Hi everyone,
I am so lost and confused. I know I typed up some of this already but now I have 3 opinions.

My brother did a tongue dissection on June 24, 2014 at Beaumont Royal Oak (this is not a comprehsive cancer center). After the surgery the doctor realized that the tumor was deeper than expected. He was diagnosed as stage 1 cancer but the depth is 0.7 mm. The doctor recommended that my brother does a neck dissection to remove lymph nodes and then to do 1 week of brachytherapy (which is radiation implants).

We went to Dr. John Jacobs (Northwestern University School of Medicine, Chicago, Illinois
M.D., 1975) afterwards for a second opinion. He is out of Karmanos Cancer Center in MI. He is at a CCC. This was his opinion... I think because of the close margins, the lympathic problem, the vascular invasion I would recommend additional therapy which would be radiation therapy alone. I would recommend IMRT opposed to an implant radiation (brachytherapy) I would not recommend an elective neck dissection. The question of Erbitux in addition to radiation therapy is an open one. They might recommend it down to cancer centers because of your age group. I personally think its probably overkill.
If he were to do a neck dissection I think 1 chance out of 5 that we will find cancer cells�

Today we went for a third opinion (also at a CCC- U of M Ann Arbor, MI) The doctors name is Dr. Matthew Spector (Loyola University of Chicago - Stritch School of Medicine, 2007) His opinion is:
The treatment we would do after that is 2 choices.
1. my recommendation is re-incision (tongue surgery again) with neck dissection, re-construction of your tongue (rebuild it) and then radiation but maybe not chemo.
2. chemo radiation now. Radiation and chemo. External beam IMRT
radiation.
�Erbitux- type of chemotherapy (never been studied in your type of cancer and shown to be affective) new type people are using. I would not give you Erbitux because such a high risk of coming back. The only drug that has been shown in randomized trials to help this type of cancer is high does Cisplatin.

Doctor: radiation isn�t as affective- the reason we use surgery followed by radiation is because surgery- because radiation is not really as affective when there is a lot of disease left so radiation is really good at cleaning up little few cells but if we have a postive margin we consider that gross disease left on the tongue.

What should I do now?? I need help?? Which opinion should I listen to?

Last edited by ak123; 07-16-2014 05:26 PM.
22 YO Brother Dx 6/17/14 w. SCC R Lateral tongue
CT scan clear LN 6/20/14
HPV-, non-smoker
R tongue, right hemiglossectomy Surgery 6/24/14
(Not reoccurrence but went to NCCC instead
R neck dissection, tracheostomy, radial free flap, R tongue dissection surg 8/11/14
PT1N2B.3 positive lymph nodes out of 13
Extranodal extension present
9-15-14 IMRT (35x) & Cisplatin (2x) begun
10-21-14 peg in. 10-31-14 1 round of carboplatin
11-4-14 IMRT rx comp
3-27-15 Recurrent tumor in lymph node, L neck diss.
10-29-15 brother passed away, 23 yrs old