Please keep your warm thoughts, prayers, and positive thoughts coming! We are about half-way there.

Hi everyone,

As most of you know, My son, Dennis, was diagnosed in April 2024 with Stage IV, Squamous Cell Cancer (SCC) of the head and neck with tumors in his mouth, tongue, and throat. Needless to say, it caught us all by surprise. Thank you to all of you who have reached out and/or sent warm positive thoughts and prayers our way. I encourage you to continue to do so. Would love to hear from you if you felt uncomfortable reaching out last time I posted (it really helps us get through the days), as well as hear from those of you again who did reach out. Even if I may not have personally responded to you because of all that is going on, I can't emphasize enough how your warm thoughts, prayers, and positive thoughts have helped us get this far. Many of you have understandably asked for a follow-up.

Here it is with a slight recap:

Back in early May surgery was ruled out as an option. It would have been too invasive and more importantly, would not have removed the cancer. Instead, Dennis went through an arduous 6 weeks of planned chemotherapy and immunotherapy requiring three different hospitalizations that took about three months (instead of the six weeks) due to complications from side-effects totaling a month's stay before discharges and delayed his planned treatments by about another 6 weeks. The next phase would involve 7 weeks of daily radiation and weekly infusion of a targeted cancer drug called Cetuximab (also known as Erbitux).

As of today, 8/28/2024, Dennis is halfway through daily radiation treatments but it hasn't been easy.

To be dentally cleared for this next phase of his treatment required the removal of four wisdom teeth and a lower back molar. This took place in the two week break between his last hospitalization during the first phase of treatment, and the beginning of the daily radiation therapy and weekly Cetuximab treatments. The following week he had surgery to place a "PEG" G-Tube into his stomach for feeding and meds, as it was expected his mouth and throat would become too inflamed to eat or take meds orally (and it did). Not a very relaxing break between the two phases of treatments but he handled it without a complaint.

He has had 18 radiation treatments so far with another 17 to go. The plan is for 35 radiation treatments and 7 immunotherapy infusions over?seven weeks. Due to his platelets falling to 48K (normal range is 150K -?450K) on Thursday 8/22/2024, he did not have his once a week immunotherapy, Cetuximab, infusion last week.?

Within the past three weeks he has had Thrush develop within his mouth (which is considered a common side-effect). Also, his Mucositis?(mouth inflammation causing many sensitive mouth sores especially on the tongue, and drying saliva thickening to create thick phlegm) has greatly increased.?

It is now very painful for him to eat, so he relies solely on his "PEG" G-tube? for liquid feeding and administering?certain meds. The thickened phlegm causes him to gag frequently with occasional?vomiting. The liquid feedings have been challenging these past weeks, but we are adjusting to this new normal. We are figuring out ways to lessen the impact of his mucositis and thrush on getting his nutrition. He also had a low grade fever?these past two weeks which fortunately seems to be diminishing.?Dennis told us he would not wish the Mucositis?and mouth sores on his worst enemy, but he has been very stoic through the gagging, the feedings, the meds, the daily radiation treatments, the infusions, the rashes, the daily car rides to Dana Farber from Hingham, our continually asking him how he feels, and more.

As you can imagine last week was an especially long week for us. We (the medical team, Dennis, and us) thought he might need to be admitted to? Brigham and Women's Hospital again. Fortunately, Dennis bounced back a bit after receiving additional IV hydration, electrolytes and minerals last Thursday.

When we met with Dennis' Radiation Oncologists (Dennis' doctors, PAs, NPs, and Nurses at DFCI have been?and are wonderful) about a week ago we asked, "We are now about half-way through with the radiation and Cetuximab treatments. We already see the cumulative impact of the side-effects from these treatments, and in Dennis' case it seems to be on the earlier side than most patients. Before Dennis began radiation treatments we were told on average, side effects from the radiation tend to be seen after the third week. For Dennis it was before the end of the second week. How do we know if the radiation therapy and Cetuximab are starting to remove some or all of the remaining tumors? Do you take an MRI and PET scan now half-way through to compare to the MRI and PET scan taken before he began treatment?"

The doctor said "Unfortunately, the answer is no, because the radiation causes quite a bit of inflammation in the mouth and tongue areas. Typically, the PET scans and MRIs are done 60 - 90 days after the patient's last radiation treatment once all the swelling has gone down."

As a parent, we were hoping for more tangible reassurance this far along that the radiation treatments are working given the formidable side effects Dennis has been facing already. However, we realize there are few guarantees in life. We know it will only be more challenging in the next four weeks ahead for Dennis. And even after treatment has ended we will be anxious waiting for his cancerous tumors detection test results for another two to three months afterward.

We need to trust the?treatment plan will successfully do what we need it to do. Faith, hope, and love have taken on an even deeper meaning for us. We are very grateful to you all for your prayers, emotional support, and generosity these past few months, and hope you can continue to do so in the month ahead.?

Thank you