Hi Gang:

As many of you know, my partner Dave is currently recovering from a radical neck dissection and lymph node removal with a free flap graft for Stage T2N1 tonsillar squamous cell CA. His surgery went well with good clean margins and only the 1 out of 28 lymph nodes we expected came back positive. The lesion itself was 3.5 cm.

Alas, the great debate continues about radiation and/or chemo. We have a post-op call in to the radiation oncologist to set up a meeting time to discuss post-op options. The initial recommendation by many (surgeons and radiation oncologists ) was that Dave could do surgery OR surgery followed by radiation because it was likely he had one positive node which did come to pass.

I have been watching the posts about this topic with great interest and need to add a new layer to the mix-what is the feeling of the board about the recommendation above and given the node issue, what do people think about the OTHER elephant in the room-does a booster dose of chemo in the beginning and at the end of the radiation cycle provide "extra life insurance" against reoccurence?

The comments about heated discussions in Tumor Board seem right on to me which si why I also want to get your take in addition to that of our friends the medical pundits.

Hope this day finds you all well,

Kim

Kim,

When I learned that some treatments included both chemo/radiation I asked my ENT oncologist why I only had radiation and not chemo, too (he was not my primary dr. at the time, my ENT was) I think he would have done both, but his comment was that "they were finding the effectivness of both at the same time was outweighed by the problems" He said it was really tough and from what I've read it is. So I personally only had radiation and can be of no assist in an answer, but I know there are people on the board that have had both.

Please up date us on Dave's condition?? How' she feeling? I've sent two private emails but I don'tthink they got to you.

Take care,
Dinah

Hi Dinah:

Thanks for the post and unfortunately the private e-mails didn't reach me at [email protected]. Oops...sorry to miss them!

Dave is feeling much better but VERY stir crazy about being post-op and still having an NG tube that is killing his throat and was supposed ot come out tomorrow but lo and behold-the barium swallow specialists will be out of town at a conference! So, option B was to wait another week or so to have the tube out and being the pushy nurse caregiver I am, I called his surgeon and said we needed a different plan because Dave is hungry and thirsty and last time I checked this was a good sign and he IS swallowing well. So,we will be formulating a new plan in the morning and hopefully he will be sans tube very shortly.

The trach site is almost closed and he is talking clearly and still sounds nasal and very British to me so I guess surgery does spare a diehard accent after all...!!

We had one visit to the ER last Friday eve after Dave spiked a temp of 102 but he was deemed to have a bit of chest congestion and a morbid fear of being readmitted and he was sent home with an antibiotic and a big sigh of relief and has been fine since. My boys think he will make a great Halloween creature and he has been visiting local stores with his friend the NG tube which has gained is some very cute looks.

Overall, I am continually impressed by the quiet dignity with which Dave has conducted himself over the last few weeks. His mom and sister are here from the UK right now which is a great help and super company. I am back to work this week and learning that caregiver exhaustion comes with the package but it will be worth it to have Dave be healthy in the long run.

The neck incision line and graft sites look phenomenonal-I am amazed at the cosmetic result so far.

I spoke with his surgeon tonight who tells us that having good clear margins and only one node positive out of all is great news. We are on to the next round of the radiation/chemo debate next.

And the beat goes on...but thanks for asking.

Now, catch us up...how are you?

Best,

Kim

Kim et al,

I've started a new topic in this section on the radiation/chemo debate. I look forward to everyone adding their two cents.

Cynthia

I guess everyone handles it diffrently, my husband did okay. He did get sick for two days after treatments, he had three treatments, every three weeks. He was just very tired from the combination radiation and chemo, but work gave him 3 months off, so all he had to do was rest.

Sherrie