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Does operating the lymph node prevent spread of the cancer?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At June 29, 2016
Reviewed AtMay 19, 2020

Patient's Query

Hi doctor,

Before two years, 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 and for which he underwent chemo (Erbitux) six sittings and radiation therapy for 27 days. While vallecula seems to have subsided, he is now detected with tumor in some of the lymph nodes and for which operation has been recommended by the doctor. Also, as observed in PET scan cancer seems to be spreading to other parts as there are some areas highlighted in the lower part of the lungs. Doctor has not given clear guidance about that. We have been exploring the other options to retard 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.

Answered by Dr. Rakesh Mittal

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 advise for surgery of lymph nodes as PET scan suggests that it may have spread to other areas of lung, though not confirmed. Doing surgery for disease which has spread beyond has 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 regarding 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.

For further information consult a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist

Patient's Query

Thank you doctor,

When he recently went through targeted therapy and radiation for vallecula carcinoma, doctors advised to remove lymph nodes to restrict the spread of cancer to adjoining areas. Considering there is a spread, how can targeted chemo go about controlling the spread to other organs? Is it like to be multiple drugs administered for each cancer detection? What is the average life expectancy in such a case? Under what circumstances immunotherapy is recommended and successful? Considering that the cancer seems to have started with prostrate and his PSA levels are once again on the rise, would Sipuleucel-T suspension helps the situation around his prostate cancer?

Answered by Dr. Rakesh Mittal

Hi,

Welcome back to icliniq.com.

  • I wish to explain certain facts about realities in these situations. Your father has a cancer of head and neck area as well as cancer of the prostate. He had been treated for both cancers and now both seems 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, means they are not curative. They can prolong life maximum by a few months. Till date, no such therapy has cured any patient.
  • There are different molecules available in the market, best is Erbitux. There are other compounds which are also come in the category of targeted therapies.
  • Doctors sometimes used different compound hoping that it may 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 patient's own blood.
  • Your doctor has to decide which cancer has more important to treat. All the best.

For further information consult a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Rakesh Mittal
Dr. Rakesh Mittal

Medical oncology

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