After having a substantial amount of radiation last summer (7wks) you can imagine my surprise at hearing that "re-radiation" may be part of a more assertive plan to deal with the cancer that was not held back in any significant way.
Meeting with my surgeon yesterday (3wks post-op) confirmed that the cancer had invaded a well radiated saliva gland, the jugular vein as well as some other structures in my right neck. The muscle that was dissected was clear as were some remaining nodes, and provided my only margins. The aggressiveness of this disease is staggering, but I do need to consider quality of life vs the assault of another round of rads. I meet with the Rad Onc in two weeks.
Does anyone have experience or knowledge of the practice of re-radiating? It was my impression from the doc that rads were a one time thing.
Thank you in advance for your input.
Fran

Fran, I am really pulling for you!

When I had 37 rad treatments, both sides, I commented that this better hold me for life because I understood it was a one shot deal. My highly respected rad oncologist said "not necessarily." I didn't get to follow up and wish I had, but if he said that, I believe. I had IMRT, which might make a difference.

If you did not have chemo in conjunction with your rad, you might ask about that option. There have been two studies of which I am aware that indicated quite conclusively that the combination of chemo and rad extended survivial rates in advanced cancers. I, too, was stage IV with mets to nodes. It sure wouldn't hurt to mention this when you meet with your doc.

Let us know what you learn, and know you are in our thoughts and prayers.

Joanna

There have been some clinical trials going on about re-radiation and they have shown that there is far less less risk and damage than originally thought.

Hi Gary,
Is that only for IMRT? I'm going to be really pissed if they have now decided that they can reradiate an XRT area and I wouldn't have needed this surgery after all.

Take care,
Eileen

I believe it was for XRT. They already will re-radiate an area in close proximity to the original site with IMRT.

Because my primary was a midline structure, I am pretty sure the bulk of my rads were "field" or broad range with the boosts done by gamma rays?? Excuse my ignorance about the technical terms. So it would follow that if a re-rad was proposed it would likely be the IMRT type.(?) At this point I do not have the strength or bodily resilience to take on anything approaching my initial experience with rads; there's 30% less of me than a year ago! I will ask about the chemo-rad combo...heck at this point I'll ask almost anything.
I do wish I had been on this board last spring, but better late than never. One certainly feels a lot more empowered when the feedback comes in.
Thanks all,
Fran

IMRT is a lot less damaging than XRT but I lost 35% of my body weight. I refused to do the PEG thing and besides some folks have lost the weight WITH the PEG. When I was researching treatment modalities a few years ago I found that some individuals actually gain weight during IMRT radiation - but I am convinced that they are the exception. As I recall Danny Boy had the best IMRT experience on this site.

When we went to the Rad. Onc. he told us that it was a one time deal. That there was too much risk of damage to the spine.

This was reiterated by the ENT.

There is a man that we see at rad. everyday who is doing his second trip. He was first diagnosed in 2001 and this recurrance was diagnosed at Christmas. When he said this was his second time we were a little stunned based on what we had been told before.

He had XRT the first time and is now doing IMRT.

I wonder that since we are only IMRT if that has something to do with the non repeat information that we got from the docs?

Definately something to look into.

Cindy

Like I mentioned earlier - this re-radiation concept is in clinical trials so your docs might not have heard of it yet. The spine is at risk as you mentioned so they have to work around that by careful programming, beam blockers and various other techniques.

Here are some clinicals trials:
http://www.moffitt.usf.edu/Prevention_and_Treatment/clinical_programs/headneck/studies.asp

http://www.ncbi.nlm.nih.gov/entrez/...&list_uids=2625112&dopt=Abstract

http://www.moffitt.usf.edu/pubs/ccj/v9n5/pdf/387.pdf