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#44828 04-15-2005 03:35 PM
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Tim Offline OP
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I had my follow-up appointment with my ENT today. In his words "Your throat looks great!" No evidence of cancer other than a little scar tissue on the walls. laugh A cat scan is schedule for May 5 (Happy Cinco de Maio, all!). This is about 7 weeks after my last radiation.

That's the good news . . .

The other news, and it isn't bad news, just other news, is that he still wants to do a modified neck dissection to the right side to yank the nodes from my jaw to my clavicle. According to the information he gave me this will involve a 4 inch or so incision lateral to my jaw line. From this, I guess he can get at all of the nodes he wants to get to without sacrificing any of the tissue he would normally need to with a radical. I guess this means the sternocleidomastoid muscle, spinal accessory nerve, etc will remain in place. He suggested that the worst lasting effect would possibly be some numbness to my jaw line.

Anyone familiar with this?

Thanks in advance!

Tim


SCC Right Tonsil, T2N1M0, Dx 12/04, Tx 40 radiation (180 rad), 8 Chemo (carbo), Tx ended 3/15/05, Selective neck dissection 5/24/05, 22 nodes, 4 levels, no evidence of metastatic malignancy!!! :-)
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Sorry Tim , I cannot help but hopefully someone will answer soon.
Marica


Caregiver to husband Pete, Dx 4/03 SCC Base of Tongue Stage IV. Chemo /Rad no surgery. Treatment finished 8/03. Doing great!
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He sounds like a doctor who understands the potential for micro mets to exist in the nodes undetected, and wants to play it safe. Good idea in my book. You will likely lose the nerve but keep the muscle. You will also lose all the fatty tissues in that side of your neck. I had a similar modified neck dissection, and you can see a picture of my final result on my story in the people section of the web site (founder's story).


Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.
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Tim Offline OP
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Thanks for the responses. It would appear that the surgery contemplated is manageable . . . plus I have a scar on the left side, so now I will be symmetrical! :-)

I read your story, Brian. It is pretty inspiring.

Thankfully, I have not had to deal with any major complications. My predicted weight loss turned into weight gain; I had sores in my mouth for 10 days . . . no big deal, stay away from vinegar and spicy foods (and liberally apply lidocaine); no initial surgery, etc. I would say I fully recovered (other than a little fatigue) within two weeks of my last radiation.

Which brings to mind yet another irksome question.

If my normal cells have been this resiliant to the treatment, why wouldn't the cancer cells be similarly resiliant? They are, after all, merely renegade normal cells. I know the adage "the lack of side effects is not an indicator of lack of effectiveness" but it still bugs me.


SCC Right Tonsil, T2N1M0, Dx 12/04, Tx 40 radiation (180 rad), 8 Chemo (carbo), Tx ended 3/15/05, Selective neck dissection 5/24/05, 22 nodes, 4 levels, no evidence of metastatic malignancy!!! :-)
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I am sure that they completely understand how it all works but to my understanding the cancer cells DNA is altered and they can't replicate so the cells eventually die. It damages healthy cells as well but not the DNA. Radiation is "fractionalized" deliberately to allow for healthy cells to repair or regenerate themselves.

You had an unusually easy time of it - did you have IMRT?


Gary Allsebrook
***********************************
Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
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"You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
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Tim Offline OP
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Hi, Gary -- IMRT was on my dance card and yes I did have an unusually easy time of it.

I am sure "they" understand it as well. Alas, that doesn't help me much ;-) Faith carries me only so far.

And my surgery has no been scheduled. It is the 24th and is to be about 3 hours. From what I've read here and heard elsewhere, this seems to be pretty moderate surgery too.

Tim


SCC Right Tonsil, T2N1M0, Dx 12/04, Tx 40 radiation (180 rad), 8 Chemo (carbo), Tx ended 3/15/05, Selective neck dissection 5/24/05, 22 nodes, 4 levels, no evidence of metastatic malignancy!!! :-)
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Tim, I had a modified radical neck dissection three years ago. My neck looks quite normal. There is a scar but it has faded so much that I forget it is there. Initial numbness of the entire area from ear to jaw receded as nerves regenerated. Today I have very slight shoulder droop on that side, but no impairment in range of motion or strength of arm and shoulder. Improvement will continue over time for at least a year. First few days will involve swelling and drains, but this passes quickly. This is a very, very smart decision on your part.

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Tim Offline OP
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Plus, scars are sexy, right? :p


SCC Right Tonsil, T2N1M0, Dx 12/04, Tx 40 radiation (180 rad), 8 Chemo (carbo), Tx ended 3/15/05, Selective neck dissection 5/24/05, 22 nodes, 4 levels, no evidence of metastatic malignancy!!! :-)
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Tim,
I too had a modified neck disection. One year ago this week. I had some loss of range of motion in the shoulder on the affected side which was temporary. Now, a year out, I've regained the range and strength, Have a barely noticeable scar, and some numbness in the jaw line. The surgery and recovery were a walk in the park compared to RAD/Chemo, and the peace of mind that negative biopsies provided are priceless. I'm very glad I had the surgery.
Any questions, please feel free to e-mail me or send a private message. I hope this helps.
Continued good fortune in your recovery,

Chuck


SCC Stage IV right tonsil T3N3M0. Dx 08/03. Clinical Trial:8 weeks Taxol, Carboplatin then Hydrea, 5FU, IMRT x's 48, SND, Iressa x 2yrs. Now 20 years out and thriving. Dealing with a Prostate cancer diagnosis now. Add a Bladder cancer diagnosis to all the fun.
It's always something
"Adversity doesn't build character, it reveals it."
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Tim,
By way of an answer to your other question, from mayo.com:
"You may be worried that radiation will destroy your healthy cells as well as the cancerous cells. But radiation is much more harmful to cancer cells than it is to normal ones. This is because cancer cells divide more rapidly than do healthy cells. Cells are more vulnerable to damage when they're dividing, making cancer cells more susceptible to radiation than normal cells are. In addition, normal cells can recover from the effects of radiation more easily than cancer cells can."


Perhaps not a complete answer, but better than "going on faith"

Good Health,

Chuck


SCC Stage IV right tonsil T3N3M0. Dx 08/03. Clinical Trial:8 weeks Taxol, Carboplatin then Hydrea, 5FU, IMRT x's 48, SND, Iressa x 2yrs. Now 20 years out and thriving. Dealing with a Prostate cancer diagnosis now. Add a Bladder cancer diagnosis to all the fun.
It's always something
"Adversity doesn't build character, it reveals it."
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