I have a few questions I need an answer to please. My mom who had a very small tumor removed from the base of the tongue & also has a 3 cm tumor around her carotid artery. No lymph node involvement but they want to shrink the tumor around the artery because if they did surgery there is a chance of hitting the artery. Anyway my question is that I have read that surgery is worse after chemo and radiation as opposed to before treatments because of what radiation does
to the tissues, is this true? She will receive chemo first, it there even a chance that chemo alone will shrink the tumor? Any info you can give will be appreciated.
thanks
denise

I was given the choice of chemo.......and the hope of shrinking my tumor, stage 4, somewhat and dying comfortably, or opting for radical surgery, my surgeons in Boston felt that if I had chemo before surgery it would weaken my immune system, so, I opted for surgery. Understand this was total removal of larnyx, vocal cords, tongue, floor of mouth and jaw bone and lymph nodes......My personal opinion would be to get a second opinion...my origonal ENT could not perform the micro surgery involved, so he didn`t recommend it...I would get a second opinion.

Denise,

I had the same questions as you regarding why not surgery before radiation/chemo. I didn't get much of an answer. I feel they are trying to avoid surgery on my mother, for what reason I don't know. Since my mother is the patient, not me, I sometimes have to defer to her. She would like to avoid surgery so was glad to hear they would try radiation and chemo first.

I would also be confused since they have not discussed radiation. In everything you read, surgery and/or radiation are usually the first line of treatment. The benefits of chemo are just beginning to be used. You should ask your mother's doctors point blank why there is a change from standard protocol. If you do not get the answers then I would agree that a second opinion may be needed - or a third or fourth, if necessary. Trust in the doctors is very important - and it is not uncommon to get many opinions. Some people fear "offending" the doctors - never mind that they may offend us!

Cynthia

Just a couple of quick answers, to add to your thought process. First chemo alone in oral cancer treatment is never the primary mode of treatment, it is an addition to surgery and radiation. So chemo alone is unlikely to be a choice. If doctors are recommending chemo alone it is usually for palliative care, to extend life, but not to affect a cure. Surgery is not worse after radiation, but it is more difficult for the doctors as the consistency of the tissues becomes gummy and difficult to work with. It is done all the time however, and was on me, radiation first then surgery for the cervical lymph nodes that were in the radiated field. I believe that we all have a natural fear of surgery, and when I went into treatment I didn't want it either. But sometimes it is the best solution to the problem. We suspected that my neck nodes were cancer free after the massive radiation treatments, but the only way to know for sure was to take them out. They were indeed cancer free, but I have no regrets about having the surgery in retrospect.

Question on the 3 centimeter lump, did they do a needle biopsy? Sometimes that confirms that diagnosis. Chemo we were told does not usually take care of a cancerous tumor (squamous cell). Cath had tongue cancer surgery ten years ago followed by radiation of tonque and neck area. Two years ago a lump formed in the surgery area of the neck. Its one centimeter and has added to the pain of the radiated nerve endings that are regenerating. The evaluation by three specialists is that it is a nuroma possibly caused by a suture that did not absorb. The carotid artery in that area shows a stenosis from the radiation to the neck and will have to be watched in the future. More opinions do not hurt.

Cynthia, Packer, Brian, & Cath
Just want to thank you for your advice and information. It truly helps to have people to talk to about this when there is still so much I dont understand. I will talk to doctors about radiation for my mom.
Thank you for your time.
denise