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Joined: Dec 2011
Posts: 126
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Joined: Dec 2011
Posts: 126
Hey katie,

Regarding your taste - this was one of my biggest concerns when I found out about the treatment I would have to do; I may be small but I am a big eater smile

Luckiy, my taste is back nearly 100% now, and I am able to enjoy all of the foods I enjoyed before. It takes me longer to eat, but i pretty much don't have anything i cant eat, other than spicy food (and sometimes giant sandwiches)!

A peice of advice though - don't eat your favorite foods past like the first week of radiation, stick to blander foods. sushi is my favorite food, and i tried to eat it once during radiation and almost threw up. i just recently started to like it again within the last few months.


Emily - 24 years old at diagnosis
HPV-, no risk factors
T2N2b Squamous Cell Carcinoma
Left oral tongue, poorly differentiated
Hemiglossectamy, reconstruction, partial neck dissection
30 Radiation treatments, weekly chemo (cisplatin)
1/13/12 last day of treatment
Diagnosed October 2011
Joined: Jul 2012
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Patient Advocate (old timer, 2000 posts)
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I heard of him, and is well known, author of several books, studies. He is Chief Surgeon at MSKCC for H&N in NYC since the 90's. Probably goes to NJ once a week. You can see a few videos of Dr. Shah and Dr. Lee, Radiation Oncologist, on their web page, and youtube, talking about H&N cancer treatment. Dr. Lee didn't want to consult witn me lol, but that's ok since I went to thier former Chief of Radiation Oncology elsewhere, but MSKCC is one of the best.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






Joined: Aug 2012
Posts: 56
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Posts: 56
Am glad you had your dental work before beginning radiation, that is usually important as having radiation can interfere with healing subsequently. See all the docs you can--the more brains considering the problem the better, but just make sure they are talking to each other and coordinating your care, not competing to determine your care.

My readings and my docs all indicate that chemo can make the tumors more susceptible to radiation in some forms of oral cancer, and it may be recommended for that reason as well.

The truth is that treatment will likely be tough, but it affects everybody differently and after a difficult few months it does begin to get better for most of us. I second the advice about avoiding your favorite foods during treatment (and for a few weeks after tx ends, as the radiation continues to affect you for weeks after the last tx); you definitely do not want your favorite foods to be associated with the tough times of treatment or with side effects such as distorted taste, nausea, etc.

Do read about your cancer and its treatment, and ask all the questions that occur to you: what are the options, what are the advantages and disadvantages of each, what will happen if I choose A over B, what should I expect and for how long, what changes might be permanent and can the risks be reduced, etc, etc. Sometimes treatment preferences are based on individual doc's experiences and preferences and not necessarily on the latest research, so make your doctor defend his choice above and beyond "in my experience"... or "that is the standard treatment protocol".

Good luck, and do use this site--I have found it to be very helpful both for information and support.


Ed H, NE Ohio
SCC BOT with lymph node involvement, HPV+, diagnosed 7/12
Radiation and Cisplatin
Joined: Jul 2012
Posts: 47
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Posts: 47
Dr. Lee is who I saw at MSKCC so if you see her let me know although I am not sure she goes to NJ. Good luck!


Stage 1 tongue carcinoma in 1999 and again in 2001, removed surgically. Stage II tongue carcinoma in 2012, surgery, neck dissection, flap from forearm, trach (removed in hospital before leaving). Finished 30 rad tx on 11/28/12.

Jessica, age 38
Joined: Oct 2012
Posts: 33
Katie B Offline OP
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Finally, a good report. The cancer has not spread to my left lymph nodes nor my lungs. I was certain it had at least gone over to the left lymph nodes. The report says " hypermetabolic focus at base of tongue to left of midline of uncertain significance". I spoke to the nurse and not the radiation oncologist. She said that he still recommends radiation and chemo. I will find out what he still wants to radiate, but my question is, why radiate the left side? Is it necessary at this point?

Have any of you had both sides of your tongue/neck radiated? Have you lost all sense of taste/salivary function? Of course I want to treat this thing aggressively to stay alive until I'm 90 or 100 but I do want to be able to enjoy eating again.

I meet with the medical oncologist on Thursday. I will go over past posts about questions to ask.

I am still waiting to get a 2nd opinion from Dr. Shah at MSK. Wish me luck in getting in this week!


10/2/12 Surgery Dx Stage II SCC RLT
11/12/12 Further tongue resec and SND. 3 of 22 lymph + SCC Stage IVa
11/22/12 Hospitalized for infection incision at neck
12/5/13 PET scan tumor at BOT
12/26/12-2/27/13 RT and Cisplatin
4/1/13-5/17/13 3 rounds of Cisplatin, Taxotere and 5-FU
7/19/13 Pet Scan possible recurrence
8/23/13 2nd op at MSKCC, CT Scan
8/31/13 MRI. Both show sizeable mass
9/11/13 CT-guided needle BX + SCC
10/1/13 Erbitux, Cisplatin and Taxotere
2/14/14 Passed away
Joined: Sep 2006
Posts: 8,311
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I was only confirmed with 2 positive nodes on my left side and BOT and I had both sides as well as my BOT area radiated with IMRT over 6 years ago at Moffitt. If I remeber correctly the rad machine made appx 6 stops from right to left each session. I imagine I received less radiation to the right neck area because the machine stopped pointing to that side appx 2 weeks before my rad sessions ended.

It took all of 2 years post Tx for my recovery and I think I am at appx 90% pre Tx levels in both taste and saliva. It's impossible to put an accurate percentage number to post vs pre Tx levels since you quickly forget what 100% was like. All you do know is that you are not what you used to be like.

Congrats on the good, i.e. FANTASTIC report!


David

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
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The hypermetabolic activity for BOT, midline, is uncertain, according to the PET, so only a biopsy can tell if it is cancer, high SUV is a strong indicator too. If there were two or more lymph nodes involved they would do chemo, and also depends on the thickness of the tumor, grade. BOT involvement can go to bilateral sides, and anything midline on the tongue also. Lymph nodes for orophargeal..BOT usually go to level II first, and oral..tongue cancer in level I, but there can be skip Metasteses.

I forgot you had root canal the same week as the PET, which can show hyperactivity in the mouth. Anyway, you are in good hands with Dr, Shah, and read of him, his work, the last few years. Good luck!


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






Joined: Feb 2012
Posts: 151
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Joined: Feb 2012
Posts: 151
Paul, what number is considered a high SUV? Just wondering for the 6 month PET scan next week.


Husband diagnosed Oct '11 Cancer of the vocal cord Nov '11 removed right vocal cord. Neck Dissection, cancer in one node, .2, very small & contained) Jan '12 Radiation and Cisplatin, 6 doses. June '12 & Dec '12 clear Pet scan. April '13 Celebrating 1 year cancer free since treatment ended.
Joined: Sep 2006
Posts: 8,311
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I was told that a SUV (Standardized Uptake Valuation) above a 3.0 is to be considered cancerous activity but remember the SUV calculation is not totally reliable as an indicator and many other factors can come into play when determining the cause of the reading itself. I also believe a SUV of 15 is the highest given.


David

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
Joined: Jul 2012
Posts: 3,267
Likes: 1
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Thanks David.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






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