Caregiver to my father; 66 yrs, diabetic normotensive with recurrent nodal metastasis

DX: Ulcerative lesion on left lateral border of tongue 2.5 months. [2009/02/01]
Biopsy: SCC LT LATERAL BORDER OF TONGUE. Well differentiated
CT: Ill-defined Assymetric enhancement in left oral tongue with 1.2x1.0x0.9 cm lymph node in left upper deep cervical region
TX: LT Partial Glossectomy + Left SOND. Stage 2 T2N1M0. [2009/02/16]
Histopath: Moderately differentiated SCC - left lateral border tongue infiltrating as cohesive broad sheets of strands. Depth of invasion 1.2 cm. Margins - all margins of resection free. Lymph nodes - 2/29 nodes show metastatic tumour deposit
TX: Concurrent CRT of 59.4Gy/33# + 6 cycles of weekly Cisplatin inj. [2009/03/18 to 2009/05/09]
Follow-up: Initially 15 days x 2, 1 month x 3 then quarterly.
DX: Ulcerative lesion on right tongue [2009/08/05]
PET-CT: No metabolically active/recurrent disease. Sub-cm metabolically active right upper cervical lymph-node could be inflammatory in nature. [2009/08/17]

Asymptomatic: [2009/08/17 � 2011/02/08], quarterly followup

DX: RT Neck Pain and clinically NED [2011/03/23]
CT: Heterogeneously enhancing nodal mass right neck level 2 � 3. Lesion: 4.2x2.7x6.5cm. RT Carotid vessels displaced medially, RT sternocleidomastoid muscle stretched laterally, IJV displaced and compressed. [2011/04/23]
PET-MRI: Enlarged metabolically active right upper mid-deep cervical nodal mass measuring 3.7(AP)x2.9(Tr)x5.8(CC) cm with perinodal infiltration of sternocleidomastoid muscle partially encasing right IJV with loss of flow and nodal thickening reaching about 2.5cm from jugular fossa [2011/04/29]
TX: 3 Cycles of Pallative chemotherapy with DCF regimen - Cisplatin (D1-D2: 60+60mg), Taxuba (D1: 120 mg), 5-FU (D1-D3: 1200mg). [2011/05/05 � 2011/05/07; 2011/05/26 � 2011/05/28; 2011/06/17 � 2011/06/19]
MRI: Enhancing nodal mass with cell necrosis � mildly progressive disease [2011/06/07]
TX: RND + Pectoralis Major Myocutaneous Flap; RT Sternocleidomastoid, IJV sacrificed, tumor peeled from RT Carotid; SAN preserved [2011/07/11]

Awaiting Biopsy reports.

Hi, Eshwar - what a difficult time for both of you. Is your father still in hospital?

Hi Maria, it has been a difficult time but prior experience with my father's treatment is helping as we have retained the hospital and doctors.

My father has been discharged on 14th with vacuum suction drain each in both the neck and chest.

Just worried about Carotid artery, reirradiation (as it may be required) and any other distant metastasis as last PET was on 29th April.

Well, you are both fighting the good fight, and your doctors seem to be pretty assertive with what they are doing. Try to take care of yourself - physically and mentally - so that you be able to find the joy in each day. I am guessing that your father feels blessed to have you as a caregiver.

Vacuum suction drain removed and got the Biopsy reports today.

DX: SCC - 6 cm Nodal mass, Perineural Invasion (PNI), Extracapular extension (ECE), 3/10 Nodes, Soft tissue from carotid sheath and prevertebral muscles shows tumor deposits.

TX: TBD, MO+RO+ENT to plan this week and communicate on 2011/07/26

Probably another round of CRT/IMRT.

Eshwar, sounds as if your dad - and you - are really going through it. My thoughts are with you. Please keep communicating here at OCF.

Welcome - sorry you have to be here... My thoughts and prayers are with you!

Eshwar:
I am saddened to hear all you and your Dad have been through and more to follow. He sure is lucky to have a wonderful daughter like you and I will pray for you both. Tell your father he has an "adopted" family of us, Forum members. Please let us know how things are going.
julieann

Thanks Cheryl and Julieann.

Happy to have the extended family of all the forum members.

It gives us immense strength and moral support apart from all the guidance which you cannot really expect from doctors and even your closest friends and relations.

Even though Cancer care in India has advanced much but access to information is less. There is still ignorance! While sharing my feelings, I also want to contribute here as last 2 years have taught me a lot.

Seeing Christine, Ann, David and many such members, it gives me courage and increases my determination to fight cancer (of not just my dad but all whom I could help)

Thanks for your best wishes. As a son, I am trying to do as much possible to help my dad succeed his fight with cancer.

Eshwar

Eschwar,

Just wanted to chime in - hoping for the best for you dad and your family.

This is the most complete intro I have seen. Now if only I understood most of it. I bet your dad has a very good caregiver by his side. Congrats on such a good complete job. Welcome to out home for your family.

My dad's radiotherapy has started today. He's planned for 60Gy/30 days reradiation of involved field only. RO was hopeful that the side-effects may not be as bad as previous time. Dad is also happy that he do not have to undergo concurrent chemotherapy (which he thinks is the worst part of Cancer treatment).

If all goes well, he RT will end by mid of Sept.

Best wishes to both of you for the coming treatments. Will be thinking of you; keep posting.

Yes best wishes !! And many blessings!

Thanks Maria and Cheryl. You all are my strength and inspiration.

Sharing the progress.

21/30 RT and 42 Gy completed. Unilateral Radiotherapy is causing much of the problems as doctors are putting all their arsenal on the affected area.

- Mouth sores - on lips as well this time that tend to bleed.
- Sores in throat - causing difficulty to swallow water
- Bad cough
- Heavy-headedness and drowsiness
- 5 Lbs lost so far
- Mouth infection slightly better after medication.
- Blood test - Hb 10.7, rest seems ok. Sodium less so Radition Onco have asked him to increase table salt intake.

Radition Onco seemed to be satisfied with the progress so far. Just hoping for the best outcome after all the pain that my dad has gone through.

I think he's doing really well with only having lost 5 pounds with all of this. I think about you and your dad when I am lucky enough to be serving my dad his dinner - he's almost 95 as as fiesty as they come. Best wishes and remember to take care of yourself, too.

Radiation is a hard process as you know- eshwar what your dad is going through is very normal - for someone without a peg - he's done really well weight wise - do you have boost or ensure available to you? Do you think he would use it? It might help with his infection - sinc they are nutritionally balanced he would like
Y get his basic nutrients in full and that would prop up his immune system... Good luck !

Cheryl, have put him on Prosure and Resource and that is taking care of his basic nutrients.

Thanks Maria and Cheryl for best wishes.