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Thread: Dad has squamous cell carcinoma

  1. #1
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    Dad has squamous cell carcinoma

    Hello everyone,

    Last year my dad , age 58 years,was diagnosed with squamous cell carcinoma (right maxillectomy) in his upper jaw which was operated and the tumour surgically removed on 26 june 2016. Afterwards he underwent 40 sessions of radiation . Since then he's not able to open his mouth,pains intensifying and now the right eye's infected.
    Its been only four months since our last radiation but the recent MRI reports indicate recurrence of the said disease along with tumour progression to the base skull now. Doctors suggest chemo to shrink the size of tumour as surgery isn't an option now. Guys I really need your help, it's my first ever experience with cancer and I really don't know what to do. Thanks

  2. #2
    Super Moderator Top User po18guy's Avatar
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    I am very sorry to hear this. Is there a reason why he cannot open his jaw? Muscle or joint damage? At this point, chemotherapy would seem to offer some hope, as neither surgery nor radiation eliminated the disease. As to which chemotherapy drugs, that would have to be left to the doctors to decide. This is a difficult time and decisions are not easy to make. I would suggest some online research into SCC and the most effective treatments so that you will know if the doctors are on the right path in treating him.
    07/08 Age 56 DX 1) Peripheral T-Cell Lymphoma-Not Otherwise Specified. >50 tumors, marrow involvement.
    08/08-12/08 Four cycles CHOEP14 + four cycles GND (Cyclofosfamide, Doxorubicin, Vincristine, Etoposide, Prednisone & Gemcitabine, Navelbine, Doxil)
    02/09 2) Relapse.
    03/09-06/13 Clinical trial of Romidepsin > long-term study. NED for 64 twenty-eight day cycles, dose tapered.
    07/13 3) Relapse, 4) Suspected Mutation.
    08/13-02/14 Romidepsin increased, stopped for lack of response. Watch & Wait.
    09/14 Relapse/Progression. Visible cervical nodes appear within 4 days of being checked clear.
    10/06/14 One cycle Belinostat. Discontinued to enter second clinical trial.
    10/25/14 Clinical trial of Alisertib/Failed - Progression.
    01/12/15 Belinostat resumed/Failed - Progression. 02/23/15
    02/24/15 Pralatrexate/Failed - Progression. 04/17/15
    04/15 Genomic profiling reveals mutation into PTCL-NOS + AngioImmunoblastic T-Cell Lymphoma. Two dozen tumors + small intestine (Ileum) involvement.
    04/22/15 TREC (Bendamustine, Etoposide, Carboplatin). Full response in two cycles. PET/CT both clear. Third cycle followed.
    06/15-07/15 Transplant preparation (X-rays, spinal taps, BMB, blood test, MUGA scan, lung function, CMV screening, C-Diff testing etc. etc. etc.) Intrathecal Methotrexate during spinal tap.
    BMB reveals 5) Myelodysplastic Syndrome (MDS), a bone marrow cancer.
    07/11-12/15 Cyclofosfamide + Fludarabine conditioning regimen.
    07/16/15 Total Body Irradiation.
    07/17/15 Haploidentical Allogeneic Transplant receiving my son's peripheral blood stem cells.
    07/21-22/15 Triple dose Cyclofosfamide + Mesna, followed by immunosuppressants Tacrolimus and Mycophenolate Mofetil.
    07/23-08/03/15 Blood nose dive. Fever. Hospitalized two weeks.
    08/04/15 Engraftment official - released from hospital.
    08/13/15 Marrow is 100% donor cells. Platelets climbing steadily, red cells follow.
    09/21/15 Acute skin GvHD arrives. DEXA scan reveals Osteoporosis.
    09/26/-11/03/15 Prednisone to control skin GvHD.
    05/2016 Tacrolimus stopped. Prednisone from 30-90mg daily tried. Sirolimus begun.
    09/16/16 Three skin punch biopsies.
    11/04/16 GvHD clinical trial of Ofatumumab (Arzerra) + Prednisone + Methylprednisolone begun.
    To date: 18 chemotherapeutic drugs in 9 regimens (4 of them at least twice), + 4 immunosuppressant drugs.

    I have been chosen to suffer, therefore, I am blessed. Knowing the redemptive value of suffering makes all the difference.

    "What is faith? It is that which gives substance to our hopes, which convinces us of things we cannot see"
    - Hebrews 11:1

  3. #3
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    Radiation therapy stimulated an overgrowth of fibrous tissue in the skin and in the mucous membranes, muscle and joints of the jaw. I've heard these symptoms subside with passage of time ,however in our case, it seems to be getting worse. Is severe pain indicative of cancer or could it be due to post radiation complications? We might get biopsy done in a few days

  4. #4
    Super Moderator Top User po18guy's Avatar
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    I would think that pain could be caused by both reasons. Due to the nerves in the area, the radiation could have damaged them, or the disease could be pressing on them. Is he able to travel for a second opinion?
    07/08 Age 56 DX 1) Peripheral T-Cell Lymphoma-Not Otherwise Specified. >50 tumors, marrow involvement.
    08/08-12/08 Four cycles CHOEP14 + four cycles GND (Cyclofosfamide, Doxorubicin, Vincristine, Etoposide, Prednisone & Gemcitabine, Navelbine, Doxil)
    02/09 2) Relapse.
    03/09-06/13 Clinical trial of Romidepsin > long-term study. NED for 64 twenty-eight day cycles, dose tapered.
    07/13 3) Relapse, 4) Suspected Mutation.
    08/13-02/14 Romidepsin increased, stopped for lack of response. Watch & Wait.
    09/14 Relapse/Progression. Visible cervical nodes appear within 4 days of being checked clear.
    10/06/14 One cycle Belinostat. Discontinued to enter second clinical trial.
    10/25/14 Clinical trial of Alisertib/Failed - Progression.
    01/12/15 Belinostat resumed/Failed - Progression. 02/23/15
    02/24/15 Pralatrexate/Failed - Progression. 04/17/15
    04/15 Genomic profiling reveals mutation into PTCL-NOS + AngioImmunoblastic T-Cell Lymphoma. Two dozen tumors + small intestine (Ileum) involvement.
    04/22/15 TREC (Bendamustine, Etoposide, Carboplatin). Full response in two cycles. PET/CT both clear. Third cycle followed.
    06/15-07/15 Transplant preparation (X-rays, spinal taps, BMB, blood test, MUGA scan, lung function, CMV screening, C-Diff testing etc. etc. etc.) Intrathecal Methotrexate during spinal tap.
    BMB reveals 5) Myelodysplastic Syndrome (MDS), a bone marrow cancer.
    07/11-12/15 Cyclofosfamide + Fludarabine conditioning regimen.
    07/16/15 Total Body Irradiation.
    07/17/15 Haploidentical Allogeneic Transplant receiving my son's peripheral blood stem cells.
    07/21-22/15 Triple dose Cyclofosfamide + Mesna, followed by immunosuppressants Tacrolimus and Mycophenolate Mofetil.
    07/23-08/03/15 Blood nose dive. Fever. Hospitalized two weeks.
    08/04/15 Engraftment official - released from hospital.
    08/13/15 Marrow is 100% donor cells. Platelets climbing steadily, red cells follow.
    09/21/15 Acute skin GvHD arrives. DEXA scan reveals Osteoporosis.
    09/26/-11/03/15 Prednisone to control skin GvHD.
    05/2016 Tacrolimus stopped. Prednisone from 30-90mg daily tried. Sirolimus begun.
    09/16/16 Three skin punch biopsies.
    11/04/16 GvHD clinical trial of Ofatumumab (Arzerra) + Prednisone + Methylprednisolone begun.
    To date: 18 chemotherapeutic drugs in 9 regimens (4 of them at least twice), + 4 immunosuppressant drugs.

    I have been chosen to suffer, therefore, I am blessed. Knowing the redemptive value of suffering makes all the difference.

    "What is faith? It is that which gives substance to our hopes, which convinces us of things we cannot see"
    - Hebrews 11:1

  5. #5
    Senior User IndyLou's Avatar
    Join Date
    Jan 2014
    Location
    Indiana
    Posts
    169
    Hello, hassan--I've just finished reading some of your posts. I'm sorry to hear about your father. I'm very sorry to hear of his situation, but I went through something similar, and I hope that I can provide you with some answers or considerations.

    First, can you tell me a little about your father's cancer? Do they know what the underlying cause was? Many forms of HNSCC are caused by the HPV virus, and are becoming very common in men in their 40s and 50s. The HPV virus can typically be acquired much earlier in life, and if the body doesn't naturally shed the virus, it can manifest itself into cancer. Believe it or not though, HNSCC that is HPV+ is much easier to treat, and has a much better outcome.

    Of course, it's possible that your father's cancer could've been caused by other things, such as smoking or drinking. The outcome for this kind of cancer is a little different, although the treatment is similar.

    In any case, let me address your questions about the treatment your father did receive. First, radiation treatment in this region of the body is insidious in terms of its effects on the body. I did 35 days of treatment almost four years ago, and while they will gradually improve over time, things will be painful in the short term. Your father should likely be taking some type of narcotic for pain associated with this treatment. Pain in the mouth and throat make eating, drinking and talking very challenging. How is your father's nutrition right now, is he able to eat and drink? Is the inside of his mouth and throat raw and red in color, possibly inflamed? It's important that 1) he manage his pain, and 2) he continue to take in proper nutrition. Doing both of those are important for his healing.

    If the tumor was treated surgically and then with radiation, and has still returned, I think chemo, or some kind of systemic treatment is the next course of action. Have they proposed a specific treatment plan for this? There are several, very good options from which to try. First, Erbitux (or cetuximab), is a targeted, monoclonal antibody. It's very effective in treating SCC in the HN region.

    Additionally, there is an immunotherapy called Keytruda, or pembrolizumab, that has proven to be very effective with HNSCC. Both the cetuximab and pembrolizumab have significantly fewer side effects than traditionally chemotherapies. I would encourage you to discuss these options with your oncologist.

    I do wish you and your father well. I will be thinking about you both.
    Age 50 Male
    early Feb, 2013 - Noticed almond-sized lump in shaving area, right side of neck. No other "classic" cancer symptoms
    late Feb, 2013 - Visited PCP for check-up, PCP advised as lymphoma. Did blood work, orders for CT-scan, referred to ENT
    3/7/13 - CT-scan inconclusive, endoscopy negative
    3/9/13 - FNA of neck mass
    3/14/13 - Received dx of squamous-cell carcinoma, unknown primary
    3/25/13 - CT-PET scan reveals no other active tumors
    3/26/13 - work/up for IMRT
    4/1/13 - W1, D1 of weekly cetuximab
    4/8/13 - W1, D1 of IMRT
    5/20/13 - complete 8 week regimen of weekly cetuximab
    5/24/13 - Complete 35-day regimen of daily IMRT
    mid-July 2013 - CT-PET scan reveals no active tumors, but shows necrotic tissue at site of original tumor
    early Sept 2013 - partial neck dissection to remove necrotic tissue. Assay shows no cancer present.
    Spring 2014 - No signs of cancer
    Spring 2015 - No cancer
    Spring 2016 - No cancer

  6. #6
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    Farmingdale NJ the stix
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    Squamous is a sneaky one. Be sure to have him checked every 4 months at least. Radiation has always left me with problems in the areas treated. My ears have both been treated and although the Cancer is gone the area never is the same. It always has a dry hard almost scabbing that hurts to touch it and will even peel at times. This may be the reason your Dad is having problems. Mine was on the Ear surface so it can be seen.

 

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