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#195536 12-26-2017 10:33 AM
Joined: Dec 2017
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Sandie Offline OP
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Hello. My name is Sandie and my husband was diagnosed with stage 4A throat cancer in February of 2017. He went through 7 rounds of chemo and 35 rounds of radiation. He had a PET scan in August 2017 and it showed all was clear. He knew this was not the case. He kept saying, “I can still feel it in my throat.” Well he was seen by his ENT and he suggested a needle aspiration of a lymph node that was very large and a concern. It came back as positive and to make matters worse they found that it is in multiple lymph nodes. So off to a special ENT that only works on people with this problem. We saw him and he stated that he has two options. 1st is more chemo, which he stated will not kill the cancer. 2nd is a left neck radical dissection with an carotid artery replacement as they feel the cancer has attached itself to the carotid artery. Of course my husband said he opts for the surgery. Well, everything is moving so fast that we really haven’t had time to think. We have no idea what this surgery entails or what the complications may be. With it being the holiday time the doctor is out of the office right up until the surgery is scheduled for 1/2/18. Can someone, anyone, give me some idea what to expect and how to best help my husband as he goes through this? I truly appreciate any advise.


Wife and caretaker.
Husband diagnosed in Feb 2017 with stage 4A throat cancer.
7 chemo and 35 radiation treatments received.
PET scan showed cleared Aug 2017.
Nov 2017 cancer back in lymph nodes. Multiple effected.
No more chemo now onto radical dissection with carotid artery replacement. Scheduled 1/2/18.
Sandie #195538 12-26-2017 06:26 PM
Joined: Jun 2007
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Welcome to OCF, Sandie! Im so sorry to read about what your husband has been thru. It sure isnt easy for either of you especially with it being right around the holidays. You have found a great resource by finding our site. We will help you with info and support.

The surgery your husband will be getting is not something may of us have been thru but I think there have been a few here who have been thru it or at least fairly similar. One of the things you will want to do is to try spending as much time with your husband as possible while he is in the hospital. If any friends or relatives offer their assistance, maybe they could help by taking a "shift" to sit with your husband. This would enable you a little free time so you can get some rest or maybe get some things done at home or get away to clear your head. If you have pets, friends and relative could always help out by taking your dog for a walk or feeding the pets while you are with your husband in the hospital.

Since surgery is probably first thing very early on Jan 2, I suggest making a list of all your questions. The surgeon will stop by and see your husband prior to the surgery. He has to sign the area he is operating on. When the surgeon comes to sign your husband, ask him your questions. I think you can expect there to be swelling, drains, maybe even staples instead of stitches. Make sure his doctors keep his pain under control. Your husband may need to have 2 different pain meds so he can alternate between them instead of having to wait for the right time to take his pain medicine when he hurts. After having major surgeries, I usually wake up not feeling too bad. But look out after the first day, the next day I usually feel much worse. Im sure I will think of many other things once I post this.

Best wishes with everything you and your husband are facing.


PS... Thank you very much for adding your signature already!!! Having the signature helps us to better help you and your husband. Great job smile




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
Sandie #195542 12-27-2017 10:53 AM
Joined: Jul 2012
Posts: 3,267
Likes: 1
Patient Advocate (old timer, 2000 posts)
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Sandie, I'm sorry for your troubles, fast moving events, and absence of your doctor.

I had my carotid artery consisting of the common, internal and external carotid arteries removed in 2013 when they discovered the tumor was wrapped around it during another neck dissection that was to involve intropaerative radiation, so they removed what they could, and sent me off from the recovery room to a sister hospital via ambulance that was highly regarded in neurology for testing to see if I was a candidate to have my left carotid artery totally removed. The testing consisted of a cervical angiogram, and a temporary balloon occlusion, some type of radiology scanning, maybe CT, and other blood work. I passed, and the next week I had my carotid removed, so I have no blood flow from the common carotid which branches off to the internal carotid and supplies the brain, and external that supplies the face, so all blood flow comes from the right side, which I have tested regularly for blockage with an ultrasound Doppler.

I did not have a vein graft reconstruction, and was having intraoperative radiation, IORT, during that surgery, which took about 5 hours, and a few weeks later did 25 Proton radiation, my 5th radiation type, and Carboplatin. I stood a chance of 17% of having a carotid artery blowout during proton radiation from all the radiation I had even though they were tied off stubs. All that treatment ended January 2014, and have been free of cancer since.

There are risks for adverse events with this operation. and even the testing, but I believe with testing there are fewer, but it's not always feasible to be done There is a time period after surgery when there is more risk for adverse events like fist day, 48hrs,,,..which I really forget, besides having lifetime risks.

Radiologic testing isn't always accurate for showing carotid involvement, and many wind up not needing the carotid artery removed.

Here is a medscape article about carotid artery involvement management:

http://emedicine.medscape.com/article/850738-overview


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






ChristineB #195544 12-27-2017 09:25 PM
Joined: Dec 2017
Posts: 3
Sandie Offline OP
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Posts: 3
Thank you so much Christine. It really is a good feeling knowing that there is support out there. I appreciate your knowledge and advise. Which I will be taking. I will continue to let you know what is happening and using the other forums to get the support that both Jimmy and I need.



Wife and caretaker.
Husband diagnosed in Feb 2017 with stage 4A throat cancer.
7 chemo and 35 radiation treatments received.
PET scan showed cleared Aug 2017.
Nov 2017 cancer back in lymph nodes. Multiple effected.
No more chemo now onto radical dissection with carotid artery replacement. Scheduled 1/2/18.
PaulB #195545 12-27-2017 09:28 PM
Joined: Dec 2017
Posts: 3
Sandie Offline OP
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Joined: Dec 2017
Posts: 3
Paul, thank you for your response. We will definitely be reading the article you attached. I have read these to my husband, Jimmy and he was very happy that I took the time to ask the questions. I am grateful, like I told Christine, that you also ahve taken the time to speak with me. Your knowledge is very useful to us as well as many others. Thank you again.


Wife and caretaker.
Husband diagnosed in Feb 2017 with stage 4A throat cancer.
7 chemo and 35 radiation treatments received.
PET scan showed cleared Aug 2017.
Nov 2017 cancer back in lymph nodes. Multiple effected.
No more chemo now onto radical dissection with carotid artery replacement. Scheduled 1/2/18.
Sandie #195571 01-04-2018 03:49 PM
Joined: Jun 2007
Posts: 10,507
Likes: 6
Administrator, Director of Patient Support Services
Patient Advocate (old timer, 2000 posts)
Offline
Administrator, Director of Patient Support Services
Patient Advocate (old timer, 2000 posts)

Joined: Jun 2007
Posts: 10,507
Likes: 6
Im checking in to see how the surgery went. I know you must be pretty busy at the hospital. Please post an update when you can.

Best wishes to your husband for a speedy and pain free recovery.


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

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