Hi,
After surgery, free-flap(Dec), chemo/radiation(Jan - March, great news each check up and a lovely summer break, I returned to work two weeks ago, feeling great. I had a CT scan last week as a 6 month post treatment base-line scan and to my horror, lung mets have been found.
We are so shocked as I have felt so well, no symptoms, recovered well after the treatments, no sign of disease in the head and neck, etc.
My oncologist has explained the limited treatment option of cisplatin and 5Fu, three weekly over 6 cycles, but asked me to consider whether dealing with effects of the chemo, when at the moment I seem well, is something I should do.
I understand his concerns, but am left with a real Hobson's Choice - Do I sit back, wait to feel ill and then ask for the chemo, even though I might then be too ill to tolerate it, or do I press ahead with the chemo and make myself feel worse, with only a small chance of any benefits? I understand the prognosis and the team have made it clear that chemo, in their opinion, would not prolong my time, at best it might be useful for symptom control.
I know that no one can make such a decision for me, but along with the shock, I am very confused.
As I understand it, squamous cell is not particularly responsive to chemo. If the chemo does have an effect, can it shrink tumours at all, or slow progress and if it can, how come that doesn't buy more time?
Any input would be most gratefully received, thanks,
Georgia

Hello Georgia

Sorry to hear that mets have been discovered in your lungs.

There are newer treatments with drugs like cetuximab that make the cancer cells more susceptible to chemo or radiotherapy and shrink the tumour and so buy time. Ask your oncologists about these other options. You could also seek a second opinion. Since you are well, an option might be to watch and wait and seeek treatment only if there are signs of growth or symptoms.

Hope that helps.

Best wishes
Vinod

Hello Geogia, I too was told I had mets in my lungs - twelve months after my first major op to the jaw. I found out by accident and my consultant said he wasn't going to tell me as they may not cause any problems for years. Like you, I was scared witless. It's now over two years since I was told about the lungs and, so far (and I'm touching wood and crossing everything) still no discomfort.

As Dr Joshi says, there is a new drug available (Cetuximab aka Erbitux) but not available on the NHS.

Best wishes, Brenda x

Hi Georgia

Dont have any words of wisdom to offer but just to say sorry to hear your news but in the light of what Brenda says, there seems to be some hope and also that the new meds become available on the NHS soon.

Do keep us posted.

If you have lung-only mets (ie the primary site has been dealt with by surgery and chemo), there is an option of special laser surgery in Germany to have the lung mets resected.

My father had a kind of sarcoma (pleomorphic rhabdomyosarcoma) which metastised to the lungs, small tumours about 2mm each. There was not much by way of options for him - his last bout of chemo had his white cell count drop so low it was very dangerous. And then we heard about this laser operation with a special laser frequency that both cuts and seals. Unlike conventional surgery under the knife with staples etc, it is a very precise operation with very little blood involved, and is able to remove large numbers of small mets.

The surgery is undertaken by Dr Axel Rolle at Coswig Hospital, if this is of any use to anyone. It is also available at other hospitals around Germany, and I think in Vienna and Italy as well. However Dr Rolle was the pioneer of it and basically the world-expert. It is expected to be FDA approved by the end of this year or beginning of next, and then will presumably be available in USA as well.

quote:

special laser surgery technique pioneered by Dr Axel Rolle at Coswig Hospital

Hello loving-daughter

Thanks for sharing the information. More information can be found here.

Best wishes
Vinod