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Should chemotherapy be given to a person in final stage of nasopharngeal cancer ?

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Practicing since : 2004
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My brother in law has surgery to remove 4 lymph nodes in the neck area. They were all malignant. This is the fourth recurrence of nasopharngeal cancer. There is one area which I believe is the primary area where the cancer was diagnosed 10 years ago that is active again but this area is too XXXXXXX to go into to perform any kind of surgery. I have written before to one of your oncologist about this case. My brother in law now has an appt with his oncology dr on Thursday. I guess they will look at the margins of where they operated to see if they did not cut into any cancerous nodes or as I understand if they did there could be cancer formation in the scar of the neck dissection they did to get at the cancerous lymphnodes. I'm not really sure. My question is even with more chemotherapy how much longer can he live. It seems like this cancer gets more aggressive with each recurrence. And to me it seems like even though he fights it with chemotherapy( he cannot have anymore radiation) it still comes back every three years or so. He is now 63 years old and his throat is so damaged they had to Intubate him through his nose this last time. What would you say his chances are now. I mean to say do you think his life could be limited? I know it will depend on certain variables but he seems awfully tired and battle weary now. I think he might be willing to get more chemotherapy. But I know he was on erbitux and had bad reaction. The cisplatin was failing his kidneys and lastly he was on zeloda. Anyway taking his history of the many recurrences, this being his fourth, do you think this cancer might be in it's last stages. Also he did have metastasis when he was first diagnosed 10 years ago
I'll appreciate the opinion of an oncologist on your staff that may have experience with head and neck cancer.........Thank YYYY@YYYY
Posted Fri, 13 Apr 2012 in Cancer
Answered by Dr. Indranil Ghosh 18 hours later

I am sorry to hear that.

Whether he had metastases at presentation initially can be commented only after seeing the reports. As per your query there seems to be metastases hence should be the final stage of the cancer.

At present he is terminal (considering he has received all active treatment modalities including cetuximab and cisplatin based chemotherapy, with resultant kidney failure).

We should provide him supportive treatment only.


Above answer was peer-reviewed by
Follow-up: Should chemotherapy be given to a person in final stage of nasopharngeal cancer ? 5 hours later
He has to talk with his oncology Doctor on Thursday. There may be a different Chemotherapy suggested to him. What I want to know do you think it's worth the side effects and the abuse his body will take after 4 recurrences now. It seems to me this will never be cured since the original site of the cancer is too XXXXXXX to operate on. And now the four lymph nodes they took out with a neck dissection were all malignant. I know it depends on him but I feel his quality of life will suffer and if this is the last stages then maybe no treatment would be better.and he did have metastases when diagnosed 10 years ago. But per the Doctors words after the nodes came back malignant, the cancer is back again. How long can this man go on? Do you think his life may be limited now whether he takes the treatment or not?
Answered by Dr. Indranil Ghosh 10 hours later

Thanks for writing back.

I think he may not be able to tolerate further chemotherapy and probably it will not be beneficial also. But ultimately the patient and primary physician should decide on it.

Above answer was peer-reviewed by
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