I don't understand why lymph node involvement per se should preclude IMRT -- in fact it shouldn't really matter, the IMRT treatment should cover all the cancerous areas if it were planned correctly. IMRT just allows better targeting and avoidance of non-target tissues. It is replacing conventional XRT at most centers and hospitals, in fact, all our larger local hospitals here in Montgomery Co. MD use IMRT for prostate cancer and I would expect, for other cancers where important non-target organs or tissues lie close to the cancerous area (like HNC).

Barry has stage IV SCC (right tonsil --removed w/ some residual at base of tongue and two lymph nodes) and he is not only getting IMRT, he is getting tomotherapy IMRT at Hopkins because they want to avoid radiating his inner ears (he has some hearing loss) and want to maximize parotid gland sparing, which is easier to do with the more precise targeting of the tomo machine.

As everyone knows, the bottom line of treatment is the final outcome, and of that, the major issue is being cancer-free, but quality of life is also a vital concern. Cancer treatments are moving both to improve the first and the second, although there is still along way to go...

Gail