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Is Methotrexate Or Is Radiation Better For SCC Therapy?

Posted on Tue, 11 Feb 2014

Question: which is better for scc therapy? i have derm that says methotrexate, and oncologist that says radiation, since i have had several (more than8)radiated, and probably that many methotrexate and d & c i keep growing these things, I don't know which has less long term side effects,.. they are both painful, and uncomfortable. They neither one suggest that i have both on any ONE "crater" as my derm call them.. site, lower legs.. I am 81, don't want extreme measures, but don't want my legs to get ROTTEN" either XXXXXXX

Answered by Dr. Chobufo Ditah (2 hours later)

Brief Answer: Please, see below Detailed Answer: Hi XXXXXXX and thank you so much for this query. I am so sorry to hear about these squamous cell cancers you have been battling with. Systemic drugs like methotrexate has systemic side effects which affect all the body. However, radiation therapy affects just the area to which it is applied. One guiding principle is that if many need to be tackled at once, then you would be better off with a systemic therapy like methotrexate than repeated radiation therapy to multiple sites. In all, the decision should be guided by the number. If they are multiple, then try methotrexate. If it is just one, please strongly consider local radiation therapy. However, the best treatment for SCC is surgery. It is only when all the cancerous cells cannot be completely removed that these measures are used. Talk with your doctor about this. I hope this helps. I wish you well. Feel free to ask for more clarifications and information if need be. Thanks. Dr. Ditah, MD.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chobufo Ditah (16 hours later)

Thank you for your response... initially the thought was to do the surgery, however, since all scc were below my knees and the circulation is poor in that area for elderly people, the surgeon didnt want to do it... worried about healing.. since then I have had new ones, but 2 at a time, as opposed to 10. I think I could heal faster and better with the excision of 1 or 2 rather than the d&c and then injections, I have had to have rounds of antibiotics after each one of those.. and that presents another problem in my system..what kind of problems, with the methotrexate? I haven't been myself sense the last round of injections, almost a month ago. I just want to have my energy and desire to move back... why can't I get these answers from my Dr.?(I guess you can't answer that, just frustration with my medical professionals. XXXXXXX

Answered by Dr. Chobufo Ditah (12 hours later)

Brief Answer: See below Detailed Answer: Hi XXXXXXX and thank you so much for following up with me. Methotrexate affect the blood cells causing anemia, low white blood cells and platelets. All these can lead to fatigue, infections and bleeding disorders. Also, it affects the kidneys, liver, lungs, etc. This is why close monitoring is often required before starting and during the entire course of treatment. I understand the difficulty your doctors face as they have to consider some more specific condition to you like the poor circulation and the many SCCs. Giving a specific straight forward way without considering the other factors that could modify these would not be the best way. I would want to believe that your doctors do factor in all these different conditions and provide you only with the best possible way forward. I hope this helps. I wish you well. Thank you for using our services and do feel free to keep the discussion going. Dr. Ditah, MD.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Chobufo Ditah (18 hours later)

Thank you so very much for responding, I have some idea how to move forward now.. I appreciate you so much XXXXXXX

Answered by Dr. Chobufo Ditah (3 days later)

Brief Answer: Thank you, too! Detailed Answer: Hi XXXXXXX Thank you so much for following up with me. I am so happy and humbled to know that you now have a good idea on how to proceed. This is our main objective here, to meet the expectations of our clients. I wish you well as you pursue the various treatment options. I wish you the best of outcomes. Dr. Ditah, MD.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar