I am a 70-year-old male with Parkinson's Disease who has just been diagnosed with stage IVa oropharyngeal cancer. The OC IVa came as a complete surprise to me. In spite of the Parkinson's, I was bicycling 20 miles every other day, and walking two miles on the days I was not cycling. I felt perfectly fine--no pain anywhere, no difficulty swallowing, no feeling of being tired, and no loss of weight. My cancer was discovered only because my neurologist noticed a lump on the left side of my neck, which turned out to be a squamous cell carcinoma metastasis from an unknown primary. A review of past photographs revealed that I had had the unnoticed lump for at least nine months without feeling the effects of anything other than my Parkinson's. In the meantime, in an effort to locate the elusive primary cancer, I have had both of my tonsils removed and the inside of my mouth biopsied in several places. My Parkinson's made dealing with just this minor surgery very difficult. Finally, I was sent to Stanford Hospital, a teaching hospital, in Palo Alto, California, where they found some noninvasive in situ squamous cell carcinoma at the base or the tongue, but no definite invasive primary. They also determined that I was positive for HPV. I have never smoked, was never much of a drinker, and have not drank alcohol for the several years that I have been diagnosed with Parkinson�s.

The cancer physicians, of course, want to give me the standard course of chemo and radiation therapy, which could leave me with some severe side effects, some of which could affect my swallowing and intake of food. As Parkinson�s Disease progresses, as it inevitably does, the person often develops swallowing problems. I don�t think I want the treatment. My wife (no children) is appalled that I am balking at the treatment, but I have told her that the quality of whatever life I have left is more important than the length. Just the biopsying has already seriously interfered with my enjoyment of life.

I was wondering whether any of you have had Parkinson�s prior to being diagnosed with OC and had the standard radiation-chemo therapy, and whether you were glad you did, or regretted it. Any guidance you could give me from your personal experience would be greatly appreciated.