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Cancer spread to supraclavicular lymph nodes


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Hi Friends,

It has been a while since I wrote - it has been a crazy time, and I always get sort of overwhelmed with everything there is to do.

Last I had a round of adjuvant chemo - Gemzar. Took one round, and then my counts were always too low to get the next round. During this time, someone at my lung cancer support group noticed that the lymph node on my neck (right above the collar bone) seemed swollen.

2 days later I pointed that out to the oncologist, he called in the pathology team, they did a needle biopsy right there on the spot, and what do you know - squamous cell all over again.

I was hoping that the radiation, chemo and surgery would have put an end to this struggle, but no... I am rather devastated, of course, but plugging along.

Have had 2 opinions so far. Both want to do radiation with chemo, and then more chemo. One suggests 60 Gy over 6 weeks, another 50 GY over 5 weeks and then a week of cyber knife directed to the obviously affected lymph nodes.

They want to do chemo concurrently. My current oncologist wants to do weekly carboplatin/taxol again, cause it seemed to have worked well with radiation last time. Then more chemo after radiation...

The other team wants to do cisplating/etoposide, or alimpta... Her hesitation makes me a bit nervous - I would like to see a reasonable argument for why one and not the other.

That is my current situation.

Has anyone dealt with something similar - with the supraclavicular nodes? And has anyone had etoposide, or alimpta, and what have been your experiences?



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Hi Z,

You haven't caught a break yet, it seems.

I have been looking for a link for you and I found it, finally. I don't know how to put the link here for you to easily follow so I will just have to tell you where to find it. DonM put me on to it awhile back and it is a good one regarding the cyberknife. It is a board of cyberknife onc's who will give you feedback related to their expertise. They seem genuinely concerned and were helpful to me.

The link is at the end of DonM's post from March 1st in the TestTime/Update forum.

I wish I had some more I could help you with regarding your decision-making. Darnit. I don't. Hang in there. We are still caring about you!

Cindi o'h

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Hi Z. Here is the link to cyberknife:


I guess that the team who recommends cisplatin/etoposide, or alimta thinks that your cancer is secondary. Carboplatin/taxol is first line treatment for a primary cancer. Alimta is for secondary cancer usually. If it is in you lymph nodes, I think it would be secondary mets.

I would favor the alimta. I also have to deal with another cancer when I thought I was cured. This will be my third one in just over 2 years. I sought an opinion at a major cancer center. They are treating it as if it is a secondary cancer and so I will be taking second line treatment, probably alimta, after I am done with image guided radiation therapy (IGRT). The intent of the radiation is to kill the tumor only. The radiation oncologist thought that the risk of pneumonitis would be too great to do concurrent chemo. My chemo will be in the adjuvant setting anyway. I have only one lung now. I have just one small tumor in the one lung. I can't do cyberknife, because of the risk of pneumothorax. So, I am having the next best thing in terms of accuracy, IGRT.

It might be that the cyberknife guys can kill any mets you have and then you could have adjuvant chemo. That is basically what I am doing. I think it is worth a visit to the cyberknife message board to ask the docs. They are top notch radiation oncologists who also can advise about IGRT or other forms of targeted radiation. I think they generally don’t do concurrent chemo with targeted radiation. That is only done with conventional radiation. Another benefit of targeted radiation is that you can repeat the treatment for multiple reoccurrences of cancer, as long as there are not too many mets.

I think you may have a third option of cyberknife surgery only and then adjuvant chemo.

Check it out.

Good luck with you next treatment.

Don M

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I am sorry to hear about the spread to your lymph node.

I don't have the same type as you, but I did have Cisplatin and Etopiside (vp16). I had both drugs on Monday, the etopiside alone Tuesday-Friday, and the following Monday I had both again. I did this for 3 cycles.

I had really good luck with the two drugs. You need to drink lots of fluids with the cisplastin. I took med's for nausea and really didn't have a problem there. I got a little tired, but not too bad. I would say overall it was a much better experience than I anticipated.

Keep us posted on next step and good luck to you!


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