing loss. I took the milder dose with less side effects. He needs to ask about the milder dose. I'm in Winnipeg Canada.
Perhaps check that out.
I just had my follow up CT scan yesterday and will find out results of treatment at month end.
Good luck. Sending good energy

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7 years ago I was told that proton doesn’t work and that “old school” is my only chance of killing my stage IV cancer.

I had 35 rounds of radiation and 3 rounds of Cisplatin.

I had left ear pain and hearing loss prior to treatment and continue with that still.

The Cisplatin did cause tinnitus which will most likely be for the rest of my life but I’m ALIVE!

MOJO

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