Hello everyone,

As some of you might recall, I'm 34 years old and was diagnosed with a stage 1 SCC to the tongue late December. I am being treated at Sylvester, a CCC in Miami, FL. On January 10, I had a partial glossectomy and a modified radical neck dissection.

The original pathology report came back clean. A second pathology report revealed a microscopic speck of cancerous cells in one of my lymph nodes. My doctor recommended radiation, although reluctantly. I went on to see a radiation oncologist (who also did not seem convinced I needed radiation, but was going to go ahead and treat me). I was ready to start radiation treatment on Monday.

Tonight, however, I had a long conversation with my doctor and there has been a recent development. My doctor (who I'm told is considered to be one of the top head and neck specialist in the country) has been discussing my case with other top doctors in Europe. These other doctors advised my doctor that radiation treatment was unnecessary in my case. Basically, the studies that exist (about people with microscopic cancer in one lymph node) are inconclusive with respect to whether or not radiation is warranted.

After telling me all this, my doctor confessed that his recommendation might have been overly aggressive, and he even provided the background of why he decided to recommend radiation. A couple of years ago, he had a young patient who came to him with an early cancer to the tongue. The small tumor was taken out and nothing else was done. Soon after, the cancer recurred and the patient ended up dying. Understandably, this had a profound effect on my doctor and he obviously does not want this to happen again.

At the same time, he was very blunt in telling me that if I don't get the radiation, I have about an 85 percent chance of being fine (i.e., I would have about a 15 percent chance of recurrence). If I do get the radiation, my chance of recurrence goes down by about 7 percent (i.e., my chances of recurrence after radiation would decrease to about 8 percent). He then went on to tell me about the negative effects of radiation: pain, dry mouth, losing my teeth, difficulty eating, etc.. some of which might even be permanent.

At this point, I'm once again totally confused. I'm not sure if a mere seven percent improvement would justify the effects of radiation.

I've learned that some of the most aggressive tongue cancers that have been seen recently are among young people who have never smoked. I smoked for about 17 years and despite by unusually young age, my doctor tells me that my cancer did not seem particularly aggressive.

Of course, he has not exactly discouraged radiation. He is just pointing out that the decision of whether or not to get the radiation is not as clear cut as I had thought. Ultimately, of course, the decision is mine.

What the HELL should I do? What would you do?

I do plan to get a second opinion. I'm considering either Sloan-Kettering or Anderson. Which one should be my top choice?

Any input will, as always, be greatly appreciated.

regards,
Gino