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#143545 12-02-2011 05:07 PM
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My Brother Chis finished up his second surgery yesterday with mixed results.

They re-entered the site above the vocal chords and made sure they had clear margins (swelling made them close early in the first surgery). They also removed the dysplasia in his mouth with clean margins. They also did a neck dissection and were happy with the visual look of the lymph nodes they removed (pathology to be in next week).

So at that point all was looking good. The surgeon was closing up when he noticed a small tendril along a nerve and sent that to the path lab. It showed up as cancer. Surgeon is now telling us Chris has a stringer that came from the original tumor that has grown down a nerve. Unfortunately this nerve wraps itself around the voice box.

While we wait for the opinion from the tumor board at MDA I thought I would ask the board if anyone is familiar with radiation to the voice box. We are worried that they may want to do a complete removal of the voice box. The doctor mentioned this as a possibility and eluded to the idea that radiating the voice box can have its own issues.
Any help here would be greatly appreciated


Kelly
Male
48, SCC (Soft Palet) Rt.,
Stage 1, T3n0m0,
Dx, 8-09, Start IMRT 35 9-2-09 end 10-21-09
04-20-10 NED
8-11 recurrence, node rt. neck N2b
10-11 33 IMRT w/chemo wkly
3-12-12 PET - residual cancer
4-12 5 treatments with Cyberknife & Erbitux
6-19-12 Pet scan CLEAR
12-3-12 PET - CLEAR
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Posts: 1,301
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Sorry I cannot be of any help Kelly and hope someone else can chime in re Chris.
You are both going through so much and I am wondering how you are doing too?


History Leukoplakia bx 8/2006 SCC floor mouth T3N0M0- Verrucous Carcinoma.
14 hour 0p SCC-Right ND/excision/marginal mandibulectomy 9/2006, 4 teeth removed, flap from wrist, trach-ng 6 days- no chemo/rad.
6 ops and debulking (flap/tongue join) + bx's 2006-2012.
bx Jan 2012 Hyperkeratosis-Epithelial Dysplasia
24cm GIST tumour removed 8/2013. Indefinite Oral Chemo.

1/31/16 passed away peacefully surrounded by family

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I think, what the doctor is telling you is, that radiation may cause fibrosis in the voice box so the outcome may be the same as complete removal. But I am not a doctor and MO is purely speculative.

Tumors like to grow tendrils to seek out blood sources. That's why the doctors will operate or irradiate to "clear margins".

Eileen had her voice box removed and is doing fine. She can enlighten you on that aspect of treatment should it become necessary.

Last edited by Gary; 12-03-2011 07:43 PM.

Gary Allsebrook
***********************************
Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
________________________________________________________
"You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
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Wish I could help but I would like o offer you my blessings and well wishes for both of you- hugs!


Cheryl : Irritation - 2004 BX: 6/2008 : Inflam. BX: 12/10, DX: 12/10 : SCC - LS tongue well dif. T2N1M0. 2/11 hemigloss + recon. : PND - 40 nodes - 39 clear. 3/11 - 5/11 IMRT 33 + cis x2, PEG 3/28/11 - 5/19/11 3 head, 2 chest scans - clear(fingers crossed) HPV-, No smoke, drink, or drugs, Vegan
Joined: Sep 2009
Posts: 618
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Gary,

Thanks for the input. I'll keep you posted after the tumor board chimes in with their recommendation. That should be soon.

Best,


Kelly
Male
48, SCC (Soft Palet) Rt.,
Stage 1, T3n0m0,
Dx, 8-09, Start IMRT 35 9-2-09 end 10-21-09
04-20-10 NED
8-11 recurrence, node rt. neck N2b
10-11 33 IMRT w/chemo wkly
3-12-12 PET - residual cancer
4-12 5 treatments with Cyberknife & Erbitux
6-19-12 Pet scan CLEAR
12-3-12 PET - CLEAR
Joined: Jul 2011
Posts: 131
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Posts: 131
My tumor was on my left true vocal cord. I got IMRT rads with 7 cisplatin doses over 7 weeks. For me, it definitely affected my voice but that seems to be getting better the more time goes on. But it got to the point where I could barely talk at all. I had swallowing issues with quite a bit of pain, also the swelling affected my airway to the point where I was in crisis at one point and needed emergency attention.

I was also told that if the chemorads didn't work I would be looking at a total laryngectomy. The bad thing is you lose your voice forever. The positives are that it rarely affects swallowing function and that particular surgery is very effective at achieving a cure. Technology has reached an amazing stage and electronic voice can offer a lot more than it used too. Do a youtube search for TruTone. They now offer devices that give you a full range of expressive tone AND hands free use.


Dx: 3/11 Stage III glottic laryngeal SCC HPV 16+ Tx Start: 7/18/11 chemoradiation 7wks - Tomotherapy IMRT x 34 / Cisplatin x 7 Tx End:9/1/11]-[as of 1/20/12 - ALL CLEAR!]


Joined: Sep 2009
Posts: 618
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Thanks Hank,
Chris is in today at MDA to have four molars removed and the dysplasia cut away. They are starting a full round of rads and low dose chemo after the first.
His doctor said they will be hitting the bottom side of the vocal chords which should diminish the damage to the voice but is closer to the area needed for swallowing. So 6 of this and a half dozen of the other.

We have our fingers crossed and I�ll update as time goes on.


Kelly
Male
48, SCC (Soft Palet) Rt.,
Stage 1, T3n0m0,
Dx, 8-09, Start IMRT 35 9-2-09 end 10-21-09
04-20-10 NED
8-11 recurrence, node rt. neck N2b
10-11 33 IMRT w/chemo wkly
3-12-12 PET - residual cancer
4-12 5 treatments with Cyberknife & Erbitux
6-19-12 Pet scan CLEAR
12-3-12 PET - CLEAR
Joined: Jul 2011
Posts: 131
Senior Member (100+ posts)
Offline
Senior Member (100+ posts)

Joined: Jul 2011
Posts: 131
All my love and hope and prayers for you guys. Ya'll will be in the front of my thoughts this Christmas and I will make sure to bring you guys up in our Christmas prayers.


Dx: 3/11 Stage III glottic laryngeal SCC HPV 16+ Tx Start: 7/18/11 chemoradiation 7wks - Tomotherapy IMRT x 34 / Cisplatin x 7 Tx End:9/1/11]-[as of 1/20/12 - ALL CLEAR!]


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Kelly, I'm thinking about both of you and sending good vibes. Seems to me that one of our most knowledgeable posters, Dr. I. Brook, had vocal cords/voice box removal surgery and is doing very well and still treating patients. I'm sure he wouldn't mind if you sent him a PM. He might be able to give you some good insight. Or if you do a search at the top for some of the key words you might find he's already contributed stuff that can help.

Please keep us posted on Chris's progress.


David 2
SCC of occult origin 1/09 (age 55)| Stage III TXN1M0 | HPV 16+, non-smoker, moderate drinker | Modified radical neck dissection 3/09 | 31 days IMRT finished 6/09 | Hit 15 years all clear in 6/24 | Radiation Fibrosis Syndrome kicked in a few years after treatment and has been progressing since | Prostate cancer diagnosis 10/18

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