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#136988 07-20-2011 11:10 AM
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Hi,
I am the wife of someone who was recently diagnosed with oral cancer. I don't know the specifics of the cancer, all I know is that they found a tumor along the right side of my husband's tongue and 3 days later we were in for surgery. The first surgery, (July 1st) they removed the tumor/some lymph nodes, took some of the neck muscle, pulled it up and attached to his tongue in order to form a reconstruction. Five days later the flap failed and we ended up in an emergency surgery to remove the flap and cauterize his tongue so that they could control the bleeding. Disheartened, they sent us home to recoup for 5 days and then had him back in for a third surgery (July 14th) to try another reconstruction, this time taking tissue from his forearm to create a flap. All seems well and we were sent home today. Poor guy has had a tracheotomy and feeding tube (the kind through the nose) in the whole time. Trach came out just a day ago. We have an appointment on Monday July 25th for some swallowing tests to see if the feeding tube can come out. We also have future chemo and radiation treatments, since some of the lymph nodes they took out tested positive for cancer. So here are my questions for those of you who have some experience with all of this.
1.Are these two surgeries commonplace and did they perform them in the right order, given the fact that the second surgery was more successful?
2.When the feeding tube is removed, what can we expect in terms of what type of foods he will be able to first consume? And has anyone had complications from being reintroduced to foods after this type of reconstruction? (Half of his tongue was reconstructed)
3.I am also curious to see if anyone is suffering from hairy tongue due to the nature of the flap and where they took the skin from. (My husband is a hairy guy.) How do you combat/take care of this?
Thanks in advance to any and all advice/suggestions/ words of wisdom.
Many happy thoughts to all.
Jingle Bell


Thanks in advance to any advice/suggestions/ words of wisdom.
Many happy thoughts to all.
Jingle Bell
Jingle Bell #136989 07-20-2011 12:21 PM
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Hi Jingle Bell:
Sorry that you had to join our group, but welcome to you and your husband. You will hear from the most knowledgable people in the oral cancer arena right here on this Forum, so you came to the right place. I don't have any experience with the type cancer hubby has, but I've read other member's comments and I'm sure you'll be getting a lot of responses soon. Just wanted to welcome you and my thoughts and prayers are with you both.
julieann


Julieann
Nov 2007 SCC on right tonsil following tonsillectomy. Was smoker, QUIT. (Stage IV T2 N2b) 7 weeks radiation one day/wk chemo (carboplatin and 5-FU). Allergic to Taxol; PEG in, lost 30 lbs. TX completed January 2008. PEG out mid- 2008. PET/CT 1/17/2011;2/3/12 NEGATIVE for cancer smile
julieann #136998 07-20-2011 04:02 PM
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Welcome, Jingle Bell,,
Sorry you have to be here, but glad you found us. I was fortunate in that I didn't have to have a trache or skin grafting. I had a good part of my tongue removed and 30 lymph nodes. I also had an entire summer (basically) of radiation combined w/three sessions of chemo. I am doing well, so far, but make sure your husband gets proper nutrition during his treatments. I had a PEG tube, and was really glad to have it out. I am still mostly eating soft foods two years out of treatment. He will just have to experiment to find out what works for him. I am still drinking at least 3 Ensures a day in addition to regular food. Yogurt was one of the first foods I could eat. I can also eat most seafood, if it's not heavily breaded. Good luck to you and your husband!


Female, nonsmoker, 70, diag. 5/09 after tongue biopsy: stage IV. Left hemi-gloss. and left selec. neck disec. 30 lymph nodes removed May 20. Over 7 weeks daily rads. with three chemo. PEG removed 12/4/09 Am eating mostly soft foods. Back to work 11/09 Retired 4/1/11. 7 clear scans! Port out 9/11. 2/13. It's back: base of tongue, very invasive
surgery involving lifestyle changes. 2/14: Now speaking w/Passey-Muir valve. Considering a swallow study. Grateful to be alive.
Jingle Bell #137004 07-20-2011 06:16 PM
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Jingle Bell,

I had pretty much the same surgery your husband had although they didn't try to rebuild my tongue from my neck muscles. I don't think I've read of anyone on this forum where that was the technique used. My reconstruction was done using tissue from my forearm and I wasn't sent home until I could swallow at least liquids. So to answer your questions:

1. Yes - again, the neck muscle part is new to me, tissue from wrist is pretty common
2. I was started on broths, jello and ice cream. Probably applesauce as well. I didn't have any trouble readjusting after surgery and was able to eat without trouble until radiation messed it up again.
3. My understanding is, the radiation generally kills of the hair on the tongue but not always. I'll let other chime in on how they dealt with that.

- Margaret


Stage IV SCC lt lateral tongue, surgery 5/19/08 (partial gloss/upper neck dissection left side/radial free flap reconstruction) IMRT w/weekly Cisplatin & Erbitux 6/30/08, PEG 1 6/12/08 - out 7/14 (in abdominal wall, not stomach), PEG 2 7/23/08 - out 11/20/08, Tx done 8/18/08
Second SCC tumor, Stage 1, rt mobile tongue, removed 10/18/2016, right neck dissection 12/9/2016
Third SCC tumor, diagnosed, 4/19/2108, rt submandibular mass, HPV-, IMRT w/ weekly Cisplatin, 5/9 - 6/25/2018, PEG 3 5/31/2018
margaret_in_ma #137006 07-20-2011 06:44 PM
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Thank you all for the warm welcome.
Margaret, I was just curious as to how radiation treatment messed up your ability to eat/swallow food. Could you please elaborate? And thank you all for your wonderful words.
Many happy thoughts to all
Jingle Bell


Thanks in advance to any advice/suggestions/ words of wisdom.
Many happy thoughts to all.
Jingle Bell
Jingle Bell #137016 07-20-2011 10:35 PM
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Hi there - I too had a very similar surgery to your husbands and finished radiation ten weeks ago today!!! Though two of those weeks were technically "radiation" time because radiation is cumulative generally the person feels okay up to week 3-4 then things get bad - with the worst of it being the to weeks following rads. -

There was another man here who had a similar surgery to your hubby - he did not have radiation or chemo but his flap was from under his chin... And yes hair is normal if the location they take it from is hairy.

The order they did the surgery in is right. I had my tongue operation, and nodes and rebuild done at the same time. Sometimes they do fail for whatever reason. Under the chin is a new technique being used it's usually the wrist or the thigh they take a graft from, with the wrist being optimal since it's the thinnest skin on the body. (that's what my surgeon told me.)

Your hubby should be able to eat soft foods until a few weeks into chemo - I have to say I preferred semi solid to mushy though. Mushy was hard to control, but things like omelets (not dry foods though) were easier to eat - so maybe small buis of meat. I used to put it in my good side chew it and swallow. It depends on your hubby though. And rads makes a mess of the insid of your mouth. It causes mouth sores, sensitivity to acidic or spicy foods, swelling of the tongue again (if it's had time to deflate after surgery) and messes with your taste buds. None of it is pleasant but it is doable. He may end up with lymphedema from his radiation, and surgery so he'll be swollen for a bit after surgery, and rads.

Good luck... My thoughts and prayers are with you both.



Cheryl : Irritation - 2004 BX: 6/2008 : Inflam. BX: 12/10, DX: 12/10 : SCC - LS tongue well dif. T2N1M0. 2/11 hemigloss + recon. : PND - 40 nodes - 39 clear. 3/11 - 5/11 IMRT 33 + cis x2, PEG 3/28/11 - 5/19/11 3 head, 2 chest scans - clear(fingers crossed) HPV-, No smoke, drink, or drugs, Vegan
Cheryld #137039 07-21-2011 06:44 AM
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Jingle Bell, I like this name but am here to welcome you to our family even tho I hate to see anyone with this disease, this is the best place for friends and answers. I am sure that any questions you have will be answered by some of our memebers. Give my best to your husband and let him know you are his #1 booster thru this time. I'm not much good at advice but haven't seen anything about drinikng water. Make sure he has plenty of it daily. I have been drinking 6 to 8- 1.5 liters a day for over 4 yrs now and it helps. I drink spring water but we all have different ideas about which we like.


Since posting this. UPMC, Pittsburgh, Oct 2011 until Jan. I averaged about 2 to 3 surgeries a week there. w Can't have jaw made as bone is deteroriating steaily that is left in jaw. Mersa is to blame. Feeding tube . Had trach for 4mos. Got it out April.
--- Passed away 5/14/14, will be greatly missed by everyone here
EzJim #137069 07-21-2011 03:51 PM
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Jingle Bell,
Radiation does more damage to the inside of the mouth than does the surgery. I actually was able to eat more after surgery than I was able to after radiation. The radiation damages not only the taste buds but the salivary glands, and that makes it hard to chew. I still am constantly rinsing out my mouth. This also effects speech. My mouth is worse in the morning.


Female, nonsmoker, 70, diag. 5/09 after tongue biopsy: stage IV. Left hemi-gloss. and left selec. neck disec. 30 lymph nodes removed May 20. Over 7 weeks daily rads. with three chemo. PEG removed 12/4/09 Am eating mostly soft foods. Back to work 11/09 Retired 4/1/11. 7 clear scans! Port out 9/11. 2/13. It's back: base of tongue, very invasive
surgery involving lifestyle changes. 2/14: Now speaking w/Passey-Muir valve. Considering a swallow study. Grateful to be alive.
zengalib #137072 07-21-2011 04:11 PM
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As far as eating goes, let me clarify something. While most of us who have done radiation have struggled with eating after the first 3 or 4 weeks of treatment, some do not. Some members have gotten thru this easily and been able to continue eating with only a small amount of difficulty. Every single person is going to respond in their own individual way. Some struggle while others wiz right thru. Ive noticed nutrition and hydration play a huge factor in how well a patient will do. If a patient gets extra fluids say 64 oz minimum and 3000 calories daily then they will have it easier than someone who just scrapes by with say 30 oz of water and 1500 calories a day.

Even when your husbands sense of taste changes and food doesnt taste like it should you must push yourself to keep eating. When swallowing is uncomfortable and he doesnt want to do it, he must anyway. The eating and swallowing difficulties are a temporary problem for most of us.


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
ChristineB #137359 07-26-2011 08:41 PM
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Posts: 188
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jb, i'm new too and sorry to be here as well but believe this a Godsent. a knowledgeable advocate is so important so be a sponge! you will become an expert quickly.

all the best.


Caco
CG to Dad. Biopsy 5/11 non-op, SCC stage IV poorly dif at base of tongue with nodes, quit smoking in '85, ChemoRad began 8/2/11 ended 9/22/11 with NED. Distant mets 11/11, clinical trials. War raging on!
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