Hello all,

Sorry I haven't been around for awhile... and that I don't feel up to responding to all questions put to me... but I thought I'd share how my surgery went yesterday.

In brief, the outcome was not as good as I'd hoped. But it was certainly the right thing to do... as I would most definitely have had a recurrence if I didn't have this surgery.

The surgeon found tissues that were still infected by SCC. As a consequence, he took out Levels 1-4 (including both 2A and 2B), and I think he took out a good bit of Level 5, as well as the accessory nerve and the sternocleidomastoid muscle. He also removed part of my Parotid gland and I think he took a few biopsies as well. The full pathology report will be available next week and I'll need additional discussions before I fully understand it all... but I think he said that the nodal mass shrunk in a haphazard manner (like swiss cheese, with holes in it) such that some cancer cells may not have remained encapsulated and could be floating around the area. Of course, they would be below a level that would be detectable on a PET scan... but he suggested that additional radiation treatment may be in order and, to support that possibility, I think he said he left behind some sort of ring of vascular clamps (which I think are like sutures that dissolve over time) around the area of concern to serve as a target for the RO.

So now we know a lot more than we ever could have learned from non-invasive techniques (like PET scans). My medical team will review the results over the next few weeks and recommend some next steps... but its now fairly clear that I'm not yet out of the woods (even though the surgery was a step in the right direction).

At the moment, I'm still in-patient and just need to focus on recovery.

Rob


Dx: T1N3M0 Stage IV SCC Left Tonsil HPV16+

CT 3/20/9. FNA 3/24/9. Panendoscopy 4/1/9. PET/CT 4/22/9
9 wk IC (TPF) 4/25/9. Port 5/11/9 removed 6/4/9 (clot)
7 wk CRT (IMRT; Carboplatin & Taxol) 7/8/9. PEG 7/9/9
CT 10/19/9. PET/CT 11/2/9. ND 12/1/9
6 wk CRT (IMRT; Erbitux, Carboplatin & Taxol) 1/6/10