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ALZ #149690 05-18-2012 07:37 AM
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"OCF Canuck"
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Hey Alz how are you doing?


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
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glocita Offline OP
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Hi Everyone,

Just wanted to update y'all that my surgery was as perfect as could be! My margins were all over 1cm, my tumor was only 1.0cm in size (where they thought it was 2.5cm) and it did not spread to my lymph nodes! yay!

However, the lab reported that I have perineural nerve invasion. Has alone else had this? I heard its not as serious as if it had spread to my lymph nodes, but I am still worried.

Thanks much!


T2N0M0
26 at diagnosis. Non smoker, social drinker, HPV -
Surgery May 15, 2012: Left Partial Gloss + 48 nodes removed, not 1 cancerous! Perineural Nerve Invasion. IMRT x34. Staying positive!
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Hello Glocita!

Thanks for the update, looks great really! I had PNI and am still here to annoy everyone so take a little comfort in that.

Keep your chin up,

Eric


Young Frack, SCC T4N2M0, Cisplatin,35+ rads,ND, RT Mandiblectomy w fibular free flap, facial paralysis, "He who has a "why" to live can bear with almost any "how"." -Nietzche "WARNING" PG-13 due to Sarcasm & WAY too much attitude, interact at your own risk.
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glocita

I was really worried also three years ago when my pathology report said PNI and I'm still here also. Plus my cancer the first time had spread to two lymph nodes and my margins at surgery were not clear and my tumor was larger, so you are looking good. Yes, it would be better if there were no PNI but this is a good question to ask your doctor/surgeon/oncologist:
So what does this PNI mean in my case? Increased risk of recurrence. More radiation or chemo? Nothing considering clear margins and zero lymph node involvement. Most likely the last one but wouldn't you feel better hearing it from your doctor? Just a suggestion
Charm


65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13
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glocita Offline OP
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Thanks guys! My doctor said I could do nothing and we monitor it very closely, but she recommends radiation - and on a lower dose.

So I will be going for radiation. I honestly am not scared about the treatments - I just want this nightmare over!

Charm - where did you go for your treatments? We're neighbors! I was treated up in Baltimore at Hopkins which I love, but is it worth it to drive that far every day for radiation? My surgeon said I didn't have to go to Hopkins, & gave me the name of another person at Suburban. I just want to make sure Im getting the best care possible. I want to be around like you guys!

Gloria


T2N0M0
26 at diagnosis. Non smoker, social drinker, HPV -
Surgery May 15, 2012: Left Partial Gloss + 48 nodes removed, not 1 cancerous! Perineural Nerve Invasion. IMRT x34. Staying positive!
Joined: Aug 2011
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I am SO happy to hear of your successful surgery, Gloria! Go ahead and knock this cancer out right the first time and get that radiation. You will likely be around for many years to come! Congratulations and thanks for keeping up posted. Best of luck with your recovery and continued treatment!

xo,
Kerri


37 y/o fem at Dx (23 wks preg @ dx on 3/16/11)
SCC L oral tongue (no risk factors)
L partial gloss/MND 3/28/11 @ 25 wks preg
T1-2N0M0; no rads/chemo
Tonsillectomy on 8/6/12 +SCC L tonsil T2-3N1M0 (HPV-)
Treated with 35 rads/7 carbo & taxol (Rx ended 10/31/12), but many hospitalizations d/t complications from rx.
Various scans since rx ended are NED!
Part of genetic study for rare cancers @ MGH.
44 years old now...I wasn't sure I would make it! Hoping for 40 more!
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"OCF Canuck"
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Hi glockenspiel..l glad you are doing well... PNI actually does have an impact - radiation is a good suggestion my surgeon said the same thing. PNI was one of the reasons he recommended it. The reasoning behind it is cancer moves along the path of lease resistance - in this case the nerves. Radiation is not easy but you'll get through it. smile 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
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Glocita

Your doctor's advice is similar to what I was told. Since my facts were somewhat worse, I had a second round of both radiation and chemo for the PNI.
I had considered John Hopkins but I trusted my ENT surgeon's recommendations of Georgetown University Hospital's Lombardi Cancer Center which is a comprehensive Cancer Center (CCC). I had Dr. K. William Harter do all my radiation including the cyberknife extra radiation when my pathology report came back with PNI. Here is a bitsy link to his page with info
Dr Harter
The commute on a daily basis to Baltimore for radiation would not have worked for me as I could barely contain the nausea on the trips to Georgetown plus I would have driven my wife crazy with my comments on how she does not drive like a maniac like I do. (Brian Hill can vouch for the fact that I put even cabdrivers to shame)
The parking situation at Georgetown is horrible, I will warn you in advance. I know some others in this area went to Inova but I wanted a CCC like John Hopkins or Georgetown
Charm


65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13
Joined: May 2006
Posts: 720
Likes: 1
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Gloria --

In making your decision about where to go for radiation, you might want to take a look at this blog by Mike S., who had his surgery at Hopkins and his radiation at Inova's TomoTherapy center in Fairfax (he was referred to Inova by his surgeon at Hopkins). (See his posts for August 2006; start at the bottom.) Just passing it on since Charm mentioned Inova.


Leslie

April 2006: Husband dx by dentist with leukoplakia on tongue. Oral surgeon's biopsy 4/28/06: Moderate dysplasia; pathology report warned of possible "skip effect." ENT's excisional biopsy (got it all) 5/31/06: SCC in situ/small bit superficially invasive. Early detection saves lives.
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glocita Offline OP
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Fantastic blog! Thank you Leslie -how did you even know about that??


T2N0M0
26 at diagnosis. Non smoker, social drinker, HPV -
Surgery May 15, 2012: Left Partial Gloss + 48 nodes removed, not 1 cancerous! Perineural Nerve Invasion. IMRT x34. Staying positive!
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