The VA team has decided on this course of action but we are still looking into another opinion. His teeth are bothering him - he onl had a few removed prior to the first round of RT - wish they had removed them all .. Dentist would like to have some extraction done to improve his pain, even though we don�t know how much pain was from the bad teeth or tumor. But she preferred to have hyperbaric treatment prior to extraction which may take more than a month, which will delay the RT. Therefore they agreed he should proceed RT first, followed by hyperbaric then extraction.

Regarding chemo, they will most likely choose some chemo regimes.

At yesterday�s tumor board, surgeon mentioned that surgical removal of the gross tumor is feasible, however oncologist has concerns about the postop recovery. So they finally agreed to proceed chemo RT only.

they will contact him next week to setup the CT sim.

he is still in a lot of pain even thouh i thought it was getting better and he managed to go to town meeting this week.

still not sure if surgery would be the "better" option

thnx for listening

Dawn

It is unconscionable that your Dad is still in pain. He should be on the 100 Fentanyl patch (although they may have to work him up thru from 25, 50 & 75 patches first) plus oxycodone for breakthru pain. Yeah, it may knock him out but pain does not promote healing and they can adjust his doses. I was lucky my doctors were aggressive in pain control. Seriously, something is wrong if he's in pain.
Charm

As a Veteran I dont trust the vA for any serois illness, if possible have your Dad treated at a CCC and at the leasr get him on some pain relief asap!!! Semper-Fi Bob

Yes, I have wondered if the VA is giving him the best of care but dad never paid into medicaid b or something but my mom has insurance that the VA has been sending bills to. I met with all of the VA doctors and they seemed competent but I still have doubts and am trying to get Dad to see someone else prior to his next treament.. just wish we maybe had done this when they first found the cancer on his tonsil. but not much we can do about his now.. the dr has upped his patch dose and gave him some anti anxiety meds for my mom said he had a meltdown at the VA .. pretty horrible to see him in this state.. how do people do after a second round of radiation? The first round was pretty tough on him.. they do not think this is curable so I think they are trying to give him best quality of life options but not sure RT will do that.. wish they could just cut it out but I guess its not that simple.

I don't know about everywhere but in Dallas the UT Southwestern medical school oversees treatment at the VA (same docs as the Simmons Cancer Center) and in KC the VA oncologists come from the University of Kansas medical school. The VA medical center in KC was the only place that would even treat my uncle's leukemia and they even gave him a couple of years cancer free that he hadn't been expecting. I would suppose in outlying areas it would be different.

It sounds like everything is pretty tough on the whole family. Hoping for the best for all of you!

Ed

I would take caution on making decisions based on finances (i.e. not paying into medicare part b, insurance etc..)and not on doing what it takes to surviving.

All - thank you for your opinions and insights - I totally agree about making decisions based on finances, however, trying to convince my Dad about that is a different story and in hindsite - I wish I got more involed with his initial diagnosis of the Tonsil but was pregnant with twins living across the country but my sister said she had these conversations with him.. but I guess they felt the Boston VA was doing all that a CCC would do and maybe they did and his cancer is just stubborn and came back or never was all gone.. We are seeking some more opinions - one from head ENT at Biloxi VA. He is suppose to get another CT scan, and get fitted for his next radiation mask.. I am not sure he is going to tolerate another round of radiation and/or this is the best way to combat this latest tumor but his other choice is the salvage surgery that the Dr's seem to think is worse. I think the Oncologist woudl just like to do more chemo and pain mgt to keep it in check... How long can one survive before the cancer invades the rest of you?

Dawn

Please quit even thinking that you could have done more for your Dad. It's just "magical thinking" because the sad truth is that your Dad's cancer is bad and the TX is even worse. Quality of life trumps even finances - and I respect your Dad's apparent calculus that he does not want to throw good money after bad. I have railed here before about how Society requires Cancer patients alone out of all the diseases to "fight to the end". You never see an obituary about how someone fought heart disease, or lost the battle to heart disease.
As for insights, I'd recommend you read this entire thread
Surviving or Existing
EZJim is one of our most upbeat posters, yet he has the same dark nights of the soul that many of us do. None of us are 85 - and I don't think EZJim, Christine or myself are counting on making 85 - but speaking strictly for myself, I would die then and there if radiation and chemo were still the only treatments.
Charm

Thanks Charm and yes reading through the survivng or existing post and all the posts for that matter makes me feel better about Dad and helps me realize this OC is really bad and Dad has had a healthy long life up to this point so I try and focus on that. I had a great visit with him and hope for more.... My mom who has put up with him for almost 50 years has banned him from driving since he bumped the guardrail driving to the VA last week ( i joked to my neice - grandma's gonna kill papa with the frying pan before the cancer does) .. He was fitted for his next mask today and looks like he is scheduled to start next round of RT on November 8th.. so we hope for the best.. Thanks for listening

Dawn
[quote]but I guess they felt the Boston VA was doing all that a CCC would do and maybe they did and his cancer is just stubborn and came back or never was all gone.[/quote]
I just wanted to add what is implicit in my signature line: that even being treated at a CCC with expert RO and MO (both quoted regularly in medical journals and major network shows) does not mean that a "stubborn" cancer will not come back. My care was top of the line at a CCC and very aggressive yet my cancer came back within a year.
Just wanted to be explicit and validate your thoughts above in that quote from your post. Being pregnant with twins sounds like a good reason to me to let your sister take the lead back then.
charm