My mother in law was diagnosed with SCC on the side of her tongue. She is 88 years old and has severe RA. Her ENT initially was going to send her to Vanderbilt in Nashville but then decided he could do the surgery. The tumor is a T3. She had 5 biopsies over the past ten years, all cancer-free until this most recent. There is no suspected lymph node involvement. She is scheduled for surgery on August 9th but is now having second thoughts. She really doesn't believe she will make it out of surgery. The family wonders if she should have gone to Vanderbilt. Given her age and condition we thought the trip would be difficult for her (about 3 hours). What will the post-op be like? Should we go to Vanderbilt? HELP!

Hi Debby, and welcome. I'm so sorry about your mother-in-law's diagnosis. I understand that distance is a factor, especially at 88 and with RA. You would most likely need at least two trips, one for a consult and a second for surgery. The surgeon would want to see her again for post-op but that is something that can be handled locally.

Despite all that, I urge you to seek out the absolutely best care within your reach. The quality of this first round of treatment will dictate your MIL's quality of life from hereon. You need a team that treats this cancer all day long and can give her clean margins but also maintain as much of her swallowing and speech function as possible. If Vanderbilt's your top option locally and and you can make that work for her, it's worth the trip.

Just my 2 cents.....

p.s. You can ask that the pre-op exam and prep be undertaken the day of consult.

Yes I agree - she should be seen at the best possible place available - as a t3 she may have nodes involved on a microscopic level. (Does not show up on a scan) Most ENTs familiar with this cancer will do a selective neck dissection as well to make sure they get it all - which is better than having a surger now and then having to go back in for a neck dissection. Finally this used to be primarily an elderly man's disease - so most CCCs have experience working with with people her age. Take care.

At the very least you should obtain a second opinion. I believe Vanderbilt is one of the countrys top hospitals which would be an excellent choice. Remember once she has the surgery the doctor cant undo it. Plus when one doctor operates another doctor may be hesitant to get on board as it is kinda like stepping on the original doctors toes.

Wishing your MIL all the very best with whatever she decides to do.