My mother was diagnosed for Tongue Cancer in Jan 2011. She had partial glossectomy followed by 30 doses of IMRT and Weekly cisplatin. Her treatment ended May 2011.

Last week (Oct 2011) she went for a regular checkup where the oncologist found a small tumour (around 1.5 cm)on the other side of the neck. The Biopsy result turned out to be positive.

She did her PET scan today. Dr advised that surgery is the only option since she had already completed her radiation.

I am a bit scared considering the recurrence happened within a span of 5 months even after extensive therapy.

Also her radiation and chemo started 7 weeks after surgery, could this have been the cause of recurrence or failure of initial treatment?

Anxious and scared, pls advise

Forgot to mention, they took out 30 lymph nodes during the initial surgery and 1 was positive, so possibly Stage 3 Cancer at initial presentment.

Amit,

Welcome to OCF, glad you found us, sorry you had to!

At this point I would not worry about what the "cause" of the recurrence is, it happens and as many on these forums can attest to it can be beaten a second and even a third time. Let's focus on getting your mom through the recurrence as that's the only thing worth putting mental and emotional energy into at this moment.

Getting a second opinion from the best medical professionals available is THE most intelligent thing you can do for your mother at this point. Second opinions are just prudence anyway however another set of eyes here from the "BEST" cancer center in your area makes sense.

You are in India and I'm not familiar with your healthcare system however we do have posters on this forum (Eshwar!) that are and can help guide you in this arena. I've sent him a PM regarding your post and I'm sure he'll respond as he's awesome like that.

Most important thing for "you" right now is to breath and do not let fear and worry take over and just take things one step at a time.

Be well

Eric

There are many that have undergone a second round of radiation upon recurrence so it is possible but none of us here are able to tell you whether it's doable with her presentation. I would however seek additional opinions, if possible, to perhaps find a rad doc that may consider that as an option especially considering the alternative might well be death.

Hi Amit, my dad had a recurrence on other side of neck just like your mother however it was after 2 years and a big one (6 cms, it probably went undetected for few months due to scar tissue and otherise also it was asymptomatic). His treatment started with Pallative Chemotherapy (TPF regimen), followed by Radical Neck Dissection and 60 gy/30 unilateral (one side of neck) external beam radiotherapy. Its been few weeks since completion of treatment and my father still having tough time due to re-radiation.

Re-radiation (Neck) is usually not a preferred mode of treatment as it presents several complexities and has significant impact on Quality of life. It is a difficult choice for doctor to make, especially if it is an early recurrence. My dad's doctors checked several times with us if he has already completed 2 years from his previous radiation before deciding to go for it.

Considering the reccurence, chemotherapy alone will not help (otherwise also gold standard is chemo-radiation) and that leaves us with surgery as the best option. The Onco surgeon may be able to get other suspicious tissue samples and mark the tumor bed (they did for my dad: tumor had invaded his Cartoid artery sheath and prevertebral muscles) to plan any further course of treatment including re-radiation.

Treatment failure does leave us with lots of questions but there are no definitive answers. As Eric said, focus on treatment and beat cancer for the second time.

If you need any further help or guidance, please feel free to PM me, will give you contact details.

Just wanted to add that you need to start giving her nutritional supplements. Give her Prosure, Ensure, Resource. She needs to put on weight to go through the treatment and try to keep her motivated (emotional well-being will be your biggest challenge).

Thanks Eshwar. Doctors at Tata Memorial Hospital (Mumbai) and Fortis (where IMRT took place) have ruled out re-radiation as it was completed only 5 months back.

We are just waiting for the PET scan+Chest X ray+ECG results and the doctors will give a date for the surgery.

I am praying that all comes up well in the PET scan and other tests.

Thanks for all the advise.

Hi just wanted to say sorry about your having to be here. Everyone's right - the how isn't important - but a friend if mine who works fo a cancer dr. Once quoted him... "a recurrence just mean's they didnt get it all " it sounds like that may be the case. Often times when they do a neck dissection and surgery, they radiation the affected areas - they don't radiate bilaterally unless theres reason to. I now this because I had the same surgery your mom did and had I not asked very specifically what my baseline ct was like, I would have received radiation only to one side, as it was there was a very small node highlighting on the other side. so hey rewrote my plan to include both sides. Regardless a nk dissection is he best treatment a his point but I would ask if her first round of treatment included radiation on that side. Good luck.

The first round of treatment included radiation on both sides, hence re-radiation to the neck has been ruled out.

Hi Amit, your mom will be alright and I am quite certain that PET and other tests will come out fine.