Hi there;
I am new here. Just for a little background, I had a partial glossectomy on 10/4/04. The margins were good, however they saw "angiolymphatic invation" which I have learned is a fancy term for cancer cells in the blood vessels of the lymphatic system. My lymph nodes looked clear on the MRI and I had a PET Scan yesterday. I am projected to start radiation on 11/15/04. I am feeling very lucky that the cancer was caught at an early stage (although a brush biobsy by the dentist missed it last year). The question I have comes from a meeting with my radiation oncologist on Thursday. He said that my husband and I should wait to start trying to have children for at least a year after the treatment has ended. He said there was a theoretical risk of genetic problems. I told my surgeon this yesterday and he said the oncologist was just being ULTRA conservative and there was no reason to wait. This may seem like and unimportant issue to be worried about right now. I probably should just be worried about getting through the treatments first. But I had been try to get pregant for a year before this whole thing came up and if it is not necessary to wait, I would rather not. Of course, I don't want to risk genetic problems just because I am impatient either! If anyone has been in this situation, or knows anything that might be helpful to me, I would really appreciate more information.
Thank you so much!
Sam

Hi Sam,
it took me a year just to recover from the radiation. I had extreme fatigue, lost a lot of weight and had muscle atrophy. I can't even imagine being pregnant in the middle of treatment let alone the possibility of genetic problems. I had to sit while showering in the end of treatment. It takes a good month of recovery for every week of radiation (and that doesn't mean full recovery either). The radiation will also effect your RBC for as long as 4 months. Maybe your surgeon is being overly optimistic.

Sam,

Welcome to this site. I'm sorry you need to be here, but hopefully you'll find the information and support you need.

I was diagnosed with tongue SCC (Stage two) 15 years ago at age 39. At that time, my husband and I had been trying for quite awhile to have children, but based on what I heard about the impact of surgery and radiation, I decided it was best to try to put our plans on hold. I should add that we had tried for so long -- unsuccessfully -- that I was on the verge of pursuing either IVF or adoption as possible alternatives, but also put those off as well due to the cancer treatment. Frankly, I don't know how I could have dealt with pregnancy while going through radiation; as you will see from many of the posts on this site, radiation to the head/neck is extremely debilitating even for people who otherwise seem very healthy at the outset.

I don't think your oncologist is being overly conservative -- I think the word is realistic.

Cathy

Thank you so much for your responses. Of course we have put off trying to have children for the time being, and I know that I will need time to heal after the radiation. I was just wondering if it was safe to resume our efforts after I was feeling better from radiation. I had myself prepared that I would be feeling better within a few months. I guess it is good for me to hear that I might take longer than that. Everyone keeps telling me that since I am young (30) and in good health otherwise, that I should do very well. Part of me a pretty scared by the whole thing, and I think it feels better to try and think about getting my life back on the track I was on before this happened. I know that being as healthy as I can be is the most important thing before having children.. and I will of course wait as long as necessary. Cathy, had your doctors told you anything about possible genetic defects from radiation?
Thanks,
Sam

Sam,

I am really interested in the story of your diagnosis. I am an oral cancer survivor and also a dental hygienist who does a lot of speaking on early diagnosis. You mentioned that you had a brush biopsy done last year that missed your cancer -- my cancer was initially diagnosed with a brush biopsy. Anyway, if you would e-mail me, I would love the opportunity to ask you some questions.

Thanks,
Barb

Hi Sam,
I have done both. I've had 7 children and had radiation. Given what I know about radiation and how a person feels for months, and months afterwards, it is not the way I would want my first pregnancy to be. Waiting will be better for you and for your child. Your nutrition will be compromised for months from the radiation treatment and that is not good for a pregnancy.
Take care,
Minnie

Sam,

My doctors didn't say anything explicitly about possible genetic risks in pregnancy - but I don't think I really pushed them on that point either. At that time I was so stunned by the diagnosis and what was involved in treatment that I pretty much concluded on my own that I couldn't take on any attempts at pregnancy for quite awhile.

Are you being treated at a comprehensive cancer center? If you are, I suspect there is a fairly good level of experience there in dealing with pregnancy issues post-radiation. Since your radiation is going to be in the head/neck region, I'm not sure I know why there could be a genetic risk, but then I'm not a doctor. My biggest concern would be along the lines of what Minnie said -- getting proper nutrition during radiation (AND its aftermath) is an extreme challenge by itself, without adding on the nutritional needs connected with a pregnancy.

Cathy

Sam, welcome to the site. Sorry you needed to find us, but we're glad to help as much as we can. My take on this, while I'm not a woman and haven't been pregnant, is the same as noted above. I can't imagine going through rad and being pregnant. Aside from the diet and strength issues, rad and chemo are poisons you are putting into your body. This cannot be good for a developing fetus. In fact, it would almost have to be bad. So I would hold off, if I were you or if it was my wife. Introducing foreign meds into a fetus, including all of the pain meds, having a peg (feeding tube) installed while you abdomin is being stretched, these are all considerations that would vote to put off pregnancy until after treatment.

Thanks again for your responses! I think that I might not have made my self clear completely clear. I would never want to be pregant DURING treatment. I was just wondering about my rad onc, comment that I should wait a year after radiation treatment because of possible genetic defects from the radiation. (I will not be doing any Chemo)However, all of your reponses about how long it takes to get back to good health after radiation have been very helpful. I was not prepared that it may take me more than a couple of months to be feeling better. I want to go into it will a possitive attitude, but being realistic about my expectations ia also really good.

Sam,
The thing is, feeling better does not mean feeling perfectly healthy! Soon to be five months post-radiation, I sure feel a lot better than I felt a month or two after, but I am definitely still convalescent.

Another thing, the treatment can temporarily stop menstruation. I thought I was going through menopause (no such luck).

I don't want to scare you, but as you said, it's better to be prepared. You'll want to be have your body concentrate only on you, not on a baby, until you are well.

Good luck!
Leena

Hello Sam,

Welcome to the forum. Being a man, I am not going to reply to your question as it looks like the replies you received are sound. Your life is about to take a big change. Your focus will be on recovery for yourself. This is one time you have to be selfish. Me First!!!! I hope your radiation goes well and you recover completely.

Danny Boy

Sam,

I am curious if you are being treated at a comprehensive cancer center. I was a bit surprised at having radiation without chemo. I have not heard of too many people doing one without the other lately. Have you had another opinion?

Ed

Hi Ed,
I was diagnosed just a few months before you and I didn't have chemo, just radiation. BUT, I also had extensive surgery and the radiation was for "clean up" my doctors called it. My margins were wide and clear and the lymphnode closest to my jaw had microscopic cancer, that is how it was put to me. Maybe that's why no chemo?? I've wondered also why some did and some did not.
Minnie

Hi Ed,
I was diagnosed just a few months before you and I didn't have chemo, just radiation. BUT, I also had extensive surgery and the radiation was for "clean up" my doctors called it. My margins were wide and clear and the lymphnode closest to my jaw had microscopic cancer, that is how it was put to me. Maybe that's why no chemo?? I've wondered also why some did and some did not.
Minnie

Ed, I am not surprised that Sam does not have chemo as treatment since her cancer is of an early stage and as far as I know, chemo is not a standard option for our types of cancer especially when caught at an early stage. My friend who was diagnosed with stage 2 head/neck cancer at more or less the same time as me just received radiation to treat his cancer, no chemo, no surgery. He has recovered very well and has been cancer free for 3 years already. Without chemo, his side effects are relatively easier to cope with than mine. Both of us were treated in the comprehensive cancer centre of the same hospital.

Karen.

Karen's right Ed, in an early stage cancer, multi-modality treatment is often not indicated. Check the NCCN oncology practice guidelines.

I think the reason it's not that common here is because many of us here don't discover the cancer until it is advanced.

Sam,
you need to ask more questions:

Is this "angiolymphatic invasion" caused from the original tumor and did this change the staging?

How did they "see" this?

Is this a separate cancer, metastesis (regional) or poor margins from the original tumor site (local)?

Ask them about the status of "differentiation" (moderate, well, poor)?