I initally had surgery to remove Type I SCC lesion in tongue last August as well a selective neck dissection removing 6 lymph nodes. The tumor had narrow margins and the lymph nodes were all clean.

Due to the narrow margins and unknown cause (not a smoker or drinker), they suggested radiation. After two weeks, I ended treatments due to intense side effects.

Early this March, I had a recurrence (possible skip lesion) and had surgery again. This time the doctor also had 5 additional biopsies he performed along my tongue (right side) from front to back. Tumor came back clean margins and all biopsies were negative.

In April, I started Radiation treatments again on my tongue and upper neck and completed them 5/20.

I followed up with the Radiologist and he said that he spoke to 5/6 other Radiologists about my situation and treatment. All but one said the radiation was the right thing (no chemo). One (who happens to be a top radiologist in the world) recommended brachytherapy. My radiologist said he is "on the fence" about whether I should do it or not.

I followed up with my surgeon yesterday and he told me to "think about it" and see him in two weeks. He has been definitive (as in the second round of radiation treatments), so I know he is also on the fence.

No one has any "hard/fast/definitive" statistics on what the right thing is to do. In fact, the first time around five doctors were "uncertain" if radiation was the right thing to do. Everyone leaned to yes, since the SCC was of unknown cause. My surgeon said that if I was a smoker then he wouldn't have me do anything else other than quit.

Any experiences or ideas here. I'm really at a loss. Thanks.

bdean, I am of the opinion, with no medical backround, that one should throw everything available at this beast, which is why three years ago I had surgery followed by rad and chemo. There are people on this forum who have had brachytherapy and if you do s search you can read about it. Perhaps you can ask the doc who recommends it why he does so. If it were me, I am pretty sure I would go for it, just for the peace of mind knowing I had done absolutey everything I could. Let us know how you do.

bdean,

I had brachytherapy at the end of my treatment -- after a partial glossectomy and neck dissection (with removal of many lymph nodes) and 7 weeks of general field radiation. (That was 16 years ago.) I've never smoked, and was just considered a social drinker. My tumor was poorly differentiated, which meant it was showing signs of becoming aggressive, and I think that was one of the factors my head/neck cancer team looked at in recommending brachytherapy.

Like Joanna, I've come to believe that you have to hit this disease with everything possible as soon as possible. Are you dealing with a team at a comprehensive cancer center? If not, I'd suggest that you get to one where the surgeons, radiologists and other related cancer specialists can give you some kind of consensus about what they feel is best in your situation (and why).

Cathy

Dad is on IMRT #18 and we meet with RO on Wed to discuss his recommendation to do bracytherapy after IMRT #25. From all the research I've done, it seems to vary from one doc to the next as to whether bracytherapy is recommended or not and has to do very specifically with the "grade" (G) part of the description of your cancer. Also, whether or not your RO and/or treatment center is experienced with the procedure. Dad's is, but Dad is so reluctant to do anything more. He's tired of all the pain...If anybody has any recent or definitive articles or stats regards rate of cure with or without bracytherapy (also called intersitial, implant, internal and is the type of rad which requires a hospital stay), I'd appreciate hearing of it.

After meeting with the local specialist in BT, I've decided to do the procedure. At this point, having had one recurrance, I feel lucky to have caught it early and want to give it a knockout punch. I'm looking at July 18th for my date.

I felt this one in my gut and knew if I labored over a decision it would just make things worse. Thanks to everyone who've provided their insight and thoughts. I'll keep you posted on my progress.

Trust your instincts and fight as hard as you can. Dad took 27 IMRT and finally made up his mind to quit there w/o the bracy, but he's older and has another cancer (NHL) he's being treated for as well, so he's at a different point than you. I admire your courage and your willingness to go the distance. Hang in there!

Bdean, I hope Michael reads your posts and I am wishing you much success with your treatment. Amy