First..Rita (so glad to have a name!) and Marieka, I am warmed to see you girls helping each other through this. This forum is so wonderful in how it brings us all together and helps us to find those who can answer our questions.

Rita..I, fortunately, cannot answer your questions about radiation, since I was fortunate enough not to have had it recommended for me. I CAN tell you, however, what my surgeon said.

Remember that each case is different, and each doctor has different philosophies about treatment.

There is a U.S. Gov't. protocol that gives a general recommended standard of care. You can access it from the OCF site, but I can't right now tell you how to do it.

Can someone else give us some help here?

ANyway....back to my case. If I am understanding you correctly, my surgery involved a significantly larger area than yours. I have no idea how long your lesion has been present. Mine had been overlooked by my dentist, so it had been there at least 8 months before being diagnosed.

I have told you that my surgeon, who is a guru in this field, lecturing all over the world, said that this is one of the best areas for being able to get all of the tumor in the surgery, if wide enough margins are taken. At the time of surgery, he said that he was "going for a cure, because he didn't want to see it come back." and he said also that because of the length of time that the lesion had been in my mouth, he felt it would be prudent to do a neck dissection, even though nothing lit up on the PET/CT.

I lost the bone containing the back five teeth, and part of the hard palate adjacent, since the tumor had spread to the flat palate.

My margins were clear, and my neck dissection was totally negative, and the pathology showed "undifferentiated to moderately undifferentiated" tumor cells.

Based on this good report, he said that radiation wouldn't be necessary. (and you can see on the protocol that it is not generally recommended for cases like mine.) I begged for it, not knowing anything about it, except that I wanted to do everything I could to make this stuff gone. He said that radiation had problems of its own, as I know now, and that though he would be surprised if the cancer came back, if it did, we'd have saved a weapon to use at that time.

It's something of a Catch-22, it seems to me....whether to hit it with everything you've got and possibly suffer the consequences of radiation damage unnecessarily or to wait and possibly have a recurrence because not all of the microscopic cells were killed. Now that it seems that he might have been right (at 2 1/2 years, I am feeling a little more relaxed, though I don't want to relax too much.)

From what I have read here, and I will have to let others reply to the questions about radiation, it seems that the beam has been refined to the point where it affects a narrowly specific area.

My suggestion: I know that you are concerned about this possibility, but your surgeon won't know what he is going to recommend until after surgery, and after waiting about a week for pathology reports on the bone. (It takes longer to do the studies on bone, since it has to go through a process to de-calcify it, I think.)

Don't expend emotional energy worrying about something that you well might not need to worry about. If he does recommend radiation, you'll have time then to get all the information you need right here on this forum. I would recommend then that you start another thread, with a very clear question in the subject line, so your query won't get lost in this thread.

Ask anything that you wish. I didn't have time to ask a single question before my surgery.......the most amazing rush job in the history of OC surgery, I think. I discovered my tumor on Dec. 20, 2005. On Dec. 21, I saw my dentist, a prosthodontist, and an oral surgeon, who took an excisional biopsy. I got the results back on Dec. 27, and I had a PET/CT on Dec. 29. I had an appointment with my chosen surgeon on Jan. 3, and they had an opening for surgery the next day, and they suggested that I take it, so my surgery was on Wednesday, Jan. 4, 2006, two weeks from the time I first noticed the problem!!

There are plusses and minuses to not having time to prepare, but the bottom line is that I knew absolutely nothing, and I suffered for that lack of knowledge. I am determined to keep anybody else from suffering in that same way.

Sooooo ....ask away. Each case is different, and I can't predict exactly how yours will go, but I imagine that I can shed some useful light on the process for you.

XO--Colleen