I am posting this here, in the hopes of any encouragement. I am just trying not to break down and be strong for everyone right now. We are in INdia, FYI, but we live in Michigan.

My father in law (Papa) has squamous cell cancer carcinoma of the oral tongue, stage 2. The clinical stage is presently somewhere around T2N1, but that will not be final until we receive back PET and MRI scan reports. OUr main wait and see right now is whether this has spread to the lymph nodes. I spend the vast majority of my time trying to read about the diagnostic and treatment options. We all spend a large portion of the day going to hospitals and meeting doctors. We have yet to find a cohesive team for cancer that is within reasonable distance and covered by ECHS (Papa's army insurance). There is simply little demand for such a thing, so there are many dots to connect.

The majority of the questions to the doctors has been coming from me directly. Papa has entrusted Vikram and I with the decision process and has asked that we choose the best doctors/team based on our own knowledge. It has come to me, primarily, to take the lead in the medical details. Vikram has been a little bit occupied with the logistics of us being here, and Ritu will not arrive until august 20th and I do not know for how long she will stay.

We hope to make final choices on surgeons and hospitals very soon, within the next week or less, and Papa would go in for surgery very shortly. At this point, it appears that papa will have at least 30-40% of his oral tongue removed, along with at least partial neck dissection of his lymph nodes, and possible radiation therapy. We don't anticipate chemotherapy as being necessary at this point but will not know for a few more days yet, and beyond that we must assume the surgery is a success and no cancer is presumably is left over.

My biggest challenge has been in having the time to read about all of this as well as apply it to Indian standards, which are quite different from the west.

The most difficult and scary part of this is Papa's rehabilitation. I am not yet sure to what extent occupational and speech therapy are available, nor how I am going to communicate well with Papa and Mom (Vik's parents), once Vikram leaves back to the USA. There is a 1-2 week gap in which I would be the only person with them, as Vikram simply cannot stay indefinitely, and papa will probably be unable to speak and mom only understands about 40% of my simple sentences. I am presently trying to order supplements and things from the USA for papa's diet, which will be liquid initially. I am trying not to be too scared and hope in the end of all this Papa will be fine and speaking and eating normally. We are very very cautious about explaining too much to papa about the difficulty recovery surgery will likely bring. We are shielding him from people who openly talk of side effects and outcomes and instead focus him on just fighting. I will very possibly stay longer than originally planned, as I see great need here obviously. VIk's mom will need to be taken care of as she takes care of Papa, and she herself is still recovering from hernia surgery.