My ENT surgeon just called and moved my recurrence treatment planning meeting to tomorrow afternoon after realizing her staff had only slotted me for 15 minutes which would have left only time for a monologue: "Hi - it's Cancer again - cutting it out this time - see ya in hospital"
When I took our Italy trip in Sept to celebrate being cancer free for 9 months, I posted our plans/hotels etc on Trip Advisor and got an amazing improvement suggestion that transformed our trip plus validation of all the other aspects. So here is what I plan on discussing with her tomorrow (my wife will be along to take notes and listen when I get too emotionally involved and hear what I want to hear)
1. With a new lump now on the lower side of the tongue where we could actually feel it with my finger clinically cancer - is partial glossectomy my best bet at "beating it"?
2. Would some CO2 laser surgery on tongue be better than scalpel?
3. What percentage of tongue are you planning on removing (1/8;1/4;1/2)?
4. How urgent is this surgery? Can it be delayed for expert flap surgeon?
5. How many glossectomies have you done?
6. How many flap reconstructions have you or a co surgeon done?
7. What are the odds on �Tin Man Syndrome�? (multiple serial glossectomies as some OCF posters had)
8. What assistance can your office provide in getting second opinion
9. What�s the SWAG risk benefit: how long would I have if I do nothing? Do I only get an extra 5 weeks?
10. Can you do a �selective� Neck Dissection that operates on fewer areas, preserving function in the shoulder, and can sometimes leave the sensory nerves, preventing numbness, especially in the earlobe.
11. Can you do a neck dissection that still removes tissue from all five levels, BUT sparing the sternocleidomastoid muscle, the spinal accessory nerve and the internal jugular vein ?
12. Should I be changing RO and MO since prescribed TX didn�t do the trick?
13. How long in hospital?
14. How long recuperation?
15. Ability to Speak?
16. Ability to swallow?



Those are my first cut at 16 Sweet questions (bad pun but after all 61 is just sweet sixteen ass backwards). Any comments on tone, tenor and most of all CONTENT welcome.
Thanks

I think this is a good series of questions.

I would not include #9 because I don't believe in not trying.

My thoughts about 15 and 16 are similar, push for total cure and LIVE with whatever side effects you end up with.

What does SWAG mean?

I like your list, Charm!

Simple Wild Ass Guess. I use it a lot in my field of work.



just kidding now

David is right about SWAG being very big in the tax area on both sides of the playing field. I saw enough inside private top level executive decisions made at the IRS based solely on SWAG - but of course not your garden variety SWAG- but high class, expensive gussied up Consultant SWAG. I mostly played the kid shouting out to the Emperor (trust me - not a career building move but fun nonetheless).
The questions implying I might not do anything at all but hook up with a morphine drip and let nature take its course are there for a strategic reason. Doctors, surgeons, etc are just people with a degree different than mine who unfortunately see patients everyday who just acquiesce to whatever plan of treatment they have or offer and are willing to accept just about any side effect or complication of treatment. Being drastic in the remedy is no guarantee of a cure. I personally believe that medical treatment of oral cancer is back where Breast Cancer was twenty years ago - double full mastectomy for a lump just in case. Neck Dissections are the perfect example. Just take a look at the OCF postings: proud announcements that none of the nodes removed had any cancer at all. Make no mistake, I will do whatever it takes to survive and thrive but it's a package deal. I want my medical team to be comfortable with doing a little less overkill in return for more quality of life. They need to know that I have understood and freely accepted the risks. If there were palliative care with a track record of 5 year survival, I'd be there - but every doctor I've seen has responded that what and where I have cancer is always fatal within two years unless treated with cutting, burning and poisoning. Sometimes less is more

Charm,

It was almost 3 years ago that I was searching for answers and discovering the barbaric Tx options akin to blood leaching in terms of advanced medical practices.

My first doctor said "regardless of what they are, referring to my swollen nodes, they must stay in".

My second doctor, a surgeon, said "regardless of what they are, they must come out".

My third doctor said "those nodes are probably infected" and he put me on antibiotics.

My forth doctor said after doing a FNA and reading the results "I will do a Radical Neck Dissection and then give you concurrent chemo and radiation and I give you a 60% chance of surviving 5 more years".

My fifth doctor said " I will do a Partial ND and then do chemo and then do radiation and I give you a 70% chance of surviving."

Finally Moffitt said "we don't recommend any surgery but we will do concurrent chemo and rad and we give you a 90% chance of surviving."

Choice to me was obvious.

Good luck.