#92795 03-29-2009 10:33 PM | Joined: Mar 2009 Posts: 3 Member | OP  Member
Joined: Mar 2009 Posts: 3 | Hi, I am new here. My mum was diagnosed with oral cancer stage 1 in her cheek lining (right side) back in January 2009. She is over at UCSF and was scheduled for surgery as soon as the could fit her in, which was 6 weeks later. They removed the cancer from the cheek, 20 lymph nodes and a small section of her jaw.
One of the lymph nodes contained cancer, the rest did not. Besides that the doctor said he would have prefered that the margins were wider on her test results. Radiation is an option, but the tumor board did not advise it based on her results. I am so worried and confused and in desperate need to find some answers. My main question what is the likelihood as the cancer spread to one lymph node that it could spread to somewhere else in the body?
Thanks for your help.
Nina | | | | | Joined: Mar 2008 Posts: 3,082 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Mar 2008 Posts: 3,082 | Nina
Good question,[quote]I am so worried and confused and in desperate need to find some answers. My main question what is the likelihood as the cancer spread to one lymph node that it could spread to somewhere else in the body?[/quote] but no good answer. Statistics never tell the story nor can they be applied to any one individual
You need to strong for you Mum and worrying won't help either of you. My GUESS (based on Stage 1, tumor board no on radiation, only 1 out of 20 nodes with Cancer) is that the likelihood is low. Read my signature line to see how aggressive my cancer was/is and it has not "spread elsewhere"
No guarantees, just HOPE and FAITH.
65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin
Passed away 4-29-13
| | | | | 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 | It never hurts to get their opinion reviewed by a new set of eyes.
That said, radiation is the ultimate weapon in the arsenal to kill this cancer and it causes the most far lasting, even permanent, life altering adverse side effects. Being able to use it twice is also very limited so some evaluations lead to the recommendation to hold off and see if the initial Tx was sufficient to kill the cancer.
Unfortunately there are no guarantees with this cancer as we have seen it all on this site.
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 $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | | Joined: Jul 2008 Posts: 507 "Above & Beyond" Member (500+ posts) | | "Above & Beyond" Member (500+ posts)
Joined: Jul 2008 Posts: 507 | [quote=ninakelly] My mum was diagnosed with oral cancer stage 1 in her cheek lining ...
One of the lymph nodes contained cancer
Nina [/quote]
Once the cancer had spread to a lymph node isn't it considered at least stage 3?
Don
TXN2bM0 Stage IVa SCC-Occult Primary
FNA 6/6/08-SCC in node<2cm
PET/CT 6/19/08-SCC in 2nd node<1cm
HiRes CT 6/21/08
Exploratory,Tonsillectomy(benign),Right SND 6/23/08
PEG 7/3/08-11/6/08
35 TomoTherapy 7/16/08-9/04/08 No Chemo
Clear PET/CT 11/15/08, 5/15/09, 5/28/10, 7/8/11
| | | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | | Senior Patient Advocate Patient Advocate (old timer, 2000 posts)
Joined: Sep 2006 Posts: 8,311 | Probably staged before they found the positive node. As far as I know, with the exception of the Nasopharynx region, any nodal involvement is staged at least a 3.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | | Joined: Feb 2009 Posts: 11 Member | | Member
Joined: Feb 2009 Posts: 11 | I would suggest getting a second opinion if you haven't already done so.
I'm debating over radiation and nothing was in my lymph nodes, in fact, they got clean margins but due to the depth of the tumor, the doctors are on the fence and so am I. My cancer was in the lower left tongue so while not in the same place as your mother, I would still get some other opinons if a node was positive.
SCC T1N0M0 Floor of mouth (under tongue) - Surgery 2-13-09. Forearm free flap with partial glassectomy and left neck dissection. Clean margins and nodes! Contemplating radiation. Non-smoker/casual wine drinker
| | | | | Joined: Feb 2007 Posts: 1,940 "OCF across the pond" Patient Advocate (1000+ posts) | | "OCF across the pond" Patient Advocate (1000+ posts)
Joined: Feb 2007 Posts: 1,940 | David staging is decided by the size of the tumour i think not the nodal involvement.Robin was T1N2cM0 and was staged at 1 because the primary tumour was just 1cm .His secondary tumour however was 5cm. I am sure i will be corrected if i am wrong but that was my understanding of how it works.
Partovis sitting on the fence is NOT an option with this cancer you will likely get splinters in your ass,so jump down off get another opinion.
liz
Liz in the UK
Husband Robin aged 44 years Dx 8th Dec 2006 poorly differentiated SCC tongue with met to neck T1N2cM0 Surgery and Radiation.Finished TX April 2007
Recurrence June/07 died July 29th/07.
Never take your eye off the ball, it may just smack you in the mouth.
| | | | | 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 | Liz,
My RO gave me a book they use with patients (and plenty of colored glossy pictures) entitled Oncology Counseling Folder - Head and Neck. In this book is a Staging Guide chart for all regions of the Head and Neck and their respective Staging Guides 0 thru IVC with a corresponding table showing each Stages' T, N, M values. None of theses charts show nodal involvement being staged less than III. You can be staged a III without nodal involvement but that was not the question I thought I was answering.
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 $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | | Joined: Feb 2007 Posts: 1,940 "OCF across the pond" Patient Advocate (1000+ posts) | | "OCF across the pond" Patient Advocate (1000+ posts)
Joined: Feb 2007 Posts: 1,940 | Hi David
i thought the statement was if nodes are involved it has to be at least a stage three lol.i just know that Robs doctors staged him a 1 even though he had a large node.I am sure no expert so i will concede to the "old timers"superior wisdom lol
love liz
Liz in the UK
Husband Robin aged 44 years Dx 8th Dec 2006 poorly differentiated SCC tongue with met to neck T1N2cM0 Surgery and Radiation.Finished TX April 2007
Recurrence June/07 died July 29th/07.
Never take your eye off the ball, it may just smack you in the mouth.
| | | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | | Senior Patient Advocate Patient Advocate (old timer, 2000 posts)
Joined: Sep 2006 Posts: 8,311 | Ok let me rephrase this...in this book in any region of the H & N if there is nodal involvement the minimum Stage is a III (with the sole exception of the Nasopharnyx region where it is IIB) regardless of what the T or M is. No where is nodal involvement ever a Stage I.
Maybe there's a different book across the pond?
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
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