When I had my initial radiation treatment last year (IMRT x 35) I asked the doc if he would radiate me again if the cancer came back. He said no.

It was my understanding that this was becuase the IMRT would do too much damage to the tissues. However, my wife understood it differently - that the reason they don't is because it would subject you to too much radiation.

So now, I'm facing the possibility of mets to a lower jugular lymph node at the base of my neck. I see some discussion on the boards that seems to indicate that under some circumstances people do get radiated again? Is this only in a case of 'distant' mets? And what is considered distant - would my lymph node 6" away from the original treatment area be considered distant?

Also, I should have a chance to ask the doc this next week, but I'm hoping to understand in the mean time: I had SCC of the tongue (with no mets), and the primary tumor is now gone, one year post-treatment. But now it looks like I have what they're calling mets to a neck lymph node. So in my case would it still be considered SCC? Or is it considered a different type of cancer or go by a different name when it moves down into a lymph node somewhere?

Sorry, so many questions....
thanks
Steve

I think that they can radiate you more than once as long as it's not in the same location. There is probably a margin to consider as well. Espceially since you had IMRT.

A few years ago they did some clinical trials for irradiation in the same area and didn't find any significant additional damage, although there is always some damage from radiation.

My understanding is that each organ and vessels and tissues have their own say max level of rad that they can receive and one of the values of IMRT is that the RO's can target different organs; different tissues, etc with different levels of rad so My RO says it is possible to get rad again depending on where it's needed and how much rad was administered that area before.

Steve,

I'm sorry you are dealing with this so close to when you finished your last treatments. I pray that there is a better explanation for the white mass on your PET scan than what is currently on your mind.

I did a lot of reading (probably too much) prior to meeting with our RO the first time. One concern I had was the one you had...since H&N cancer can recur as H&N cancer I wondered how it is treated the 2nd time around because I thought I had read that Radiation can't be done twice.

Since this was the cart before the horse, we didn't go into any great detail. However, our RO did say that my assumption that radiation can't be done twice wasn't always correct, and there are many factors (like David mentioned above)that go into that decision. So, I think in some situations it is an option.

Let us know how your appointment goes. We will be thinking about you!

Steve,

We were told by our former ENT who was NOT affiliated with a cancer center that radiation could not be repeated.

When my husband had the recurrence, we opted to pursue treatment at a cancer center. They indeed radiated again, but we were told that this will be the last time he can be radiated on that side of his neck.

There have been some problems with cellulitis and infections of the soft tissues since he was treated, but so far, that has been a small price to pay for what really looked like an initial treatment protocol. The radiation was administered differently the second time...rather than daily, it was done 2 times a day six hours apart...and the field was more targeted and less deep.

I suspect each case is different, but from our interaction with "regular," non-cancer center affiliated ENTs, the ENTS and other docs at the centers are better informed of various treatment options, including reirradiation.

Good luck. Let us know how things turn out for you.

Loretta