My mother who had surgery for tongue cancer in Feb. 2002 recently found out it has moved to her right lung. She has been referred to something called Thoracic Oncology Program at the local SUNY Upstate Medical Center. The literature says her appointment will take aproximately 4 hours with docotors from different diciplines examining her and the xrays, etc. from the beginning of this whole thing. I know this is not directly related to Oral Cancer, but I have read people posts on the board talking about this kind of team approach for treatment. My sister and I will be accompanying my mother for the appointment and I was wondering what to expect. Do they present treatment options on the same day or will that come later. The whole thing sounds pretty intensive, but I am glad that her ENT referred her to this program.

This sounds like a tumor board meeting. In my own not only were all the pathological findings discussed and confirmed among the attending doctors, but various treatment plans were discussed as well. After each doctor had the opportunity to present his point of view a consensus was reached and my treatment began. This is definitely the best approach to treatment planning.

My mother met with the doctors today and they told her they would recommend surgery to remove the tumor from her lung. It is SCC the same as the original cancer in her mouth, but since they cannot see any other signs of cancer from the tests they would be treating this as another primary cancer. The surgery will take 3-4 hours and would involve removal of the entire top lobe of her right lung. They would try a less invasive approach, but it appears that the lesion is deep and large about 4 cm. and appears to be very close to the blood supply to the right lung. They said they probably would not recommend following the surgery with radiation and would not recommend radiation instead of surgery because of the size of the lesion. Her Pulmonary Function test showed good results at about 87% capacity. She wants to think everything through before making any decisions. If she decides to go the surgery route she will need to have a stress test and be examined again by the ENT who did the surgery on her mouth to determine what concerns there may be regarding her airway, swallowing, etc. He will also be involved in this surgery if she chooses to go ahead with it.

Dear Vince,

My heart goes out to you.

It is a major operation, but one that can possibly lengthen your mother's life.

My husband had the same procedure, only because we could not safely biopsy the lesion. His was benign, but there was no way to know that until the surgeon had taken out the top 1\3 of the right lung.

If she is not showing any other tumors, please, in my uneducated (until recently) opinion, let her have the surgery. If she is able to safely endure the surgery, I think she has a chance of more quality time.

I want you to know that I'm not an expert. Only someone who has gone through the same procedure. It is hard, but if it puts the cancer in remission, it's worth considering.

Please email me if you would like to hear more of our experience.

Mandi

Vince,

When your mother had the tongue cancer removed back in February 2002, did she also have nodes removed from her neck area?

(Why I ask: I'm told tongue cancer would first spread to the neck nodes, so be agressively sure, it's best to remove the tongue cancer AND the nodes and run tests to see if it spread to the nodes, and if it didn't, things are looking up aka it has not spread anywhere else in the body.)

Thank you,
MaryC

Hi Mary,
In May of 2001 my mother had a radical neck at which time they found some nodes that were positive for cancer. She opted not to have surgery on her tongue at that time and the radiologist told her he thought if she had the neck surgery and radiation she might be able to avoid the more extensive surgery. As it turned out it was probably a poor choice, because although it looked good up until December of that year, I don't think the cancer in her mouth was ever completely gone. When she had surgery to remove her tongue the PET and CT scans all showed it had moved to her jaw and the floor of her mouth. She had 60% of her tongue, the right mandible and teeth on the bottom and the floor of her mouth removed. She developed an infection and was in the hospital for over a month. So as you can see she is not enthusiastic for more surgery. Even though the doctors see no other areas in her body besides on her lung about 4-5 cms, it is the same cancer squamous cell, and her thoughts are that even though they would treat it as another primary cancer the chances are it will turn up somewhere else after she goes through all this.

Sorry I probably gave you a little more info than you requested, but thanks for your interest.