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#28523 01-16-2007 06:01 PM
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Okay, so the post surgical pathology report confirms that I do have cancer. The surgery, performed by my ENT, removed "Right Tonsillar Fossa Mass & Right Neck Mass".

My first appointment with an oncologist at our local cancer center (Santa Barbara), is scheduled for Friday. I need a little help with some of the terminology so I'll have a better idea of what questions to ask.

Here are some of the comments from the surgical pathology report;

"... confirms the diagnosis of invasive poorly differentiated carcinoma that extensively involves this sample. The term lymphoepithelioma-like is used in this case given the associated prominent lymphoid infiltrate. the right neck mass submitted as part "B" represents an enlarged lymph node that is extensively involved by metastatic carcinoma with an identical morphologic appearance to that seen in the right tosillar fossa although the metastatic tumor in the lymph node contains areas suggesting some degree of suqamous differentiation ....

My best friend is coming into town to go with me for this ititial appointment with the oncologist and I'm trusting her to be in a clearer state of mind for asking appropriate questions. Any suggestions are most welcome.

In the mean time, can anyone explain "like I'm a two-year-old", what "lymphoepithelioma-like" means? Or, how about "morphologic appearance"?

As stressful as these last few weeks have been, I'm at least kinda glad to finally have some kind of diagnosis - even if I don't yet fully understand it or the consequences. I also understand that while I may not be the one who will be driving this train, I will be on it and will NOT be run over by it!


SCC, Right tonsillar fossa, T4N2M0, Dx 1/12/07
#28524 01-16-2007 07:34 PM
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JB--I am sorry that you have to take this "trip," but at least you have made a beginning. It probably won't be fun, but if you choose professionals that you trust, you will be ok. I am glad that you have someone to go with you to the app't. with the oncologist. You need to make a list of your questions, but that person needs to be in charge of being sure that they all get asked and to make notes of the answers. YOU will not remember everything that they tell you. Neither will she, but she can write, and you need to be free to talk with the doctor. I didn't do it this way, and now I am sorry, bec. I don't recall everything that they said. Good Luck. Keep us posted. We're pulling for you.


Colleen--T-2N0M0 SCC dx'd 12/28/05...Hemi-maxillectomy, partial palatectomy, neck dissection 1/4/06....clear margins, neg. nodes....no radiation, no chemo....Cancer-free at 4 years!
#28525 01-17-2007 06:25 AM
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Jellybean,

I like your train analogy. You'll find many passengers on this board that can answer your questions, or at least help with the unknowns. Use the search function on this board. Type in a key word, and get real-life experiences and explanations.

Morphologic is defined as "Describing the form and structure of an organism or any of its parts", so it sounds like they are saying the two samples have some of the same traits.

Ditto what August said. There will be a lot of terminology thrown around. Write it down. Same goes for the questions you have, but aren't in front of a doctor at that time.
This site is an excellent resource too. It had a very positive effect on my journey.

Best of Luck, and keep that attitude up!
Mike


Removed righside lymph node(stage III)on 10/10/05 Unknown Primary. 6x Carbo, 2x cistplatine, 8 weeks Radiation (not IRMT)
#28526 01-17-2007 08:21 AM
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I agree that it's best your friend is coming with you so you have another set of eyes and ears on Friday. Good luck with your appointment.

My husband Jack has right tonsil cancer as his primary site with metastasis to the lymph nodes. Mike has already answered the question on morphologic and I think lymphoepithlioma is describing the location of where they found malignent cells in the tissue of your mouth. The report is also stating that the cancer started in the tonsil and spread to the lymph nodes.

I would encourage you to spend a little time on the homepage of this site as you will find extensive resources, including the ability to do a search for terms. It's organized and easy to follow and will save you time since everything is in one place.

There will be many terms that are confusing and I think August is right that you need to make a list and ask the doctor during your appointment. Even if you know the definition you still need to have them explain what that means in your particular case. Severity and scope determine how significant any of this information is so don't overreact to anything you read.

You get a short audience with these doctors and it's good to be organized so you get all your questions addressed. Both you and your friend should have copies of the list to refer to during the appointment.

One of the other significant terms in your report is that the tumor is poorly differentiated. That was the case with my husband as well and means the cancer is fast growing or aggressive. That's neither good nor bad, it's a characteristic of the tumor. You also want to know what stage you are in but don't get too hung up on it. I would ask them to stage it from the TNM classification as that will give you a better picture of the size of the tumor, the lymph node metastasis, and whether there is any distant metastasis to other organs such as lungs. Many oral cancers are not diagnosed until advanced stages and there are lots of long term stage 4 survivors on this forum.

Many patients have lymph node involvement and they will base their treatment recommendations with that in mind. No matter what they recommend - and please bear in mind that all cancers are different, therefore the treatment plan MUST be individualized for your specific circumstances - always get them to discuss the pros and cons of each and ask for their rationale in recommending something. Ask them what they would do if it was them. I would think that the combined radiation and chemo regime is going to be discussed with you. Ask about the side effects of whatever they are recommending, but also the track record. You need to determine if your comfort level is sticking with a gold standard that has proven results or newer therapies. No one can tell you how you really feel other than yourself so learn to listen to your inner voice and trust your gut.

Look up the comprehensive cancer centers that are within driving distance - you may want to get a second opinion from them. They can also coordinate the treatment plan with your local center, which is very helpful. You can get the radiation and chemo locally but still have oversight by the CCC. We did that and it's given us additional peace of mind - something very important to cancer patients and caregivers. You want to know that you did everything you could based on the information that you had at the time.

It's all very overwhelming right now, and it will get more so, but reach out to your support system and to us. You're not alone. Use the resources on this site and you will gets tons of information and suggestions.

Mostly, remember that people are surviving cancers today and keep a positive outlook - it really helped Jack and I get through this, and continues to. I hope all goes well on Friday.

Regards JoAnne


JoAnne - Caregiver to husband, cancer rt. tonsil, mets to soft palate, BOT, 7 lymph nodes - T3N2BM0, stage 4. Robotic assisted surgery, radical neck dissection 2/06; 30 IMTX treatments and 4 cycles of cisplatin completed June 06.

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