70 years old so too old for chemotherapy so only radio therapy

I had Chemo alongside Radiotherapy at 68... not a walk in the park... Chemo is an extra layer of protection so not too drastic if you don't have it.

Thank you. Which was the worst to deal with then?

HPV 16 plus tonsil cancer has around a ninety percent cure rate...I suspect under 70s tolerate chemo better... write down all your concerns, bring them up at your consultation.... ask about a feeding tube, loss of taste and appetite, mask fitting, dental scans, CT scans, MRI scans etc....try to avoid Dr Google.

Radiotherapy was challenging... chemo alongside made it doubly challenging.

Hi. 
I’ll try to answer your questions 

HPV positive SCC is very sensitive to radiation with cure rates around 90%

Chemotherapy increases the chance of cure by around 6% by making the cancer more sensitive to radiation but the drug used, cisplatin, is toxic to the kidneys and us old folk are especially susceptible. So if it can be avoided without affecting the outcome it will be. 
I had HPV positive oropharyngeal SCC treated with six weeks of RT at 68 years old no chemo, seven years ago and I’m well. 

CRT has been the mainstay of treatment for the years that most oropharyngeal cancer was HPV negative and due to smoking and alcohol. There is evidence now that HPV positive disease is being over treated. 

PS

Take somebody in with you to be an extra pair of ears 

As for questions just make sure you have your CNS contact details because once you have digested the contents of your appointment they will be the ones to talk to before things start moving to prepare you for treatment 

BadDays said:

Which was the worst to deal with then?

Radiotherapy is much worse. Chemo on top of it makes it even harder. 
Dont worry about missing out on the chemo. It won’t make much difference at all. 

You could ask for Carboplatin rather than Cisplatin.  It is a gentler chemo.  For all intents it is as effective when you consider the slight difference in effectiveness over a whole course, but as carboplatin is tolerated better the course tends to be completed rather than cut short.

I went down the carboplatin route and found it relatively easy, especially compared with the RT. 

I am 72 years old and in October 2025 finished a 7 week course of radiotherapy with no chemo for HPV 16+ tonsil cancer T2N0M0  The reason given was age and possible side effects which would be more damaging to my older body.  Last month my PET scan showed a ‘complete metabolic response’ and I am now on.a 6 week check up schedule. The treatment for me seemed less traumatic than others perhaps due to no chemo.  I ate throughout although softer foods and topped up with ensure shakes and lost only 5lbs. I drove myself to the daily appointments, religiously moisturised my neck several times a day and had no skin problems and maintained an oral hygiene program with frequent mouthwash given to me at hospital but also a salt and bicarbonate one. Paracetamol and later co-codamol interspersed with ibruprophen kept on top of pain. It was a long and tiring time and does take time to recover from. I am left with some scarring in my throat which is improving but I suspect will always be there and am and will do daily swallowing exercises and lymph drainage exercises although I only lightly effected by lymphoma and it’s now gone. Trust your team and follow their advice. Good luck 

Brilliant Caro53  It’s really good to read how well we can do 

Hi I was 61 when diagnosed I was due to have 3 chemo but only over the last years I’ve come across a lot who have t had the chemo or onky had 1 or 2 sessions. I woukd t worry too much about the chemo  had 2. As my oncologist said radiotherapy is the main course of treatment Trent chemo onky adds a round 6% the success rate.i had 7 lymph nodes affected and I’m still here to tell the tale. HPV driven tumours respond very well to radiotheraoy . 

Ask any questions 

Hazel