Hey guys, I was curious as to which treatment is more beneficial, IMRT radiation or regular radiation? It sounds like the IMRT is less likely to cause damage to the surrounding areas. Thanks again for everybody's help on this matter. This foundation is a wonderful thing for patients and family members. It is so informational.

I have 9 IMRT treatmrnts left and I am still swollowing solid food. IMRT IS the state of the art treatment and I would insist on it.

Gary, thank you for the wonderful encouragement. My dad goes to the oncologist today to get his chest cat scan results. Unfortunately he is in
Michigan and I am in Illinois. I have informed him of the treatment and he said he will talk to the doctor about it today. I hope they encourage him to go that way. Thanks again for the feedback

Bill, you may find some differing opinions on this board regarding the IMRT/Conventional radiation, with some saying the IMRT isn't as effective because it takes a more surgical/pinpoint approach rather than just painting a whole area with radiation.

I've had the IMRT option, and the side affects are much reduced from what I can tell. Was in the hostpital getting fed introveneously the last week of treatment, the burns to the tongue just got to painful even for ensure. But that healed rather quickly and was back on solid food in 2 weeks, to relatively normal diet in 4 weeks. You could actually see the stripes as burn marks on my tongue where the radiation had been pinpointed. But, I finished my treatments on Thanksgiving day, was eating stuff like soups, pasta, well cooked veggies by the Christmas parties mid December.

As far as using a "broad brush" approach on my neck, I had the usual scorched skin from above my jawline to my collarbone, with the most radiation centered around the tumor area. It's all in the talent of the techinicians, radiation oncologist in my opinion.

Something else to ask about is possibly HFRT, called Hyper-Fractionalized Radiation Therapy. They split the one a day dose to 2 a day, one in the morning one in the afternoon, separtated by a time of like 7 hours. Supposed to reduce the side affects even more, but the daily dose winds up being higher and supposedly more effective some how.

By the way, Gary, sounds like you're doing well, hang in there.

I think I was the first person on here to have IMRT, and while I was burned clear around my neck and on my jaw, after a dry spell,I have regained 85% of my saliva, do not have to travel with a water bottle, and can eat pretzels and sandwiches, and lick envelopes, and I can spit! The burns, exacerbated by the chemo, were very bad and even though I have a very high tolerance for pain, I needed some good drugs for a few weeks. I would do it all again, though, because the outcome has been fantastic. JetAgeHobo is exactly correct about the skill of the radiologists. In my case, there is a book 4 inches thick with the treatment plan used. I met with the physicist and the radiation oncologist to plan the treatment, and was very impressed with the time and skill that went into it. As time passes and statistics are compiled, I am quite sure that IMRT will become the treatment of choice for head and neck patients. So Bill, if that is available and the docs are experienced with it, I would recommend that for your dad. My best wishes for good results go out to both of you.
Joanna

The Doc said I have a T-1 close to T-2 tumor on my tongue that can be treated by surgery or radiation. He is suggesting to treat it as if it were T-2 with surgery followed by radiation. I go in tonight for an MRI to see if there is anything in the neck.

Are there any links to sites that have comprehensive info on the various radiation treatments? The doctor mentioned a chemo/radiation combo that shelds the salivary glands but 25% to 35% of those treated get pretty sick, maybe requiring a tube for feeding.

Steve,

I had a T-2 on my tongue and on on the floor of my mouth. I also had a radical neck dissection and the floor of my mouth rebuilt from tissue and skin from my neck. I did not have Chemo or RAD as they got clean margins from the removal of both tumors and my lymph nodes were clear. Please get another opinion before you agree to the RAD or Chemo. I had my surgery two and 1/2 years ago and I'm still cancer free today. In the event I have a reoccurance in the future I can still get RAD if necessary. My understanding is that you can only have it done one time. Brian, please correct me if I'm wrong.

Anne.

With 6 IMRT treatments to go I am feeling the burn now. I started back on the duragesic patch tonight with Vicodin as a breakthrough med. I also have 15mg. morphine sulphate as a backup if that doesn't work. I am also on a prescription corticosteroid for the skin on my neck as it's VERY itchy. I don't even want to imagine how bad this would have been with conventional XRT...

You guys have me interested, so I just emailed my rad. onc. to ask what type of radiation I had. It certainly does not seem like it was pinpointed since it affected my esophagus.
Has anyone besides me experienced pain in their arm sockets/rotator cuffs? It hurts when I reach out with my right arm or even when I use it to wash under my left arm. All of the doctors that I ask say that they have never heard of this pain as a side effect of radiation, but I certainly did not have it before treatment.

Danny G.

Danny,
I have no other pain except in the vicinity of the radiation. Throat pain, teeth hurt, tongue burns, etc. My muscles have atrophied a lot though because of all the bed rest I get (and weight loss), maybe that's part of what's happening with you.

Gary,
I am not sitting around so much anymore. I played 18 holes of golf today. But the pain in my right arm socket area persists whenever I reach out of up or around. It is minor pain, but still annoying.

Keep up the good work.

Danny G.

The MRI came back clean of problems in the neck or nodes. I'm looking for seconds and thirds on whether radiation is necessary, or in what order treatment should happen.

I've scheduled surgery for March 26 and will be getting the 2nd opinions next week. I'm scheduled at Mission Hospital, and looking into City of Hope.

Anyone have any experience with either of these two?

Hi Steve,
I have a stage III SCC in the right tonsil and they gave me the same odds of survival with rad/chemo vs. surgery. They said that the morbidity with surgery would have been higher because it would have been a 12 hour procedure and bleeding and infection would have been potential problems. And they would have given radiation anyway. I opted to go with rad/chemo and yes, it did make me sick for a while. I also opted to go with IMRT to minimize damage to healthy tissues and salivary glands. So far, so good, I have 3 treatments to go and no evidence of the tumor. These are all very tough choices to make and I recommend that you do your homework as to the different treatment options out there. You will have to be your own advocate.