[/i]Hey there![i]

I hope you all are doing well. This is my first post so forgive me if I commit any mistake.

I have found this forum to be extremely helpful for the queries I and my family had during the course of treatment. You see my father was diagnosed with basal cell carcinoma (or is that squamous cell carcinoma? I think both these names were used in the file). He had it in the jaw and underwent surgery for the same. It was the first stage and the surgery was performed on 6th December last year. The doctor prescribed adjuvent radiotherapy. Three weeks after that the radiotherapy sessions began. He was given 31 rads and 6 chemo therapies. I don't know the name of the chemo/drug but it was supposedly very mild with no side-effects associated with chemo. This phase was thankfully not as difficult for us as it was for some of you. For once, he did not have to be on that feeder tube thing. He did get blisters but it was only after the rads ended did he realize their existence. It has been three weeks since the rads ended.

Now coming to my main concern. My father still has a significant amount of swelling just close to his lips. A few hours after the operation half of his face was swelled up (as my mother who was with him told me, I was staying with my aunt in another city). But now it is just that ball shaped bump. The swelling is both inside and outside so that sometimes when he speaks, his speech is not clear due to the tongue hitting that region. Also it keeps increasing and decreasing. I think if a measurement is taken the bump would measure an inch or an inch and a half.

A little background before I tell you the next point. So, my family are immigrants and a doctor (lets call him X) here advised us to go to our home country for operation. Now after completing the treatment my father and we have returned. My father's next appointment with the surgeon is in April. Since my father was concerned about the swelling he decided to pay a visit to doctor X. He was quite stunned and then explained that though he had taken training he had never performed such a surgery. He checked for pus in the area of swelling by inserting a syringe on both the sides. There was none.

So, my father has become quite heartbroken, though the surgeon and the radiotherapist did tell that it will take time for the swelling to go down. But he isn't sure. Especially due to DrX's stunned face and his comment that 'that's a lot of swelling'. He always wears a mask when in front of somebody or when he goes out. Being a cancer patient/survivor myself I know that depression is real especially when it comes to your appeaeance. From all that I have read and know (I am preparing for the medical field) I do know that he will be normal, but even I have doubts. What should I tell him?

Welcome to OCF, Eram! Im very sorry to read about everything your father has been thru! We will do our best to help you with info and support. Please remember we are NOT medical professionals but are patients/survivors and caregivers. Our experiences with oral cancer (OC) are first hand not learned from years of medical school, clinical patient interactions, etc.

I read your post, twice and am having a little trouble following the timeline of your fathers history. Probably due to being a bit tired this morning. I would like to ask you some clarifying questions to better understand his situation. Not being a medical professional makes these thing difficult for me to sometimes understand.


It seemed to me like the surgeon who preformed the surgery never did that kind of operation before, is that correct? Or is this the doctor in the other country?

What country was he treated for surgery and radiation?

Is it only 3 weeks since he finished radiation w/ chemo treatments?

After your fathers surgery did he have radiation treatments started immediately or was he given time to recover from the surgery? If so, how long?

Im a bit confused by your description of "the bump". What is that and where exactly is it?

It sounds like this "bump" is affecting your father right after surgery. But then the post discussed radiation so Im very unsure about what this situation is. Maybe Im just not understanding this correctly? Any major swelling that interferes with speech could also interfere with your fathers breathing. Pay close attention to this and if he is not able to breathe properly take him immediately to the hospital.

Recovery from such a major surgery takes a long time! Radiation treatments with also having chemo can take the patient 2 full years until they are completely recovered. Radiation continues to work even after the treatments have stopped. Usually the very worst time for OC patients who have rads is the first 2 to 3 weeks after finishing rads. Then they will very slowly begin to start getting better. Most oral cancer (OC) patients experience significant side effects from rads w/ chemo. Many, as you mentioned have painful mouth sores, nausea, extreme fatigue, very thick mucous that is not easy to get out, sinus problems, pain issues, sore throat, major weight loss, constipation, diarrhea, dehydration, etc to name just some of the side effects. If your father is only now 3 weeks post radiation (if that is correct?), his side effects sound to me like he has done very well getting thru everything.

Im sure the doctors reaction to your father was very unsettling. Their reaction tells me your father is in the wrong place and should seek out someone who is trained in treating oral cancer patients. Do NOT let him continue seeing a doctor who does not understand what oral cancer is and what the treatments do to a patient! I cant imagine being treated by a doctor who had no understanding of OC and tried to remove fluid from a swollen area in their initial office visit. That could cause serious harm if they dont know what they're doing.

You are correct that cancer can make patients depressed. OC patients have a very high level of anxiety, depression and stress. Most other cancers the patient can hide their illness. When its right there on your face that isnt very easy to do. Being different in todays society that is all about a persons looks is NOT easy! I speak as someone who has been thru this and survived. In 2009 I had surgery that was mandatory in saving my life but it left me disfigured. At this time your father is recovering where what you see now probably will not be how he will be 6 months from now. I suggest getting your father to see a therapist who understands and treats cancer patients. Your father may need medication to help him get thru this difficult phase in his life.

To help with your fathers recovery he needs higher calories and protein helps with healing. I know just completing rads (I think?), its not easy to take in much with a sore mouth but he must push himself to or he will struggle with recovery. Every day he should be taking in at least 2500 calories and 48-64 oz of water. I would check with a family doctor about if its ok to add high protein whey powder to help boost his protein intake.

Im sure I will think of something else after I send this thru. I wish your father and family all the very best with his continued recovery. He is lucky to have such a supportive family!!!

Best wishes!!!

Hi Christine!

I am so sorry that you found some of the details vague. I was in a hurry when I wrote this post up, I will try to answer all your questions one by one 🙂

1. No, the doctor he went to see yesterday wasn't the one who performed the surgery. My father just wanted an opinion regarding the swelling. This doctor has had no hand in my father's treatment. He was the one who 'discovered' the cancer. He didn't do anything and straight up advised us to go to India.

2. He was treated in India. The surgeon who performed the operation is highly skilled and one of the best in the country. He received rads and chemo in our city while surgery was performed in another city.

3. Yes, the course ended on 13th feb.

4. There was a gap of atleast three weeks between the surgery and the first radiation.

5. Well this bump is beside the jaw and lips, if that is clear (?) After the cancer was removed my father had a second surgery (plastic surgery) that same day, so he doesn't have any disfigurement.

I do understand your concern about the doctor and I feel that he shouldn't have inserted a syringe there to check for 'pus'. I am not sure why he did that. I hope that it doesn't create a problem. I am really worried now. But, we are going to see the main surgeon in April and if anything happens before that we will still go to India to the main surgeon.

As for difficulties in breathing, we have asked him multiple times but he says he has no such problem apart from the swelling. And exteriorly too, I don't think his breathing is effected. Since the swelling is only on the lower right side of the face and nothing on the throat. I think the only problems that arise from the swelling is a slight difficulty to eat and sometimes a very minor alteration in speech.

He is recovering really well after the rads and chemo. He didn't have any adverse side-effects (at least none that we could see) and a few days earlier he said that he has regained some taste sensations.

He is currently taking no medications though and yes we are trying to increase the protein content in everything he eats. My mom did ask abouy medicines but neither the surgeon nor the radiotherapist said it was necessary or needed.

Thank you for explaining everything is such great detail. Im sorry that I was a bit confused. It was pretty early when I read and responded to your post, around 6AM. It took me quite a while to figure everything out and post my reply.

Here in the US, most OC patients who undergo a major surgery like your fathers will have 6 weeks recovery prior to starting any further treatments. As you see, every country has their own way of doing things. I do not have any info on how medical systems countries outside of the US function. Im sorry if I caused you any concern about the doctor with the syringe. It always makes me nervous when doctors are stumped about things but still attempt to help the patient. Its so much better for the patient to be treated for whatever condition is affecting them by an experienced doctor in that field.

It sounds like your father is doing extremely well for everything he has been thru. He still has quite a long road to go before he will be completely healed. One day at a time and soon he will begin to notice more improvements. The worst is already behind him.

The "bump" could be some sort of fluid retention. Your father might benefit from seeing a physical therapist or someone who could examine him for possible build up of lymphatic fluid. Ive seen members who have had surgeries then rads have issues with swelling which could be helped by a special massage a skilled therapist teaches them. Im sorry but I do not have much info about this where other members who have been thru it could give you more details. Its just a guess that this is what your father has going on. It could be any number of things causing his "bump". Radiation treatments can bring inflammation as well. Im not sure why it would be in only one spot. Is there an oncologist or an ENT (ear, nose and throat) specialist your father could see in your area? Here in the US, many patients follow up with their ENT and see the oncologist at first every 6 months then yearly thru about 5 years post treatment. I still see my ENT every 4-6 months as he follow up on my thyroid testing and monitoring of my thyroid medication and Im 9 years since my last cancer treatment.

One thing you may inquire about is something called magic mouthwash. It could be made of several different combos. The type I had consisted of malox, benedryl and lidocaine. The magic mouthwash is to be shaken well then the patient takes a small amount (maybe around a teaspoon) and swishes this around in their mouth for at least 30 seconds then spits it out. This will help lessen the discomfort from his mouth sores and temporarily numb your fathers mouth so he is able to eat without much pain.

Best wishes with your fathers continued recovery.

I just want to add that your father should not be doing any lymphatic massages (in the neck or face) until he has been declared cancer free. I suppose it is to prevent any residual cancer cells from going into the rest of the body. The best is still to go and see an oncologist who is experienced in oral cancer.

A second thought: can you email your father’s doctor in India or call him to discuss the situation?

Christine thank you for explaining everything! You definitely don't have to be sorry about causing me any concern. I found it weird even before you said it as though I have read about 'lymphatic build up' or 'fluid retention' , I didn't read about a doctor using this method to figure it out. We all know that the worst is already behind him but men and men like my father are impatient, like really impatient! They want to see immediate results which is kind of impossible when you undergo treatment for such a life threatening disease. As for the ENT doctor, I will ask my father to talk to his oncologist about that. Right now, I wouldn't send him to any doctor here since there are no decent specialists.

gmcraft, oh is that so? Thanks for informing. This was definitely something I thought I should check up but now I will avoid it. I can call the doctor but the problem is that both the oncologist and the radiotherapist have seen my father (with the swelling) and both have said that it is something that is normal and it will heal with time. So even if I call them I know what their answer will be.

How long did it take for you people to notice a significant change in the swelling after the rads?