| | Joined: Apr 2013 Posts: 319 Platinum Member (300+ posts) |  Platinum Member (300+ posts)
Joined: Apr 2013 Posts: 319 | I personally don't think that a two-week break will hurt his chances a bit.
I remind you that this is only my PERSONAL opinion. Not a medical opinion.
My intro: http://oralcancersupport.org/forums/ubbt...3644#Post16364409/09 - Dx OC Stg IV 10/09 - Chemo/3 Cisplatin, 40 rad 11/09 - PET CLEAN 07/11 - Dx Stage IV C. (Liver) 06/12 - PET CLEAN 09/12 - PET Dist Met (Liver) 04/13 - PET CLEAN 06/13 - PET Dist Met (Liver + 1 lymph node) 10/13 - PET - Xeloda ineffective 11/13 - Liver packed w/ SIRI-Spheres 02/14 - PET - Siri-Spheres effective, 4cm tumor in lymph-node 03/15 - Begin 15 Rads 03/24 - Final Rad! Woot! 7/27/14 Bart passed away. RIP!
| | | | | Joined: Nov 2006 Posts: 2,671 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Nov 2006 Posts: 2,671 | Sounds like the doctors are being very positive about the outcome if they are suggesting a two week break, but it might be worth asking the doctors Why? here so they could reinforce their medical reasons for the break. Everyone is different of course even though we may see similarities between diagnoses and patient experiences. My son had 48 lymph nodes removed (all negative) at the same time as the surgery to remove the lump under his tongue, but his was a stage 2.
Anne-Marie
CG to son, Paul (age 33, non-smoker) SCC Stage 2, Surgery 9/21/06, 1/6 tongue Rt.side removed, +48 lymph nodes neck. IMRTx28 completed 12/19/06. CT scan 7/8/10 Cancer-free! ("spot" on lung from scar tissue related to Pneumonia.)
| | | | | Joined: Dec 2010 Posts: 5,260 Likes: 3 "OCF Canuck" Patient Advocate (old timer, 2000 posts) | | "OCF Canuck" Patient Advocate (old timer, 2000 posts)
Joined: Dec 2010 Posts: 5,260 Likes: 3 | Ultimately rather than having surgery twice they should have removed the nodes at the same time. But that's a moot point. The neck dissection isn't too bad of a surgery but he will need physio after - depending on how the dr cuts he'll Likey have a wonky shoulder and arm for a bit. Physio will help. As for pain and what not depending on how much of his tongue they removed going home is a possibility. I was in for 10 days but I also had reconstructive surgery. Radioactive seeds.... I suppose they could use that but the standard is actual beam radiation for anywhere between 6-7 weeks with possible chemo. I would definitely get a second opinion.  hugs
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
| | | | | Joined: Jul 2012 Posts: 3,267 Likes: 1 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Jul 2012 Posts: 3,267 Likes: 1 | For head and neck cancer, they usually like to keep the "total treatment package" less than 100 days for better tumor control, survival. After the neck dissection, radiation is usually done within 4-6 weeks, depending on healing. Sounds like brachytherapy, which is an option for radiation or permament seeds, which I'm not as familiar with. There is low dose rate, LDR, and Hgh Dose Rate, HDR, Brachytherapy can be given solely or as a boost to EBRT, Extetnal Beam Radiation also, within 1-2 weeks. I had a newer form of Brachtherapy called High Dose Rate Intraoperative Radiation Therapy, HD-IORT, during resection of tumor, followed by IMRT after healing, and a 2nd one this year with Proton Therapy.
Good luck.
10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs
| | | | | Joined: Jun 2014 Posts: 86 Supporting Member (50+ posts) | | OP Supporting Member (50+ posts)
Joined: Jun 2014 Posts: 86 | I am so confused. My brother did the surgery with an Otolaryngology doctor on June 24, 2014. Our doctor works out of Beaumont Royal Oak and thats where my brother had his surgery. They do have a cancer center but I dont think its a comprehensive cancer center. (I tried to open ChristineBs list of comprehensive cancer centers and it wasnt working) I opened the hospital one just fine and U of M-Ann Arbor MI was number 24.
Anywho...our doctor who performed the surgery recommended that my brother does a neck dissection to remove lymph nodes and then to do 1 week of brachytherapy (which is radiation implants).
Today- we went to a 2nd opinion at Karmanos Cancer Center. The doctor there says that both Karmanos and U of M-Ann Arbor are the comprehensive Cancer Centers in MI.
This was his opinion...
I think because of the close margins, the lympathic problem, the vascular invasion I would recommend additional therapy which would be radiation therapy alone. I would recommend IMRT opposed to an implant radiation (brachytherapy) I would not recommend an elective neck dissection. The question of verbatix in addition to radiation therapy is an open one. They might recommend it down to cancer centers because of your age group. I personally think its probably overkill.
If he were to do a neck dissection I think 1 chance out of 5 that we will find cancer cells�
Can someone please help me? I am so lost.
22 YO Brother Dx 6/17/14 w. SCC R Lateral tongue
CT scan clear LN 6/20/14
HPV-, non-smoker
R tongue, right hemiglossectomy Surgery 6/24/14
(Not reoccurrence but went to NCCC instead
R neck dissection, tracheostomy, radial free flap, R tongue dissection surg 8/11/14
PT1N2B.3 positive lymph nodes out of 13
Extranodal extension present
9-15-14 IMRT (35x) & Cisplatin (2x) begun
10-21-14 peg in. 10-31-14 1 round of carboplatin
11-4-14 IMRT rx comp
3-27-15 Recurrent tumor in lymph node, L neck diss.
10-29-15 brother passed away, 23 yrs old
| | | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | | Senior Patient Advocate Patient Advocate (old timer, 2000 posts)
Joined: Sep 2006 Posts: 8,311 | This doctor is recommending no neck dissection and no brachytherapy but IMRT most likely to include both sides of the neck and of course the tongue. I assume the cancer cells did not test positive for HPV. IMRT is pretty standard for our cancer.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | | Joined: Jun 2014 Posts: 86 Supporting Member (50+ posts) | | OP Supporting Member (50+ posts)
Joined: Jun 2014 Posts: 86 | [quote=davidcpa]This doctor is recommending no neck dissection and no brachytherapy but IMRT most likely to include both sides of the neck and of course the tongue. I assume the cancer cells did not test positive for HPV. IMRT is pretty standard for our cancer. [/quote] Yes David he is negative for HPV. Do you think IMRT is good? Did you do It?
22 YO Brother Dx 6/17/14 w. SCC R Lateral tongue
CT scan clear LN 6/20/14
HPV-, non-smoker
R tongue, right hemiglossectomy Surgery 6/24/14
(Not reoccurrence but went to NCCC instead
R neck dissection, tracheostomy, radial free flap, R tongue dissection surg 8/11/14
PT1N2B.3 positive lymph nodes out of 13
Extranodal extension present
9-15-14 IMRT (35x) & Cisplatin (2x) begun
10-21-14 peg in. 10-31-14 1 round of carboplatin
11-4-14 IMRT rx comp
3-27-15 Recurrent tumor in lymph node, L neck diss.
10-29-15 brother passed away, 23 yrs old
| | | | | Joined: Jun 2007 Posts: 10,507 Likes: 7 Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) | | Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts)
Joined: Jun 2007 Posts: 10,507 Likes: 7 | ak, check the signatures of other members. You will find most members (David included), have done the IMRT.
ChristineSCC 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 | | | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | | Senior Patient Advocate Patient Advocate (old timer, 2000 posts)
Joined: Sep 2006 Posts: 8,311 | IMRT is used much more often with our cancer than brachytherapy. Judging by your comments I'm not sure he is being seen at a CCC? I would want to make sure he was at this point.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | | Joined: Jun 2014 Posts: 86 Supporting Member (50+ posts) | | OP Supporting Member (50+ posts)
Joined: Jun 2014 Posts: 86 | [quote=ChristineB]ak, check the signatures of other members. You will find most members (David included), have done the IMRT. [/quote]
Opps- Sorry Christine! I forgot about that. Christine- How do I get the CCC list to open? It wasnt working last time?
22 YO Brother Dx 6/17/14 w. SCC R Lateral tongue
CT scan clear LN 6/20/14
HPV-, non-smoker
R tongue, right hemiglossectomy Surgery 6/24/14
(Not reoccurrence but went to NCCC instead
R neck dissection, tracheostomy, radial free flap, R tongue dissection surg 8/11/14
PT1N2B.3 positive lymph nodes out of 13
Extranodal extension present
9-15-14 IMRT (35x) & Cisplatin (2x) begun
10-21-14 peg in. 10-31-14 1 round of carboplatin
11-4-14 IMRT rx comp
3-27-15 Recurrent tumor in lymph node, L neck diss.
10-29-15 brother passed away, 23 yrs old
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