- The radiation therapy
The radiation therapy is the primary treatment, the chemotherapy is merely an add-on which supports the effect.
The radiation therapy will enhance the odds that any cells with HPV, which were not surgically removed is destroyed , so you will not experience relapse, – trust me, you do not want to go through this treatment again!
The radiation therapy in my case were 33 treatments, 6 days a week(yes also Saturday) for 6½ weeks.
It takes place in accelerator and the treatment itself is very quick, from i arrived to the accelerator to i left. The treatment took about 20 minutes:
- 6-8 minutes were calibration and positioning of the accelerator to my profile before treatment
- 4 minutes were pure x-ray treatment
- The rest were clothes off/on.
You will wear a custom fitted mask designed for your head which will keep your head in a fixed position to assure treatment is only given the specific areas, it is not unpleasant and the 10-12 minutes is manageable.
During the treatment you will not experience any pain and you can not feel the treatment, the effects of the radiation is delayed and cumulative, so the effects are usually felt in the evening
The first week you will not experience any pain, however your loss of taste will begin to accumulate after 4 or 5 treatments and will probably be quite dead at week 3.I did not experience any pain, before around week 3 and then i could keep it down with Paracetamol until around week 5. The phlegm began slowly after week 2, but was worst from week 4 and 1 week after treatment.
- The chemotherapy
Cisplatin
If you are not very fragile or have a bad kidney, you will probably be prescribed Cisplatin intravenous 5 or 6 times , one every week.
Cisplatin is very effective in combination with radiation therapy, but it is one of the chemotherapeutic medications, which has the most unpleasant side effects. It can result in temporary or permanent hearing loss and some also experience nerve damage to fingers and legs and this is not rare side-effects, the statistical numbers of those who experience these is very high.
You will be prescribed a myriad of pills to counteract the effects of Cisplatin, pills against nausea, pain, loss of bone marrow, and on top of that, pills that counteract the side effects of the counteracting pills!
My experience with Cisplatin was that the day you receive the medication intravenously, you will not feel any changes, but for the next 4 days the side effects will be in full force.
The counteracting pills removed the nausea and reduced though not removed the flu effects, but they could not remove the strong loss of appetite which made me unable to eat for 3 days, for mere details, see Side effects.
Cisplatin as other chemotherapy medications also boosts the side effects of the radiation and you will be in a flu like state for 4 days. Furthermore I experienced my tinnitus was magnified by the Cisplatin, so after two intravenous rounds, I asked/demanded another type of chemotherapy and received Paclitaxel
Paclitaxel
When you have experienced the side effects of Cisplatin , to be given paclitaxel was like going from winter to spring.
Sure, it also boosted the effect of the radiation therapy and also has the flu effects, after all it is a kind of poison they add to your veins, but compared to Cisplatin it was a walk in the park.
Paclitaxel can cause an allergic reaction, so you will be given anti histamine and the first time they will survey you for 30 minutes ,to check for any allergic reaction. Paclitaxel might also cause loss of hair,though usually only with much higher doses , I did not experience it.
I dont know how less efficiently it is compared to Cisplatin, but when you are prescribed Cisplatin, i will advise you to be very alert about changes in hearing or nerves. Cisplatin can cause permanent damage and if you feel things are going this way, tell it to the oncologists immediately.
- Nimorazol
These pills should enhance the reaction of the cells to the radiation therapy, I had to eat 5 of these 2 hours before treatment, this means in total 165 pills!
They were horrible, they gave nausea, mood swings and had a really bad aftertaste and I could only manage one week, then I told the doctor I would stop with these pills from hell and he was fine with it.
If you have non HPV neck cancer Nimorazol is probably nesccesary,but as HPV cancer responds very well to radiation as this article describes, i could not understand the purpose and I felt over-insured.
- The medication
The medication you will receive is solely based on relieving you for pain or side-effects from the chemotherapeutic medication.
Morphine
Morphine is an efficient pain reliever, a pill usually lasts 6 hours, you can also get a 72 hour patch which releases morphine slowly.
Morphine has however, two primarily side-effects, the first is constipation, you need laxative medication when you are using morphine in order to avoid unpleasant problems, i do not think i need to say more..
The other side effect is physical addiction. When you do not need morphine anymore, you will need to phase out the morphine slowly, otherwise you can experience side-effects, ranging from insomnia to convulsions.