Bee --

My husband was diagnosed with SCC Stage IV, right tonsil, base of tongue and at least two lymph nodes (on right side). He had surgery first -- but only removal of the primary tumor, the tonsil, essentially down to connective tissue. The ENT surgeon would not touch the cancer which had spread into the base of tongue (BOT) because of the potential for serious after-surgery problems with swallowing and speech. Surgical margins were negative except at boundary with BOT. This healed pretty quickly, and he was then ready for the next step. From then, it was combined chemotherapy and radiation, 33 treatments of radiation (tomoTherapy IMRT) and 7 weekly treatments of chemo (carboplatin). This was after review of his case and consensus of tumor board at the CCC where he was treated (Hopkins) and appears to be a pretty standard approach -- we had gone up to Sloan-Kettering for 2nd opinion and they recommended almost exactly the same protocol. (He had no surgery after the chemoradiation, not being recommended by his RO or MO, but it is done when residual disease is found or suspected).

You have come to a great resource for help -- both of you get educated and don't fear asking questions of your doctors!

Gail


CG to husband Barry, dx. 7/21/05, age 66, SCC rgt. tonsil, BOT, 2 nodes (stg. IV), HPV+, tonsillectomy, 7x carboplatin, 35x tomoTherapy IMRT w/ Ethyol @ Johns Hopkins, thru treatment 9/28/05, HPV vaccine trial 12/06-present. Looking good!