Hi,

I'm at a pretty critical juncture right now as I'm trying to figure out what the right path is to combat this disease. I'd be grateful for any feedback or insights that anyone might have. My backgroud is:

4/27/05: Had a 3cm lyph node removed from my neck that turned out to be cancerous (in total I had 4 nodes removed and only the 1 was cancerous).

5/5/05: Had a pandenscopy and right side neck dissection. 9 more nodes were removed from my neck and none of them were cancerous. So, I had a total of 13 nodes removed and 1 was cancerous. The primary source from the cancer was found to be on the base of my tongue, right hand side. The tumor is about 1.9 cm long and 1.1 cm deep. My staging is T2N1M0 Stage III SCC. I've had CT, PET Scans and MRI's and so far nothing is showing below or above the neck (my kids would say that they aren't surprised about nothing showing above the neck).

My ENT recommends that I go with Chemo-rad for 8 to 9 weeks. Chemo will be cisplatin (100 mg/m2) and will likely be administred the 1st, 4th, and 7th week. Radiation will be on both sides of my neck.

I went for a second opinion to a highly recommended Dr at the University of Minnesota and he agreed. I got a third opinion at Rochester Mayo from a very highly recommended Dr and was told that he would rather do surgery and then follow with radiation (maybe chemo too).

I've gotten somewhat conflicting opinions abut what works best; surgery first or chemo-rad followed up, if necessary, with surgery. Two Dr's told me that the latest results are showing that chemo-rad tx has as good of results as surgery followed by tx. The Mayo guy says that it really is an interpretation of the data and he could show me data that would indicate that chemo-rad had the worst results. All of them say that there really isn't a wrong answer. It seems that the recommendations are associated somewhat with the tendency of the center. Mayo likes surgery, Anderson and likes radiation, etc.

I'm leaning towards having the chemo-rad tx and then having a biopsy done about a month after tx. If the tumor dies, I dodge a bullet and don't have to have suregery on the base of my tongue. If the tumor still has life, I can have the Dr do a "surgical salvage" (i.e., do the tongue surgery). One bad part about waiting is that both the surgery and recovery is more difficult/painful after tx. For example, if I did the surgery now, recovery could be about 2 weeks. If I wait until after tx, recovery could be 1 to 2 months.

Sorry to write so much, but I thought the info would be interesting and help you understand my situation better. Any comments?

Thanks - Tim