Were there clear margins after the second surgery?

Everyone- Im so sorry for the confusion.
At this moment he is cured. The doctors said there is a chance that there is microscopic cells but they don't know. There is a chance that he is completely cured right now.

He does not have a definitive diagnosis of cancer. If he did we would definitely treat it. I even asked if he can do the clinical trials even without a definitive diagnosis and the chemo doctor said no.

He did go to a second opinion with another surgeon and he agreed that the surgeries were done well. Also, the doctor used an ultrasound machine and said things are looking good. All doctors (surgeons and chemo doctors) agreed that Taxol and Erbitux wouldn't really help because there is no studies. Brandon is now a different case because the left side of his neck didn't response to the initial IMRT and Cisplatin.

If God forbid this cancer comes back they will do clinical trials on him.

Okay so he his cancer free is what you're saying? This is good.

Ideally what they do upon discover of this type of cancer - is they perform a hemiglossectomy and dissection at the same time then hit him with the IMRT... which it appears they did though the dissection was done a tad later than the initial surgery. Now as far as I gather this was all to the right side of his neck and tongue.

SO, I am not sure what you mean the left side of his neck not responding to chemo and rads... If there was cancer present there they would have radiated it. It is on the opposite side of the surgery and cancer so it may have been left out of the radiation field. They would have treated only if there was evidence of cancer there.

The assumption is that after the surgery he is for all intents and purposes - cancer free. If he has risk factors for recurrence - the amount of nodal involvement in this case would qualify - then they follow up with rads and chemo.

now assuming there is no cancer there... this is just a precaution type treatment.

If they didn't get clear margins on the dissected tumors/nodes then it's more than merely precautionary.

So- in this instance whatever cancer is left is either eliminated during rads and chemo... (which would make him cancer free) or it's not - which would mean he didn't respond to IMRT and chemo, and still has cancer...

so assuming he is as you said cancer free then he should be monitored every three month

if he is not cancer free - then he needs further treatment ASAP and NOT only chemo as it is not curative.

hope I clarified everything.

hugs.

Cheryl:
Yes, in June of 2014 when he was diagnosed we rushed and he got a partial glossectomy surgery by an ENT doctor. It was NOT at a NCCC. After the pathology report came out he suspected that it spread to the lymph nodes so he wanted to do a neck dissection.

After speaking with you and multiple members on this forum i found out that NCCC are much better and have much better knowledge.

So we then took him to two NCCC and they both recommended that he should do a Right neck dissection, tracheostomy, radial free flap, right tongue dissection surgery. We ended up going with one of the NCCC and the surgery occurred on 8/11/14.

Afterwards, the report revealed that there was 3 positive lymph nodes out of 13 and extranodal exntesion was present. he began IMRT and Cisplatin. This was all for the RIGHT side. HIs neck dissection was for the right side and the positive nodes were on the right side.

THe doctor told us that his left neck did get partial radiation but it wasnt targeted because he didnt have cancer on his left side. In September of 2014 there was no cancer on the left side (at least none that showed up on the scan) .

In March they found cancer on the LEFT side of the neck. He did another neck dissection and they also found positive nodes.

im not understainding this comment " If he has risk factors for recurrence - the amount of nodal involvement in this case would qualify - then they follow up with rads and chemo." im sorry can you please clarify for me?

I thank you for all of your help. I was going through all our olds emails and you have helped so much.

In our old email- I saw that we were chatting 2 days after he was diagnosed and you mentioned that most of the time a hemiglossectomy also needs a neck dissection at the same time. I am so mad at myself because i told the initial doctor everything you told me and he didnt do the neck dissection at the time. I told him that i wanted to go to more opinions and He also told me "well you have to cut the cancer out no matter what. Thats what all doctors will tell you" do you think from June 24,2014 to the August 11,2014 surgery was a lot of wasted time? I ask our doctors that everyday.

Okay thank you that clarified everything. SO...

his left side wasn't targeted during the initial treatment. It was his right. Post treatment it jumped the midline and was found in the left side. Surgery was done. With the number of nodes involved on the left side he should have radiation (and possibly chemo) to the left side.
If the left side wasn't targeted in the initial treatment then its not that it didn't respond, its simply that it didn't get much or any of the rads. There is always a spray radius but that is usually far less than a targeted treatment. So this should be available to him now.

This is a recurrence. having had nodes pop up and salvage surgery on the other side to me is reason one to go through another round of rads, and then the number of nodes involved would also suggest to me that he should have it - even as a precautionary treatment.

PaulB has been through this before and has had numerous radiation treatments. He may be able advise you - but I would continue to push for follow up - multiple nodes tells me this is an aggressive cancer particularly because it jumped to the other side after surgery, radiation and chemo - go for another opinion if you have to. It may be that he has no cancer - but with his history, and age - i would push for the maximum treatment just to be on the safe side.

HUGS.