Hello to everybody,

My mother-in-law (age 72) was first diagnosed with oral cancer - tongue cancer in January 2010. She never smoked in her life. In March 2010, she had surgery to remove 1/2 of her tongue. The cancer was found on the right side of her tongue. She did not undergo radiation or chemotherapy. The doctor believed that he removed all the cancer in her tongue and when they did a biopsy of the lymph nodes and did not find any cancer cells.

Last May 2012, she noticed a lesion on her right gum but she did not pay attention to it. She has so overwhelmed about her cataracts that needed surgery. In July 2012 all the issues concerning her eyes were taken cared of. August 2012, she noticed a lump on the lesion on her gums which was a size of a marble. She went to her dentist to have it checked. The dentist advised her to see her oncologist. September 2012, the biopsy of her lesion revealed squamous cell carcinoma. Immediately her doctor request an mri of her face. The MRI showed cancer of her jaws, including some dead bones. With that result, the doctor order a CT Scan of her head and half her body. The CT Scan revealed nodules and micro-calsification on her lungs. A sputum test was done. Result showed no infection, no tuberculosis. The nodules were so tiny that it was impossible to do a biopsy.

October 8 she will have her pre-op and October 10 is her actual surgery. Mother-in-law never recovered physically after her tongue surgery. She is 5'4 and weighs 98 lbs. She has hypertension and an enlarged heart. However, due to the request of her children she is willing to under go surgery. The surgery will entail the removal of her right upper jaw, followed by reconstruction. They will remove part of her leg bone and implant that on her jaws. She will be given a month to recover and heal followed by a series of 33 radiations. Rest then chemotherapy to target the lung cancer cells.

The sad part about all of this is that she lives overseas. She has no medical insurance. The children are doing everything to shoulder all the expenses. God is good they will be able to do this.

We are hoping that she will survive the surgery and proceed with her medical treatment. Thank you for reading my post.

Welcome to OCF, Ina. So sorry to hear about your mother in law! She sure has alot coming up. I hope she is being treated at a large cancer center that is familiar with oral cancer patients. Is a second opinion possible? The surgery is a big one. Recovery can be hard, but it can be done. With her being so small she needs to begin to get more calories in right away. Daily she should be getting 3000 calories and 48 oz of water. This is very important to build her up before the surgery. Is there Ensure or Boost available where she is? That would certainly be very helpful to her. Best wishes to your mother in law!!!

Ian,

That's a lot on everyone's plate. Please use this site as often as you want. That's what we are here for. There are many on this site that have had that exact surgey. Christine is correct that she needs to eat as much as possible now.

Thank you so much for the information. The sad part is that nobody knows the extent of her cancer. The children are scared to know the truth - denial. And if I ask too much questions I am the bad guy. I am different, when my mother had a stroke I read a lot about it and wanted to know what I was facing. My inlaws are different, they are going in blindly.

Based on what I read and the bits of pieces of information I hear, I think her cancer is: T3 (the cancer not only invaded her tongue on 2010; it is recurrent since it came back in her gums and jaw bones), N0 No regional lymph node metastasis (as far as the last biopsy in 2010). M not certain but they found UNIDENTIFIED nodules "dust like" particles or calcifications all over her lungs. I think she is Stage II because on apparent nodules are infected.

My question is could the nodules on her lungs be cancer that metastized. They could not do a biopsy since they are so tiny.

As far as ensure is concerned I know they had to stop giving to her after her partial glossectomy since her blood sugar was going up.

Her current physical condition: 5'4" 98 lbs with hypertension heart problem and high sugar depending on her diet.

Include her in your thoughts her upper right jaw will be removed October 10 and reconstruction to follow.

thanks to all

[quote=davidcpa]Ian,

That's a lot on everyone's plate. Please use this site as often as you want. That's what we are here for. There are many on this site that have had that exact surgey. Christine is correct that she needs to eat as much as possible now.[/quote]

thank you so much David...it has been so stressful for us both emotionally and financially. Most of all it would be good to really know what is going on...ASK QUESTIONS I told them. But nobody is willing to do it. And for an inlaw to voice out her thoughts is a big NO NO!! My comments are being misinterpreted as not wanting to help financially. So I just listen. I always tell my husband that with this kind of disease we have to be knowledgeable, ask questions. Sorry for venting, it has been very very frustrating for me.

Hi there Ina... It would be unusual for the nodules in her lungs (the flecks. That are too small to biopsy) to be cancer - particularly if there is no nodal involvement . 80 % of the population has flecks - it could be environmental crap. My RO scared the poop out of me (actually his med student assistant) read a scan that said insignificant specks in my lungs and after almost having a nervous breakdown - and having talked to two RO's I was told it was likely environmental junk we all have it. My lungs are clear and continue to be. (my family dr. Read the same report that said it was nothing.) but I was nervous aout this for a year! Until my dr. Actually read the report to me.

Radiation and chemo should help. A lot of drs make the mistake of thinking they got it all only to find they didn't - proactive drs. Do the chemo and rads following surgery - especially if there is perineural involvement,

Best of luck to your mother in law. And many blessings.

[quote=Cheryld]Hi there Ina... It would be unusual for the nodules in her lungs (the flecks. That are too small to biopsy) to be cancer - particularly if there is no nodal involvement . 80 % of the population has flecks - it could be environmental crap. My RO scared the poop out of me (actually his med student assistant) read a scan that said insignificant specks in my lungs and after almost having a nervous breakdown - and having talked to two RO's I was told it was likely environmental junk we all have it. My lungs are clear and continue to be. (my family dr. Read the same report that said it was nothing.) but I was nervous aout this for a year! Until my dr. Actually read the report to me.

Radiation and chemo should help. A lot of drs make the mistake of thinking they got it all only to find they didn't - proactive drs. Do the chemo and rads following surgery - especially if there is perineural involvement,

Best of luck to your mother in law. And many blessings. [/quote]

We just spoke to my father-in-law and he explained to us everything: My mother-in-law's cancer is as follows: squamous cell carcinoma in her muscle cheeks and Stage II - T2N0M0 in her lower mandibular jaw.

Due to her fragile health they need to admit her 2 days prior to her surgery. She has not been eating solid for quite sometime. We hope and well that she will do well during her post surgery. I will keep all of you posted.

So glad it's not in her lungs wishing her luck, and prayers for her surgery.

[quote=Cheryld]So glad it's not in her lungs wishing her luck, and prayers for her surgery. [/quote]

We are getting anxious since she has a day and 1/2 prior to surgery. Not sure of the extent of the mandibular resection. They said tumor is 2cm could be larger once exposed. Part of her bone is already gone as cancer ate it. She will have a titanium implant and may have a flap coming from her underarm.

It's a tough surgery but he'll get through it if she has good drs. Best of luck!

Hello Cheryl,

Thanks for helping me out. Surgery will be Wednesday and we getting anxious. I guess the lack of medical insurance is a big factor. My husband and his siblings had to send money to pay for all the expenses of the surgery.

Mom will stay in the hospital the least time possible. Her surgery is Wednesday and my father-in-law told me that he wants her to go home that Friday. How could it be, she won't be ready!! No choice after all I guess.

I will give you all updates about her surgery. Please include her in your thoughts and prayers. 2 more days and it is the big day.

Prayers headed your way for a successful surgery and recovery for your mom-in-law.
julieann

[quote=julieann]Prayers headed your way for a successful surgery and recovery for your mom-in-law.
julieann [/quote]

Thank you for your thoughts and prayers, we are a bit anxious about everything but we are hoping and praying that she will do well. God bless to you.

The doctors should have done a scan like an MRI, PET, or CT to determine how advanced the cancer is. The scan could also help with how big the tumor is. There is a type of ensure or boost made for people that are diabetic. She must get nutrition or will have a heck of a time recovering from this major surgery.

So sorry to hear you have some disputes with other family members over this. At times when emotions run high disagreements can happen easily. You are 100% correct in thinking knowledge is power. Going into a major surgery without knowing anything about what was being done is like putting your life in someone elses hands to do whatever they want and its ok. Thats just beyond my understanding why everyone isnt doing research to find out about this disease.

To me I would have to guess and say since the tumor has gone from tissue into her jaw bone, she would be classified as a Stage IV patient. Dont get hung up on Stages. Some Stage 1 struggle while some Stage IV cruise right thru easily. Ive been both and to me the mandibulectomy was one heck of a hard time. I had alot of complications and ended up staying int he hospital for 2 months. Many get thru it and are home in about 10 days. Its not easy but it can be done. I hope her mental state is in fight mode as I really think a positive outlook and being motivated to get well will help her with this. Ive always thought this helps anyway, not sure if its ever been scientifically proven or not.

Best wishes to everyone involved, especially the patient!

Thank you Christine. I am aware that Joyce had a CT Scan and MRI but not a PET scan. The PET Scan is way above the budget. Without insurance some sacrifices have to be done. And is one of the test that they decided to forgo for now.

Another big issue troubling my mind is the number of days she will be in the hospital. My father-in-law wants her to go home 2 days after surgery. During her glossectomy she was confined for 5 days. I don't even know which surgery is more radical and intense.

I will keep all of you posted after her surgery. I appreciate all your kind words and advise.

It will not be possible for your mother in law to be removed from the hospital only 2 days after this type of surgery. He needs to understand the severity and complexity of an operation like this. She needs medical care and may be in ICU. I was kept there for 3 weeks then moved to the burn unit for about another week to 10 days so I would still receive more attentive nursing care. There is no way possible she will be ready to come out of the hospital even in 5 days. If I had to make and educated guess based on what I went thru and what Ive seen others here go thru I would guess she will be in the hospital for at least 3 weeks.

I would suggest if cost is an issue to track down the hospitals financial department and talk this over with them. Maybe this has already been done but if not do it right away. Many hospitals have charity programs that will pick up the cost of treatment for low to moderate income patients. Many also hide these programs and if you dont ask you dont get. I ended up needing some help and got a discount on my health care but if I hadnt asked I would never have been given a break. This goes for major hospitals too not just small regional facilities.

I know you care deeply about your mother in law or you wouldnt be here trying to get help and find info to better understand her health. Its not the best situation at all she is in. A mandibulectomy can be rough. I know I wouldnt want to ever go thru it again. My recovery took a year but I had problems most patients dont go thru. Other patients have had it easier but still are in the hospital for 2 weeks. Keep up the good work with asking questions, we will be here to help guide you thru this.

[quote=ChristineB]It will not be possible for your mother in law to be removed from the hospital only 2 days after this type of surgery. He needs to understand the severity and complexity of an operation like this. She needs medical care and may be in ICU. I was kept there for 3 weeks then moved to the burn unit for about another week to 10 days so I would still receive more attentive nursing care. There is no way possible she will be ready to come out of the hospital even in 5 days. If I had to make and educated guess based on what I went thru and what Ive seen others here go thru I would guess she will be in the hospital for at least 3 weeks.

I would suggest if cost is an issue to track down the hospitals financial department and talk this over with them. Maybe this has already been done but if not do it right away. Many hospitals have charity programs that will pick up the cost of treatment for low to moderate income patients. Many also hide these programs and if you dont ask you dont get. I ended up needing some help and got a discount on my health care but if I hadnt asked I would never have been given a break. This goes for major hospitals too not just small regional facilities.

I know you care deeply about your mother in law or you wouldnt be here trying to get help and find info to better understand her health. Its not the best situation at all she is in. A mandibulectomy can be rough. I know I wouldnt want to ever go thru it again. My recovery took a year but I had problems most patients dont go thru. Other patients have had it easier but still are in the hospital for 2 weeks. Keep up the good work with asking questions, we will be here to help guide you thru this. [/quote]

It is a big shock to me to know that Joyce has Stage 4 cancer. Once again this is something that I cannot even attempt to tell my in-laws. I am the bad guy for trying to find out what is truly happening to Joyce. Truthfully I think they are in denial, like she is having a tooth pulled, that is how lightly they talk about it. Sort of in and out surgery.

I tried to read about Stage 4 Mandibular cancer and I would like to know what makes it stage 4 oral cancer.

I deleted the information from another source - - sorry again..hope you don't hate me at this point

Thank you again Christine...you are such a big help to us.

I do not know if she is Stage IV for certain. It is something I suspect due to the locations and it entering the jaw bone. This does NOT mean she cant get thru this! I was a Stage Iv patient myself going into the mandibulectomy. I know several others who went thru it as Stage IV too and they are fine. We have some after effects but we all have learned to manage them. Your mother in law has oral cancer of the mandible from what you have said.

PLEASE do NOT bring medical info from other websites without stating where they came from as it could be from an unreliable source.

When looking for info online be extra cautious, look for well trusted sites where they are part of Health on the Net. This is very few. OCF complies with the Health on the Net code and is watched to ensure correct medical info is given. There are more sites online that give faulty info than dont so please use caution.

Oral cancer is much more dangerous than a simple tooth extraction. This is something your family will need to learn on their own. Many people are in denial and dont want to know their loved one has a deadly disease. Many people can and do die from oral cancer, while others do not. It is no walk in the park at all what she is facing. Its a very difficult surgery for a patient to recover from as it involves so many areas and her doctors will be sewing together tiny blood vessels to ensure the skin that was transplanted gets blood flow.

My suggestion is to print out several pages from the main OCF pages about oral cancer and leave them where they can 'accidently' be found when you arent there. Leave them laying out like you had been reading it and just put it down. Take a good look at them and see if they had been touched when you go back later. Thats how many caregivers pass info to their patients without nagging or arguing with them.

Thanks and sorry Christine ( deleted the info that I copied and pasted) I will email the link of OCF to the inlaws and they can decide what to do. I am so certain that they are in denial and don't want to know what the diagnosis and prognosis of Joyce is. When I attempted to say something, they say that what if that happened to your Dad. So after that exchange of words I won't say much to them.

Hi Ina, I can't offer any helpful advice I'm afraid, but i just want to say that my thoughts and prays are with you and Joyce and your other family members at this very difficult time. My fingers are crossed for the best outcome possible. Sally

[quote=saxicola]Hi Ina, I can't offer any helpful advice I'm afraid, but i just want to say that my thoughts and prays are with you and Joyce and your other family members at this very difficult time. My fingers are crossed for the best outcome possible. Sally [/quote]

Thank you so much Sally, we are counting down to the big day. Less than 12 hours and counting. God bless!