I�m near a crossroads in my treatment.

From California I came to MD Anderson in Houston with the idea that my base of tongue and bilateral lymph node cancer tumors would be treated using Chemo and IMPT (Proton Therapy). When I arrived, I found out the only way to get Proton Therapy here at MD Anderson would be if: (1) the coverage area for the tumors was not too big and (2) I agreed to take place in a randomized clinical trial where I would have a 50/50 chance of receiving Proton Therapy (the other 50% would be treated with IMRT). I have no family with me full time here in Houston.

The doctors here decided on an approach of using preliminary chemo for 6 weeks prior to starting radiation treatment. For the past 6 weeks I have received weekly chemo treatments, which included Carboplatin, Paclitaxel and Cetuximab. The goal was to reduce the size of the tumors and make them softer and more treatable with radiation. Though I don�t know the exact dimensions, the tumors have decreased in size according to the Chemo Oncologist and the CT scan. So, it seems the preliminary chemo approach has accomplished its� goal.

At this point, I�m not sure if I will receive the Proton Therapy or IMRT. On Friday, I received an orientation and training to the radiation therapy side effects. Next week they will tell me which type of therapy I�ll receive.

I am here in Houston by myself. My fianc� and my sister have come at different times to be of support to me, but neither can manage to be here with me full time. At this point, I have serious concerns whether I can handle the radiation part of the treatment without more support. I would have more support at my home in California than I would have here. If I�m not chosen for the Proton Therapy, I will receive the IMRT here in Houston. I can also receive the IMRT in California. One of the main reasons for me to come here to MD Anderson was the Proton Therapy offered supposed more effective delivery of the radiation with less side effects. The other good reason to come here was MD Anderson�s stellar reputation for treating Head and Neck Cancer.

Does anyone have any thoughts/experience with taking radiation treatment (either Proton or IMRT) without the support of another person at home to navigate the challenges of food, medication and transportation?

In the next couple of days, I will learn whether I am to receive Proton Therapy or IMRT. If I am to receive IMRT, I can choose to return to California to take it there. The decision pretty much comes down to the advantages of the specialized care here at MD Anderson (though I�m sure the care is excellent in my home town) without much support versus treatment at home with more support.

Your insights are appreciated�thank you. Roger