Hi there,

Today we had a big meeting with all of the doctors (radiation oncologist, surgeon, oncologist, nurse practitioner, infusion nurse, etc.) to determine whether the cancer had responded well enough to the treatment to be operable. They took two scans today of his neck, and based on those scans and feeling his neck, they are going to be able to do the surgery! Tentatively, it is scheduled for April 7th. It will be another radical neck dissection, which means they will take out all of the nodes in the left side of his neck, and because his large tumor had been wrapped around his jugular vein, they will also be taking that out. This surgery carries some risk; the jugular vein on the right side of his neck was removed last year, and removal of both can lead to blindness or brain swelling, although they think the risk for him is low given his surgery was over a year ago and his body has compensated by now. They will put him in the ICU immediately after surgery though just to be safe, so that they can watch his brain.

They are going to finish up the chemo and radiation on Friday, but are going to give him the Erbitux all the way until surgery. What happens after surgery depends on whether they find any live cancer cells in there - possibly more radiation and/or chemo.

The doctors are thrilled with how this has responded to treatment. There was some fear in the beginning it would not be operable even after treatment, so this really is wonderful news. There is at least one other cancerous node (up under his chin) that they can see on the scans, but they will be taking that out in the surgery. The doctors are particularly thrilled with Joe's reaction to Erbitux -- his rash is TERRIBLE and the poor guy looks like hell but that is supposedly a really good sign (also - the tumor immediately started shrinking when he had Erbitux, even before chemo and radiation started) and he is handling it like a trouper.

Thank you all for your continued thoughts and support!