I had my follow-up with my radiation oncologist yesterday, who is no ordinary doctor. He is also a professor, ENT, and a Hematologost too, specializing in head and neck cancer, and is the chairman of the Cancer Treatment Centers for about 5 hospitals, so when I see him, that's the final say.

I thought it was going to be routine, post-op visit, and was told by his fellow in the hospital no further radiation was planned, which is sometimes given after IORT, and did so last year.

My doctor had his fellow working with him again, actually several, and went over the usual history, surgery, exam, but asked if my ENT went over the pathology. He did, but I didn't pick up a copy yet, and went over much that was known to me, but added, we are trying to see if more radiation can be given safely, so I figured things changed in two weeks. My oncologist eventually comes in with everything updated, and starts to go over surgery, the findings and what he wants to do...my first surgery they saw cancer was wrapped around the carotid artery, so pretty much everything was scrapped after deciding to come back and remove the
Carotid arterty, to remove the cancer, and so I can have more radiation during surgery, which was done after pssding the balloon occlusion test, agiogram. Anyway, my doctor said being I'm young, fairly healthy, good shape...I know whete he is going lol, he wants to give it everything he can, and do more radiation and chemo, but this time he wants to send me to do Proton Therapy in New Jersey, which will be inconvienant for a few weeks, and once a week do chemo at the hospital, which will be a visit to New Jersey and Manhattan. He believes there is a 75% chance the cancer will return, and I said it's probably 100% with me, and agreed, and would die from it. More radiation is not without risk either with my prior radiation. and it's good the carotid was removed, but there is still risk of the stumps leaking, 20%, which would be instant death, so he basically said, which odds do you like, 75% or 20%. Of course I chose the 20% risk, and agreed I was doing the right thing, and said he was not giving up on me yet.

The problem is getying to New Jersey is very inconvienant being I don't drive, and get around with nyc para-transit, aka Access-a-Ride. Basically I have everything set up at home for my convienance..food deliveries, prescriptions, laundry, a cleaning women, and only need to travel outside to go to the doctors by access-a-ride, which does not go to New Jersey, and never figured going there being everything I need is in NYC, except Proton Therapy. There are only 10 places in the U.S. that has Proton Therapy, none ate in NYC, not even MSKCC.

Surgical Pathology for 10/16/13:

A. Left pericarotid mass rule out carcinoma, excision: Moderately differentiated SCC in Fibroadipose tissue.

B. Supplemental Deep margin excision: Involved by carcinoma

C. Left pericarotid mass #2, excision: Squamous cell carcinoma in scar tissue with suture granuloma.

Surgical Pathology for 6/24/13:

Catotid: Segment of Artery showing squamous cell carcinoma in perivascular soft tissue. Perineural invasion present.

Note: The superior and inferior cross-sections are involved.