#80054 09-06-2008 05:00 AM | Joined: Aug 2008 Posts: 14 Member | OP  Member
Joined: Aug 2008 Posts: 14 | We have just gotten the fantastic news that my husband will not require radiation or chemo post-surgery and that he will be coming home from the hospital just shy of two weeks after surgery. Margins were good. No positive lymph nodes. No functional defects except some numbness in the cheek and right lower lip. The surgeon at Sloan Kettering is confident that nothing further needs to be done except the customary monitoring for recurrence.
Just curious if this is common/uncommon or simply Chip's great good fortune. I can see from this board that many of you have experienced recurrences and that there is a risk of microscopic invasion notwithstanding clear margins, etc. It therefore surprised me that radiation and chemo were not routinely suggested even with great surgical results (not that we want them - not at all). I suppose it all depends on the individual circumstances, but I am interested in your views and experiences.
We do plan to ask the surgeon to explain Chip's good fortune, the basis for his recommendations and the prognosis when Chip has his first post-surgical appointment and when the surgeon is not in scrubs, trailing a bevy of fellows. Meanwhile, it's time to celebrate, which Chip plans to do today with a milkshake.
Karen
husband 58 DX mid-July 2008 SCC right retromolar trigone region. Surgery 8/26/08 segmental mandibulectomy with fibula free flap reconstruction. Insulin-dependent diabetic.
| | | | | Joined: Jan 2008 Posts: 706 "Above & Beyond" Member (500+ posts) | | "Above & Beyond" Member (500+ posts)
Joined: Jan 2008 Posts: 706 | Karen- I'm so happy for you and I'm sure the surgeon will explain the decision not to treat with rads and chemo. They are wonderful there. Hopefully it was all caught in time especailly with no node involvement. It's much easier to actually get clear margins when that is the case. Congratulations!
Sue
cg to husband, 48 Stage 1V head and neck SCC. First surgery 9/07. Radiation and several rounds of chemo followed. Mets to chest and lungs. "Life isn't about waiting for the storm to pass, it's about learning to dance in the rain." Went home to God on February 22, 2009.
| | | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | | Senior Patient Advocate Patient Advocate (old timer, 2000 posts)
Joined: Sep 2006 Posts: 8,311 | Great news. Maybe we need a new Forum for Great News.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | | Joined: Aug 2008 Posts: 531 "Above & Beyond" Member (500+ posts) | | "Above & Beyond" Member (500+ posts)
Joined: Aug 2008 Posts: 531 | Karen this is wonderful and Chip way to go what flavour???I like strawberry...I can only hope that my surgery on Monday compares to how well you did. This is indeed a blessing!!! Congrats
Dianne..treatment at cc at Victoria Hospital, London, Ontario...insulin dependant, Surgery Sept 8/08 Tracheotomy,composite resection and bilateral neck dissection, left radial forearm free flap... T2N0 squamous cell carcinoma. No radiation A little over 2 yrs clear YAY
| | | | | Joined: Jun 2008 Posts: 309 Platinum Member (300+ posts) | | Platinum Member (300+ posts)
Joined: Jun 2008 Posts: 309 | wonderful news and i don't think they would say no further treatment needed unless they felt secure in that decision. I am excited for you!
Rita - Age 44
wife, mother of 4 - ages 3,16,21,24 & grandma to 1
(R upper) Maxillectomy 8/8/08 - UW / Seattle, WA.
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"Those who think by the inch and speak by the yard, should be kicked by the foot."
| | | | | Joined: Apr 2005 Posts: 2,219 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Apr 2005 Posts: 2,219 | Karen,
You can see by my signature that the results of my surgery are similar to Chip's. Over the years in this forum we have discussed the protocol of throwing everything possible at oral cancer and some of us have not had that done. Well, if I don't have a recurrence, then I did the right thing. If I do, then I didn't. Right now, being almost 3.5 years post surgery, I don't regret my decision and I will have the option of doing more at that time if it is recommended. Don't think, however, that I and the others in this situation, didn't spend time worrying if we had done the right thing.
I went along with my surgeon's recommendations to do nothing else and this decision was backed up by the radiation oncologist at the CCC where I was treated.
If you would like to discuss this further with me, you can send me an email with your phone number and I would happy to talk about it.
BTW, it wasn't too long ago that Brian had stated that this protocol is being followed more commonly in cases like ours.
Jerry
PS
I don't think I ever answered you about my daughter no longer working in Lower Manhattan. She left the firm and is now an in-house counsel for Verizon Wireless.
Jerry
Retired Dentist, 59 years old at diagnosis. SCC of the left lateral border of the tongue (Stage I). Partial glossectomy and 30 nodes removed, 4/6/05. Nodes all clear. No chemo no radiation 18 year survivor.
"Whatever doesn't kill me, makes me stronger"
| | | | | Joined: Jun 2007 Posts: 5,260 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Jun 2007 Posts: 5,260 | That is great news. The same I received but less than 2 months later, I had to have the rads and chemo plus. My Dr was a different one from a different Hospital. Lets say your Dr gave it to him straight and he doesn't need rads or chemo. Good Luck and enjoy life.
Since posting this. UPMC, Pittsburgh, Oct 2011 until Jan. I averaged about 2 to 3 surgeries a week there. w Can't have jaw made as bone is deteroriating steaily that is left in jaw. Mersa is to blame. Feeding tube . Had trach for 4mos. Got it out April.
--- Passed away 5/14/14, will be greatly missed by everyone here
| | | | | Joined: Aug 2008 Posts: 14 Member | | OP Member
Joined: Aug 2008 Posts: 14 | Thank you all for your good wishes and the information about post-surgical treatments. This is helpful. We will certainly ask the surgeon about his approach. We will also inquire whether Chip should have his esophagus examined with an endoscope A close friend (gastroenterologist) pointed out that esophageal cancer is often caused by the same SCC as oral cancer and shares many of the same risk factors. He was adamant that Chip get scoped. Soon. Egads! I guess this is our new normal - doctors, doctors and more doctors.
husband 58 DX mid-July 2008 SCC right retromolar trigone region. Surgery 8/26/08 segmental mandibulectomy with fibula free flap reconstruction. Insulin-dependent diabetic.
| | | | | Joined: Apr 2005 Posts: 2,219 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Apr 2005 Posts: 2,219 | Karen,
Although it was not suggested by my surgeon, on my own I have been getting scoped once a year. It gives me another level of comfort.
Jerry
Jerry
Retired Dentist, 59 years old at diagnosis. SCC of the left lateral border of the tongue (Stage I). Partial glossectomy and 30 nodes removed, 4/6/05. Nodes all clear. No chemo no radiation 18 year survivor.
"Whatever doesn't kill me, makes me stronger"
| | | | | Joined: Aug 2008 Posts: 100 Senior Member (100+ posts) | | Senior Member (100+ posts)
Joined: Aug 2008 Posts: 100 | Congratulations Karen, when my wife had her surgery we were not expecting to need radiation/chemo but had positive lymph nodes and a margin that was clear but closer than they like. Our chemo oncologist explained that they recommended chemo/radiation for any of 4 pathology findings. Of course, right now I only remember the positive lymph nodes and poor margins. I will try to find in my notes or someone else may know other reasons for recommending chemo and radiation.
Tom-CG to wife, Pam 46@dx
Stage IV Tongue Cancer T2N2C
Dx 6/08, Surgery 7/08, 3 nodes positive
9/08 33IMRT/7Carbo/Taxol
4/09 node biopsy positive, mets to lungs/stomach
5/09 Cisplatin or Cis/Alimta study
6/09 Cis/Taxotere
9/09 Taxotere
1/10 Xeloda
3/10 Cetuximab weekly
6/29/10 lost battle
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