Thanks all. They let me go home today. That's a nice step in the right direction. I see my surgeon again Wednesday when I'll get my staples out. I was pleased that my MO came in to talk with me last night; she and the rest of my team haven't had much time to confer yet... and the pathology report won't be available until Tuesday. I told her I feel we're now moving into uncharted territory where I'll need to rely very heavily on their experience & advice. She said I've received the entire spectrum of treatment; nothings been left out simply to make my life easier. Normally there is no further treatment from here, but she said they will discuss the possibility of extra radiation. My MO also said she went over the PET/CT scans once again and confirmed they didn't show much FDG uptake; hopefully the pathology report will be illuminating.

BTW: My surgeon said he sent my tissue samples from the OR to the pathologist and then spoke with the pathologist by phone. My surgeon asked the pathologist if he was CERTAIN there was SCC present and the pathologist responded affirmatively before he proceeded to remove my accessory nerve and SCM muscle. My MO said my surgeon told her he felt the cancer may have invaded the SCM muscle. Also, my surgeon told me that, while he felt the surgery itself went very well and was a success, it was a difficult procedure... he spent nearly 4 hours in the OR where he would normally spend only 2.5 hours... and he's concerned for me clinically.

David: I had the surgery because the mass of lymph nodes in my neck didn't shrink enough. It was over 6 cm (N3) before any treatment. Then I had Induction Chemo (9 weeks, 3 rounds, TPF) followed by ChemoRadiation (7 weeks, IMRT with weekly carboplatin and taxotere). This shrunk the mass to 4 cm... if it was less than 2 cm, they would have deemed it a "complete response" and not recommended surgery; but, because it was an "incomplete response", 3 doctors recommended surgery and 1 was ambivalent. I elected to proceed.

I'll start outpatient PT soon too. My arm/neck/shoulder function isn't too bad, but I need to encourage my other muscles & nerves to compensate properly. Also, I want to avoid getting a "frozen shoulder"... not that I really understand what that is. But this weekend I'll mostly just take it easy.


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