| | Joined: Sep 2013 Posts: 6 Member | | Member
Joined: Sep 2013 Posts: 6 | Hi
my friend aged 52 has a small lesion in his tongue ( he does not drink and smoked for about two years, over 35 yrs back ).
The biopsy indicated 'infiltrating squamous cell carcinoma -moderately differentiated'. smear positive for malignant cells' . They did a CT scan and the results look normal except for this lesion and the report says
"Ill defining enhancing lesion along the right lateral border of anterior 2/3rd of tongue 2 *1.3cms. NO significant cervial adenopathy. The lesion infiltrates the genio-glossus muscle and there is no extension across the midline. The extent of the lesion could not be adequately evaluated due to dental artifacts. Prominent subcentimeter bilateral level IB, II and right level III nodes are seen, largest right level II node measures 1.1*0.7 cms.'.
He is due for a surgery in a week.
They said the lesion will be removed and that should be it.
What is to be expected? The entire family is in panic.
They say his speech and eating should not affect.
How soon can he start eating? I hear people can get back to work in 2 weeks or a week. Is that right?
Does anything in the above report look bad?
A million questions in mind. Any positive feedback will be a great moral support.
Good luck to all of you that are brave and some day hope this gets eradicated completely too.
Prayers
CTS
Last edited by Cts; 09-02-2013 04:52 PM.
| | | | | Joined: Jun 2013 Posts: 262 Gold Member (200+ posts) | | Gold Member (200+ posts)
Joined: Jun 2013 Posts: 262 | Hi there CTS and welcome to OCF. I'm too new to offer any wisdom for your friend, but hope he/she will get at least two opinions from large academic hospitals with dedicated head & neck cancer teams. There are many controversies in HNC treatment right now and it's worth it to seek out viewpoints from different teams.
The report seems to suggest prominent nodes, those can be an indication of spread that should be investigated.
Best,
Mama
53
T3N2aM0 HPV+
5/26/13 discovered painless superball-sized lymph node in neck
6/26/13 DX SCC R palatine tonsil
7/16/13 TORS tonsillectomy & selective ND, mets to 2 nodes
9/3/13 Cisplatin and rads begin, tolerated 1.5 of 3 planned chemo doses
10/16/13 Treatment ends
Dec 13 Ulcer appears at surgery site
Jan 17 Biopsy -- no cancer!
Feb 17 CT/PET Scan lights up tonsil bed & nasal cavity, docs say probably inflammation, don't panic, rescan when ulcer subsides
| | | | | Joined: Sep 2013 Posts: 6 Member | | Member
Joined: Sep 2013 Posts: 6 | Thank you.This is in India. They have gone to the best hospital there. There is going to be a cut like a T to remove some of the nodes to make sure everything is alright said the Drs.
As soon as the biopsy results were seen they suggest removal of the lesion - referred to couple of Drs.
Could the nodes be results of the dental artifacts? he had couple of root canals done. Dr suggested it could be due to that as well.
Everything should be all right, right? | | | | | Joined: Jun 2013 Posts: 262 Gold Member (200+ posts) | | Gold Member (200+ posts)
Joined: Jun 2013 Posts: 262 | The snip you posted said the extent of the lesion couldn't be determined due to dental artifacts. Metal fillings and crowns "scatter" the scan image, making it hard to see detail. That may have been what was meant.
Many people on this forum have faced similar illness and come out swinging --
53
T3N2aM0 HPV+
5/26/13 discovered painless superball-sized lymph node in neck
6/26/13 DX SCC R palatine tonsil
7/16/13 TORS tonsillectomy & selective ND, mets to 2 nodes
9/3/13 Cisplatin and rads begin, tolerated 1.5 of 3 planned chemo doses
10/16/13 Treatment ends
Dec 13 Ulcer appears at surgery site
Jan 17 Biopsy -- no cancer!
Feb 17 CT/PET Scan lights up tonsil bed & nasal cavity, docs say probably inflammation, don't panic, rescan when ulcer subsides
| | | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | | Senior Patient Advocate Patient Advocate (old timer, 2000 posts)
Joined: Sep 2006 Posts: 8,311 | If there is nodal involvement then removing the lesion alone will not be the end of his Tx.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | | Joined: Dec 2010 Posts: 5,264 Likes: 5 "OCF Canuck" Patient Advocate (old timer, 2000 posts) | | "OCF Canuck" Patient Advocate (old timer, 2000 posts)
Joined: Dec 2010 Posts: 5,264 Likes: 5 | Hi david is right. It sounds fairly large. This being the case - ideally the treatment is surgery, including a neck dissection where a minimum of 28 nodes are removed - ideally more. If he comes back with clear margins, on the tumor, and clean nodes that could be the end but he should be closely monitored for several years. If there is anything like perineural involvement (which is possible based on the size and description of the tumor/lesion) or any kind of nodal involvement then they should radiate and possibly do chemo. microscopic cancer could easily be living in the nodes but cannot be detected on a scan because it is so small.
best of luck to your friend.
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 2013 Posts: 6 Member | | Member
Joined: Sep 2013 Posts: 6 | Thanks Cheryl & David. I wish this is the end of this problem. They did the surgery removed the lesion and nodes have been removed. He is in hospital now. Able to walk . The incision is upper neck closer to cheek/chin line.feels pain in throat. is this normal? he could drink water in spoon (very little). still in IV - just a day since the surgery. has NG tube but feeding hasnt started. Please include him in your prayers as well. Thank you for the wishes and prayers. Means a lot.
Hoping the pathology report comes all clear and normal.
Thanks | | | | | Joined: Dec 2010 Posts: 5,264 Likes: 5 "OCF Canuck" Patient Advocate (old timer, 2000 posts) | | "OCF Canuck" Patient Advocate (old timer, 2000 posts)
Joined: Dec 2010 Posts: 5,264 Likes: 5 | This is all very normal worry not!!!  glad the surgery went well - here's hoping for a good pathology report!
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 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | | Senior Patient Advocate Patient Advocate (old timer, 2000 posts)
Joined: Sep 2006 Posts: 8,311 |
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | | Joined: Jun 2007 Posts: 10,507 Likes: 8 Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) | | Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts)
Joined: Jun 2007 Posts: 10,507 Likes: 8 | Recovery can take several weeks for most surgeries like what you described. Sounds like your friend is doing pretty good if they have him up walking the halls only the day after the surgery.
Best wishes for a speedy recovery!
ChristineSCC 6/15/07 L chk & by L molar both Stag I, age44 2x cispltn-35 IMRT end 9/27/07 -65 lbs in 2 mo, no caregvr Clear PET 1/08 4/4/08 recur L chk Stag I surg 4/16/08 clr marg 215 HBO dives 3/09 teeth out, trismus 7/2/09 recur, Stg IV 8/24/09 trach, ND, mandiblctmy 3wks medicly inducd coma 2 mo xtended hospital stay, ICU & burn unit PICC line IV antibx 8 mo 10/4/10, 2/14/11 reconst surg OC 3x in 3 years very happy to be alive | | | | | Joined: Sep 2013 Posts: 6 Member | | Member
Joined: Sep 2013 Posts: 6 | Thank you all. He has throat pain, and numbness below ear and neck near the stitch areas. he can talk but unable to open his mouth normal. There is a cut in cheek too that got pus.
His IV area is swollen and the nurse tried the other hand with no luck. Starting to feel the pain i guess and depression and fear sinking in. This is all so sudden until last weekend, it was normal life going to work coming home to a loving family & now in bed with all this pain is making him anxious.
Any tips to turn the anxiety and or how to cope up? Make him listen to something or talk about something or what will help? Any suggestions please?
Thanks for all your kind words | | | | | Joined: Apr 2013 Posts: 319 Likes: 1 Platinum Member (300+ posts) | | Platinum Member (300+ posts)
Joined: Apr 2013 Posts: 319 Likes: 1 | Since he is in India, I would suggest that he have a chat about his anxiety with a Buddhist monk.
And while you probably know this, I mention it for the benefit of others on this board as well.
Buddhism is not about religion, it's about precisely your friend's problem, i.e., how to calm the mind and eliminate fear and anxiety.
Johns Hopkins is running a program to deal with that also, but that is of little use to your friend in India
My intro: http://oralcancersupport.org/forums/ubbt...3644#Post16364409/09 - Dx OC Stg IV 10/09 - Chemo/3 Cisplatin, 40 rad 11/09 - PET CLEAN 07/11 - Dx Stage IV C. (Liver) 06/12 - PET CLEAN 09/12 - PET Dist Met (Liver) 04/13 - PET CLEAN 06/13 - PET Dist Met (Liver + 1 lymph node) 10/13 - PET - Xeloda ineffective 11/13 - Liver packed w/ SIRI-Spheres 02/14 - PET - Siri-Spheres effective, 4cm tumor in lymph-node 03/15 - Begin 15 Rads 03/24 - Final Rad! Woot! 7/27/14 Bart passed away. RIP!
| | | | | Joined: May 2011 Posts: 287 Gold Member (200+ posts) | | Gold Member (200+ posts)
Joined: May 2011 Posts: 287 | Hi CTS, your friend is fortunate to have you for his support. It will take around 7-10 days to recover from surgery and in the meantime, your friend will get reports which will tell whether the margins were clear and how's the lymph nodes that were extracted.
Depending on the result, oncologist will decide on further course of treatment. If things are good, your friend may need few monthly follow-ups and then every quarter. If not, he may have to go concurrent chemo-radiation. Tell your friend to be brave - will to win this disease is what helps the most.
Father; 67 yrs; RIP: 2012/05/26
TX:SCC pT2N1M0G2;Glossectomy+SND+CCRT(59.3Gy+6xCis.)[2009]
TX:Nodal Mets; 3xDCF[2011/05/05]
TX: RND + PMMC Flap[2011/07/11]
DX:SCC PNI+ECE
TX:Re-RT 60Gy[2011/09/21]
TX:Gefitinib 250mg[2011/12/18]
| | | | | Joined: Sep 2013 Posts: 6 Member | | Member
Joined: Sep 2013 Posts: 6 | Thanks again for the kind words. The Dr sat with him for a bit today and that helped him gain some confidence.
He feels a lot of irritation(pain) when he tries to swallow liquid ( not too much just little bits using straws ). Is this normal? Wishing Praying and Hoping results are good.
I appreciate your kind words. Means a LOT.
| | | | | Joined: Jun 2013 Posts: 262 Gold Member (200+ posts) | | Gold Member (200+ posts)
Joined: Jun 2013 Posts: 262 | Hi CTS, everyone is different. It helps some to be in touch with reminders of loved ones, places and times w/pics nearby and mementoes. It helps me more than I would have guessed to stay in touch with my "pre-cancer" self.
53
T3N2aM0 HPV+
5/26/13 discovered painless superball-sized lymph node in neck
6/26/13 DX SCC R palatine tonsil
7/16/13 TORS tonsillectomy & selective ND, mets to 2 nodes
9/3/13 Cisplatin and rads begin, tolerated 1.5 of 3 planned chemo doses
10/16/13 Treatment ends
Dec 13 Ulcer appears at surgery site
Jan 17 Biopsy -- no cancer!
Feb 17 CT/PET Scan lights up tonsil bed & nasal cavity, docs say probably inflammation, don't panic, rescan when ulcer subsides
| | | | | Joined: Sep 2013 Posts: 6 Member | | Member
Joined: Sep 2013 Posts: 6 | Hi - he is having burning sensation in mouth that he is unable to bear with. it seems to have worsened today and he is unable to bear it. Is this normal? Any ideas? Some injection helps him for 1 - 1.5 hrs. then it starts again. he is unable to bear it.
Has NG and tries to take through straw as well. Burning sensation is too much... | | | | | Joined: Dec 2010 Posts: 5,264 Likes: 5 "OCF Canuck" Patient Advocate (old timer, 2000 posts) | | "OCF Canuck" Patient Advocate (old timer, 2000 posts)
Joined: Dec 2010 Posts: 5,264 Likes: 5 | He can ask for pain medication. Also pus???!! That's an infection. He'll likely need antibiotics. Best of luck.
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: May 2011 Posts: 287 Gold Member (200+ posts) | | Gold Member (200+ posts)
Joined: May 2011 Posts: 287 | Burning sensation could be due to Thrush. Kindly ask doctor to inspect and give antibiotic to get rid it of it.
Father; 67 yrs; RIP: 2012/05/26
TX:SCC pT2N1M0G2;Glossectomy+SND+CCRT(59.3Gy+6xCis.)[2009]
TX:Nodal Mets; 3xDCF[2011/05/05]
TX: RND + PMMC Flap[2011/07/11]
DX:SCC PNI+ECE
TX:Re-RT 60Gy[2011/09/21]
TX:Gefitinib 250mg[2011/12/18]
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