Does lymph node dissection help control cancer spread at 73?

Question

Hi doctor,

Two years ago, my father was diagnosed with prostate cancer and has been undergoing treatment using Eligard and Xgeva. Early this year, he got diagnosed with vallecula carcinoma, for which he underwent chemo (Erbitux) six sittings and radiation therapy for 27 days.

While the vallecula seems to have subsided, he is now detected with a tumor in some of the lymph nodes, for which an operation has been recommended by the doctor. Also, as observed in the PET scan, cancer seems to be spreading to other parts, as there are some areas highlighted in the lower part of the lungs. The doctor has not given clear guidance about that.

We have been exploring the other options to retard the spread of his cancer. We need your guidance on therapies that can be considered to extend his healthy life span. He is 73 years old. Wanted to check around immunotherapy for treatment and its availability. Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I went through the details of your father's illness, and I will concentrate on the present problem.

I will not agree with the advice for surgery of lymph nodes, as the PET scan suggests that it may have spread to other areas of the lung, though not confirmed. Doing surgery for a disease that has spread beyond is of no value.

Unfortunately, for this type of cancer, there is no immunotherapy. There are targeted therapies. He has already received Erbitux (Cetuximab). You should discuss with your oncologist the possibility of regular chemotherapy.

However, I must caution you that his tolerance to chemotherapy will depend upon his general health. You must discuss all the options with your oncologist.

I hope this helps.

Feel free to reach out in case of any further queries.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I wish to explain certain facts about realities in these situations. Your father has cancer of the head and neck area, as well as cancer of the prostate. He had been treated for both cancers, and now both seem to be progressing.

First, for his throat cancer, word immunotherapy and targeted therapies are used synonymously. There are no separate immunotherapy or targeted therapies.

These therapies are used in palliative settings, which means they are not curative. They can prolong life by a few months. To date, no such therapy has cured any patient.

There are different molecules available in the market; the best is Erbitux. There are other compounds that also come in the category of targeted therapies.

Doctors sometimes used different compounds, hoping that they might give some response. But all therapies can have serious side effects. The oncologist has to assess the condition before giving such therapy. So, please discuss in details all these factors before taking any such treatment.

Regarding your query about Sipuleucel-T, it is a kind of cancer vaccine, prepared from a patient's own blood.

Your doctor has to decide which cancer is more important to treat. All the best.

I hope this helps.

Feel free to reach out in case of any further queries.

Thank you.