My FIL was treated for T4N1M0 squamous cell carcinoma head and neck cancer. He had a surgery followed by radiation and chemotherapy. It has been less than 3 months since his completion of radiation therapy that he is being told that there is recurrance of cancer on the right side. I am currently in india to help him and for support. The doctors here are giveing conflicting reports from recommending surgery to saying there is no point in treatment. I am lookiing for the following help and information and suggestions are highly appreciated. Please let me know if you need addtional information to help
1) can the oral cancer recur so fast after radiotherapy
2) what are the options to cure the recurrance. He is very weak and lost conciderable weight. Can he get additional radiation or chemotherapy. Is surgery an option again.
3) What are the side affects of radiation. Is there a chance that the biopsy report can be inaccurate immediately after radition(as one of the doctors suggested after radiation). He has a large growth on right side of his face and under his chin. The growth seems to increase during morning and reduce during the night. Can this be infection or side affects of raditation.

Hello there
if you read my signature line you will get the answer to your first question.Robin finished his radiotherapy on April 13th,and his recurrence happened in June.As he has had all the treatment options then his choices will likely be limited to chemo or more surgery.

If his recurrance was diagnosed by MRI or biopsy,or just plain visual examination,then it is unlikely to be a false positive ,which tend to relate more to PET scans.If it was infection then he would have all the symptoms of generalised in fection ie:Fever,chills,localised heat and redness,and with an offensive odour.If the size of the swelling alters over 24 hours it will be fluid accumulating round the swelliing when he is upright,and diffusing when he lays down.Fluid will be soft and mobile,tumour in the parotid gland will be hard and fixed.You don't say how old he is as this too can have an effect on recovery,although our elder statesman here on OCF has had more surgeries than Frankenstein had and he is still bouncing around .
Its a lottery my dear with big winners and losers,there seems no logic or rhyme and reason to who wins and more so who loses,and one things for certain,there are no guarentees.

liz

Without knowing everything his doctors do I can only say if I were him I would stay far away form the one's that say there's nothing more that can be done until everyone has that opinion. As Liz has said nothing is uncommon for this aggressive cancer but it may also be inflammation or infection especially if it's bigger in the am than at night.

Thank you very much for the responses. Really appreciate you taking time to respond and enlighten me. We are planning to see 2 more oncologists tomorrow for their opinion. The original doctor who operated on the turmor seems very money minded and all he seems to want is to operate again.
Here some addtional information i could find based on looking at his discharge reports and latest biopsy report. The surgery was done on right side and the recurrance is on the left now.

08/11/08
Final diagnosis
Squamous cell carcinoma grade 11 - right lower alveolus
Surgery: Wide excision of right side slveolus lesion + right mrnd type 11 + modifeied hemo mandibulectomy + free fibular flat repair
Chemotherapy : 7 weeks of Cisplatin
Radiation : IMRT, dose : 5880cgy for 28 times 5 days a week, 1000 cgy 5 times a week for 5 days. In total he got radiation for 33 times ending on 11/05/08

Latest biposy report suggesting recurrance 02/13/2009 on left side.
Left submental area - Smears ad cell block sections show features of a squamous carcinoma - consistent with recurrance in a known case of carcinoma right alveolus

He is 58 years old and has diabetes.

I will share more information once we sees the other oncologists tomorrow. Thanks for the reponses i have got again. I trust the information i see getting posted on this forum than the half baked money minded reponses we have been getting from the doctors we have seen so far.

Keep in mind that it may not be just money -- One tends to do what one does best, so a surgeon prefers to cut.

One medical oncologist suggested to take a anti inflamotory medication for a week and MRI after that. He would decide the treatment based on MRI results. He only wanted to talk to us on the condition and treatment options after he looks at MRI after a week.

The second surgical oncologist we saw said he cannot give much hope at this point (did not share much information as to why). He referred us to a medical oncologist who specializes in chemotherapy who seemed to share the surgical oncologist's opinion. The chemotherapist suggested any treatment at this point is only palliative and any recurrant head and neck cancer cannot be completely treated. He suggested palliative chemotherpy and if we wanted and able to afford he could consider cetuximab or biomab.

1) would cetuximab (ertibux) or biomab (indian version of ertibux) help with recurrant head and neck cancers.
2) This is the 3rd doctor who suggested without any PET, CT or MRI (only basing on biopsy and physical examination) that any treatment is only pallative. Is this truly thee case that there is no hope for treatment.
3) finally i think we need a real oncologist someone who truly cares and knows what he is doing. Any references to such doctors in India especially in banglore is highly appreciated.

One medical oncologist suggested to take a anti inflamotory medication for a week and MRI after that. He would decide the treatment based on MRI results. He only wanted to talk to us on the condition and treatment options after he looks at MRI after a week.

The second surgical oncologist we saw said he cannot give much hope at this point (did not share much information as to why). He referred us to a medical oncologist who specializes in chemotherapy who seemed to share the surgical oncologist's opinion. The chemotherapist suggested any treatment at this point is only palliative and any recurrant head and neck cancer cannot be completely treated. He suggested palliative chemotherpy and if we wanted and able to afford he could consider cetuximab or biomab.

1) would cetuximab (ertibux) or biomab (indian version of ertibux) help with recurrant head and neck cancers.
2) This is the 3rd doctor who suggested without any PET, CT or MRI (only basing on biopsy and physical examination) that any treatment is only pallative. Is this truly thee case that there is no hope for treatment.
3) finally i think we need a real oncologist someone who truly cares and knows what he is doing. Any references to such doctors in India especially in banglore is highly appreciated.

[quote]finally i think we need a real oncologist someone who truly cares and knows what he is doing. Any references to such doctors in India especially in banglore is highly appreciated.[/quote]
There have been several people here who either have been treated in India or have had family members who were -- I've seen references to treatment in New Delhi (at a specialty cancer hospital there), Chennai and Hyderabad. If you go to the search box in the upper right of each page and type in India, you'll find many of them -- screen names include Dileep, chilled_fire, Seema, Kum71, Marma, Ramamurthy and Kavita. I'm sure there are more.

Once you're on a posting, click on the name and choose "View profile" -- you can get the poster's e-mail address and write him or her directly.

(An aside: We lived in Bangalore in the mid-1990s. I would love to go back and see how it has changed!)

I am so sorry to hear what you are going thru. I am responding because our family is going thru much of the same. My step-dad was 1st diagnosed in Dec. 2003 with SSC to Right Lower Lip. At that time he had V Wedge Resection and Closure. On Jan. 6,2004 it was discovered per lab a wider margin was needed. On Jan 9 wedge resection with excision with slight advancement and suprahyoid neck dissection. Path revealed clean margins and no mets.Nov.21,2006 back to the Dr. with s/s of reoccurence? Dr. states Cervical Inflammatory Infection to neck along margin of mandible with fullness and thickness noted. ABT initiated. May9,2007 bx done. Results:Recureent invasive SSC lower lip into facial soft tissues. Radical neck disection with peck muscle flap to L side,PEG,Radiation daily x 40. Scans clear. Nov.2008: Reoccurence. Large tumor under chin involving mandible. Chemo started Dec.2009. Taxapere & 5FU every other week. Pump started on Mon, takes home over night,ect... Erbitux every other week. The Erbitux is now making him very sick. The tumor is shrinking. However, now he has episodes of bleeding from the nose and mouth. The Chemo was "pallitave". All Dr.'s stated it was that or taking out his jaw,trach,another feeding tube,ect...He is having difficulty with increased Potassium. The Erbitux did shrink the tumor! He goes to the Oncology Surgeon Mon. If it is major reconstuction sx he states he will not do it. So, Mon. will be decision day.
Your in my thoughts and prayers.

Hi,
I am hoping to get some information from you as you this is the first time I have signed in to the oral cancer site. I was diagnosed with squamous cell ca of the gum Feb 11, 2008 and have undergone radical surgery in Chapel Hill NC to remove the tumor as well as having the fibula free flap as well. My doctor tole me when I first saw her that this is cureable. please let me know how your first surgery went. I thought I was alone out here in the world of oral cancer.