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What to expect
Mar 19, 2013

Dr Doc. Back in 2009 I was diagnosed with a malignant neoplasm of tonsillar fossa (oropharynx cancer) The tumor behind the left tonsil was removed along with the left tonsil, some soft pallet on the left side and a part of my toung and all my neck lymph nodes on the left side removed as well. My flap is slightly damaged but I am able to eat with out a feeding tube. They told me it was an HPV type cancer. I also had 30 radiation treatments after surgery. My t cells when down to 150 after radiation and it took 3 years to go back up to 386. The last test a few months back showed a decline of 100 points on my t cells and I have had 7 episodes of herpetic whiltlow. I have been HIV+ since 1996. I am 52 years old now and although I have a really good Dr. My problem is that I am not as energetic as I once was and have become depressed. The cold winter months now hurt when I go out. Any suggestions. I am struggeling to get used to my new body and it's not easy as I once was a work horse.

Response from Dr. Henry

The outcome from oropharyngeal cancer is variable. Even patients who respond well to treatment often have loss of energy and a drop in CD4 count. I would expect that your HIV infection likely can be well controlled so that your health will be more impacted by the cancer and other health issues. Loss of energy can be due to deconditioning, depression/seasonal affective disorder, low hormone levels, anemia, vitamin deficiencies and other conditions that merit consideration. Herpetic whitlow can often also be a challenge to manage occasionally complicated by development of resistance to standard drugs. If the isolate remains sensitive to drugs like acyclovir then prophylactic use between episodes is sometimes helfpul. KH



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