Hello Friends,

Greetings From Gayatri!!!

A few months ago my father was diagnosed with Ca RT AEfold
Stage : T2 No Mo
Surgeon & Oncologist Doctors was recommended Radiation Therapy for 1 & 1/2 months, he had gone through Radiation for 5960 Doses. While treatment he did smoking once & after finishing also he did thrice. As per doctors he responded very nicely & Oncologist suggested to routine check up every 6 weeks & after completion of three month should do CT Scan. now after 55 days completion of radiation treatment he had a pain & swelling in left side, when we show the surgeon he said its coz of radiation but stiil suggested CT Scan, & we did CT Scan.Now we visited Oncologist for routine check up after 6 weeks, & we show the CT Scan Report also ,he examined & said its perfectly alright there is no any doubts whatever are there its just of Radiation side effects. BUT when we show the report to Surgeon he had got doubt & suggested to do Endoscopy. Again i discussed with Oncologist & he added that we never give advise to do anything before 3 months coz that part become very sensitive due to radiation. Still he discuss with surgeon & requested that do only Endoscopy Not Bio pacy.
Hence My question have arises coz of different opinions of both doctors.

Doctor can we go for Endoscopy in this short of period ? & if so then how can judgment will be so perfect without Biopacy ?

Now i am writing the conclusion of Ct Scan Report as below.

Conclusion :
K/C/O Ca right arryepiglottic fold,Post RT Status.

** A 1.88*0.98 cm size heterogenous moderate enhancing soft tissue area seen in mylohyoid muscle involving the right vallecula epiglottica and right side of epiglottis possibility of residual mass lesion /? Post radiotherapy fibrosis.

** A 0.85*0.78 cm size enlarge necrotic lymphnode in medial aspect of pterygoid muscle on right side at

If anybody have same experience as like me kindly share or advice what to do ?

Thanks & Regards

Welcome to OCF, Soofy.

You will find info and support to help you learn and understand about oral cancer. Sorry, I am a bit unsure of exactly where your fathers cancer was located from your description. Things can be done differently in different countries too. It would be wonderful if there was a worldwide standard of care for all cancer patients.

Here at OCF we are made up of survivors and caregivers, not medical professionals. Second guessing what your doctors do is not something we can assist you with. We do try but we lack many years of medical training, having the patient in front of us and their full medical chart to read. Not that seeing a patient or having their life long medical history would help us to give an opinion. We do however have our own experiences plus all the info we have learned from being around the forum to help us to give you some sound advice.

First thing I would suggest is that your father quits smoking forever. There are many chemicals added to tobacco that are known to cause cancer. If a person continues to smoke after having cancer, the body will not heal as easily and also it will push the recurrence odds up much higher. No patient should use any tobacco products after having cancer, its like a time bomb in only a matter of time before something serious will happen.

If the physician is experienced in treating oral cancer they can visually see if something doesnt look right by doing the scope. Only if there is an area of concern would they have something to biopsy. Scans should be done only after waiting 3 months to give the body time to heal and for any swelling to go down. The mass could be scar tissue or inflammation, not just cancerous. My doc explained to me that the CT scan takes slides in such tiny sections that its not possible to see very much below 2 cm which is the size of a grain of rice. I would expect your fathers doctors will need to follow up with more testing to find out exactly what they are looking at.

I hope this turns out to be only inflammation and nothing serious! Best wishes!

Hi Christine

Many Thanks for your quick reply.

I am from India, and my Father is having In Rt side of Throat at Vocal Cord. And he had taken radiation 5960 dose for 1 & 1/2 months. & after 6 weeks doctor suggested to do CT SCAN & their this doubt has occurred.

I hope your hope will be come true for my father

Thanks again

Regards.

Hi Gayathri,

Sorry you had to be here. Your father has Laryngeal cancer and smoking is the most important risk factor. As Christine mentioned, your father must quit smoking and I wonder after going through 60Gy radiation, he still has courage to continue smoking! Go through this link for more understanding: http://www.cancer.gov/cancertopics/pdq/treatment/laryngeal/Patient

Anyways, CT scan after 1.5 months is not very conclusive as body needs some time to heal and the hotspots may be immflamation from radiation. Endoscopy will also be too inconclusive if something suspicious comes up and would require biopsy.

Are your surgeon and radition oncologist from two different hospitals? My honest suggestion here is while you are undergoing treatment, you should not go second opinions, especially in India. Better to have it before.

As your radiation oncologist suggested, it is not in practise here for any surgical intervention before completion of 3 months of radiotherapy as healing is difficult.

Discuss out with your oncologist any other choices you have including ultrasound-guided-FNAC of the necrotic lymphnode.

Wish you and your father good luck.

Hello Eshwar And Christine,

Thanks a lot for your message. After passing 4 months of radiation,my father has been gone through Endoscopy & again CT Scan. Doctors not found any suspicious symptoms. He said post radiation symptoms only. But we must have have to go for check up every 15 days 4 next 1/2 months, and then every 3 & 6 months.

My father totally quitted smoking.But right now big problem is that he is having too much pain, too much weakness & roaming swelling, which is sometimes increase & decrease too..After & during radiation he was not having this much pain. But after 1 & 1/2 month of radiation pain was started.

And now after endoscopy pain has increase more..he used to take 3-4 times pain killer which is DICLOPARA medicine, and sometime ICPARIL. i just need to know that is it normal to having pain after 4 months of radiation ? & also after endoscopy ?

And Mr Eshwar you are right we can't trust on some hospital in India But i must say that this ,The Gujarat Cancer & Research Institute (M.P. Shah Cancer Hospital) & The Gujarat Cancer Society, Ahmedabad is the best hospital in India & Asia as well.. if we go in private hospital they only wash our pockets but here not like that... Best Doctors are here & success ratio is more more than other hospitals...

you know after experienced of my father's treatment i suggest every Indian who is unluckily suffering from Cancer, they must take treatment here only whether they are rich or poor.

But just as a daughter i concern about his pain, weakness & swelling. if u people have any knowledge or experience kindly share..

Thanks & Regards.

Good Luck.

Gayatri.

Gayatri, yes it can be normal for the patient to be in pain for months after finishing treatments. He has been thru alot and it will take time to heal.

A high protein diet can help speed the healing. Even though he has finished his treatments, for at least the first year his nutrition and hydration still need to be much higher than an average person. His body is trying to rebuild itself and will need extra fuel. I suggest daily getting a minimum of at least 2500 calories and 48 oz water, plus the high protein added. Here in the US there is high protein whey powder that easily dissolves in water or any other liquid without changing the taste.

Im very glad to hear your father has given up smoking! That will help to ensure no further damage is done by tobacco.

Best wishes with your fathers continued recovery!

Hi Christine,

Thxs a lot for your quick response & also suggestion for diet..

God Bless U always

Good Luck

Thanks & Regards.


Gayatri..

Glad I was able to help! Best wishes with everything!

Gayatri, good to hear from you after a long time and that too with good news. Finally, your dad quit smoking and is on way to recovery. Post-radiation healing takes long time and depends from patient to patient; for some it may take anywhere to an year to become normal and pain-free.

You need to pay special attention to his diet as Christine had mentioned, increase protein intake. Go for Dals (Pulses/legumes). Egg whites are also good options. Discuss with doctor for some Protein supplements. Ask your father to drink as much of water as he can, it may be difficult as water also tastes different after radiotherapy. Try coconut water, it has cooling effect - you may have to filter it using tea strainer.

Thanks a lot Eshwar for your response...

God Bless u always...

Regards..

Gayatri Jat

Hello

Thanks to all members for inspiration and exchanging experiencing who help to make a cancer patient strong.. I have some question if you can give reply with your experience i ll be very thankful to you. As i stated before in my post. My father at age 74 ,was having EARLIER right side throat cancer before a year. He survived from it by radiation therapy, after 6 months of treatment again in PET scan recurrence of tongue cancer, doctors prescribed oral chemo therapy.. coz as per Doctors at this age other chemo & operation are not possible. After 1 month taking medicine cancer was totally disappeared, as per radiation oncologist , he was also surprised , he said his response is very good... But from last 15 days he is having pain in left side he used to take 4 pain killer in a day still he can not make it out...Now when we show the surgical oncologist he said its not gone, its just stop and it roaming around everywhere..!! As per Doctors recurrence is always danger. We are very much on worry...taking 4-5 Dyclopara also effec kidney in future... Even he is not able to drink water, when he eats something or drinks anything he gets IRRITATION & COUGH what is exact ? We can't understand ,is it after radiation pain ? anybody is having experience after finishing only radiation of almost one year,still having a pain too much..??

In this end of the September doctor sugaregested to do CT/PET Scan, but right now situation has showing difficult..!whats your experience says ?

Regards !

Gayatri..

Oral chemo doesn't normally kill head and neck cancer. If your father is in good health surgery is an option, normally.
I'm not quite sure what is going on with him. Based on your description, it sounds like he had a recurrence (which this close to radiation sounds more like they never got it all to begin with) I would be very surprised if the chemo killed it (maybe the dr missed seeing the tumor?) did they do just a PET and determine the cancer was back and treat him with the oral chemo? Or did they actually biopsy the area? It could be if they didn't do a biopsy that it wasn't even cancer.... And that is why the chemo worked. Now it may be... Have they confirmed that this free roaming cancer is really cancer?
Are you at a top medical facility?
Best of luck

It's not uncommon for cancer to return, minus HPV related, due to field cancerization in tobacco, carcinogen related cancer, and could be metachrounous or synchronous cancer too, and one could even being chemo and radio resistant due to other factors. I had roaming cancer, and had surgery to remove tumors in level III, V last year, had surgery, and in less than a month cancer went into epidermal layer of the skin in level V, and needed further surgery, high dose radiation during surgery, pec flap, and more chemo and radiation. As Cheryl mentioned, chemo alone usually does not kill cancer, if it does, it usually returns, and happened to me at 8 months due to not being able to have further curative treatment at that time due to illness, but did resume radiation treatment after a year from my original chemo induction.

The throat irritation, coughing, can happen after radiation, and I still have it two years later, but speak with the doctors to see if it is caused by a tumor.

Good luck with everything.

Thxs Cheryld & PaulB for your quick response

As per Doctors , they said my father age factor is the main reason to not do surgery and other chemo...At age of 74 it is very tough to tolerate.They didn't do biopcy, only did PET & start Oral Chemo, they said it will not remove cancer but it can be stop, if patient's body response is well. They strictly said v can't do surgery at this stage.yes here doctors are extremely well qualified & experienced. But still i have doubts that many people have recurrence but still they survived very well ,even at old age...Now this end of this month again PET ll do...lets see what ll come out...

I hope for best...

Thxs Guys

Good Luck