If his cancer is differentiated, like mine was, he might be a candidate. I had no lymph node involvement however and that might make a difference. Actually many of the local and regional RT centers have been upgrading there LINACs for IMRT. I wouldn't let them pull my teeth unless they are in bad shape or he has gum disease. I kept all mine. The main reason they pull the teeth is to avoid Osteo Radio Necrosis (ORN) literally bone-radiation-death. It can happen about 10% of the time. I figured a 90% chance of NOT getting it didn't justify the quality of life issues, but once again the condition of gums & teeth is highly relevant. I have always seen a dental hygenist at least twice a year (more often now) and have taken really good care of my teeth. The "pull your all teeth" mantra seems to be standard policy but I personally think it is barbaric and uneccessary most of the time. Some people get ORN WITH all of their teeth pulled. They zapped a bunch of my lymph nodes as a precautionary measure so maybe they can treat him with IMRT. He will lose the parotid salivary gland behind the tonsil, but the other ones will make a comeback. It makes a huge difference. You will need to hurry and get a second opinion from a RO where they offer IMRT. RO's are not prone to recommend a treatment modality that they can't offer.

If I was in Texas, I would be going to MD Anderson anyway. They are one of the best. Be warned they probably won't touch once treatment is started so you must act fast.

This is one disease that is worth the effort to go the distance and get it right the first time. You're going to spend a little less than 2 monthes treating this - get the highest standard of care you can.
Institutions that call themselves "Comprehensive Cancer Centers" (CCC) or ones that call themselves "Cancer Centers" must meet specific NCCN and/or NCI standards of care. They will be on a list of institutions. I have posted this list many times - see if your cancer center is on the national list (try the NCI list for CC's)


Gary Allsebrook
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Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
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"You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)