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Head and Neck Cancer

Stage 4 Laryngeal Ca - mets to pleura and MPE

06/10/2008

Question:

My 47 year old husband had a total laryngectomy 1/2007 with a positive left margin (No risk factors). He had a rad/plat treatment to follow. He just had a VATS procedure for pleural bx, drain MPE, and pleurodesis (talc) 6/2008. The pleural bx are positive for squamous cell ca. So does my husband have NSC lung cancer or Stage 4 Laryngeal Ca with mets to pleura? Also, what chemotherapy drugs are used for this new dx? Any info on intrapleural chemo would be helpful? Your thoughts on staph enterotoxin superantigen. Should he have a PET/CT scan? Is the chemo given at this point just palliative? Any information regarding treatment plans would be very helpful. Thank you.

Answer:

Head and Neck Cancer has an increased risk for second primaries. Based on the information you have given I do not know for sure whether this is a new primary or metastasis. Recommendations for treatment would be based on many things including a persons performance status and co-morbidities. A PET/CT would be appropriate to help complete the staging process. Talk openly with your husband's oncologist regarding your questions and concerns.

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Response by:

Heather  Hines, RN Heather Hines, RN
Medical Oncology Nurse
School of Medicine
Case Western Reserve University

Panayiotis  Savvides, MD Panayiotis Savvides, MD
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University