I am posting this for my husband. He has stage 4a scc of the tongue and floor of the mouth that was surgially operated on on 6/9/2006. His jawbone was replaced, and ENT did a neck dissection and all nodes were clear. His cancer was moderately differentiated.

His staging is a T4N0M0 this is a 3rd recurrance.

His ENT suggests 33 radiation TX along with chemo.

My husband does not want to have radiation yet. Nor chemo. He has appt for another opinion.

Currently he can only swallow liquids, has terrible shoulder pain and is down to 126. He has a PEG in place used for his meds. He is not ready for peg feedings until another few days when his visiting nurse can come out and start the process of ordering that for him.

Does anyone have survival statistics on a stage 4a T4N0M0 with surgery only vs surgery radiation and chemo?

The Dr said that this recurrance of the cancer invaded bone and muscle, but they got clear margins, no nodal involvement and his prognosis with surgery and radiation is 35%. What is concerning us is that if he does do the radiation and chemo and it recurs agaim ( a 4th recurrance) there will be nothing to fight it with per the Dr. He did not do well after the surgery and was in ICU for 2 weeks, then developed cellulitis in his leg graft. He is a surgical mess right now, and he is discouraged, tired and ready to give up. He wants a break.

So he does not want to expend all options since this was a 3rd recurrance, same location within 6 years.

He wants to postpone radiation and chemo for 6 months and wait and see what happens. His RO was agreeable but not happy as she feels that it is his choice and she respects that but from her side he should have this ASAP.

My husbands concern is that he can barely swallow now, weighs 126 pounds and he can barely keep any energy up now.

Any advice would be very welocome.

I am sorry that you find yourself in this dillema again. This is just my persomal opinion but T4, third recurrence and no radiation or chemo is suicide -what "options"?. Listen to the RO. 6 months from now it could well be palliative radiation that he's getting.

What surprises me is that they waited until the third recurrence to suggest radiation.

If you are not already at a CCC then I would find one immediately and get a second opinion.

I'm with Gary on this one -- unfortunately, the notion of waiting until the "right time" to use radiation can turn out to be waiting until it's too late to be of any good use.

However, I also went back and reread your first post and noted that, as of that time, your husband was continuing to smoke and drink heavily, even after multiple recurrences. That's something that radiation won't cure, and if he really wants to get better, he needs to focus on that now.

Cathy

Ditto what Gary and Cathy said. You need to throw everything you can at this and aim for a currative response if possible. I briefly when we meet with my Father's MO the first time mentioned should we do all of this with the first occurrence as we will have nothing left if it returns. He informed me that you throw everything you can at cancer. You don't save anything for the "next time". As a doctor he said he wanted to cure my Father and the only way to do that was to aim with all of your ammunition and fire. Don't mean to be harsh here as sounds like your husband has been through alot and radiaton is no picnic - but it is your chance at trying to beat this thing.
Good luck and keep posting........
Kim

Just my opinion too, but it sounds like it's time to give it everything. And please see that he starts using his PEG for nourishment. My DH has had to use it since the day after his surgery. It's routine now and nothing to be afraid of. No one knows he has it. Nothing shows and we plug him in at night and he is done in the morning. He actually has a J-tube which takes longer to pump in, but he could not survive without it. DH is 62, still working fulltime and fishing. He could not do this without his PEG.

I went back to your original post - "3 pack a day day smoker and alcoholic". I am sorry to be be so blunt but I would make every effort to make sure that his affairs are in order - revocable living trust, will and advanced directives.

Addiction is a " cunning, baffling and powerful" thing (as the Big Book of Alcoholics Anonymous puts it). He (or the disease of addiction) has chosen this path for himself and unless HE WANTS to change, there's really not much else you can do.

Get help for yourself for co-dependency. You can find CODA meetings in your local phonebook. There is also Alanon. Get to a meeting as soon as you can. You will much much support there.

About the statistics the AJCC gives a stage IV 26.1% 5 year survival rate that those are averages and don't reflect health habits, ethnicity or age.

I had a stage 1 tumor (1.2cm on right lateral tongue) and 1 node positive (4mm) and I am going through both radiation and chemo. Although many have done it other ways, I can't imagine why a stage IV patient would not be the most agressive with this doing everything and then some. I think your husband might be in denial not only about what his habits are doing to him, but also what this choice might mean for him in the future.