| Joined: Nov 2015 Posts: 16 Member | OP Member Joined: Nov 2015 Posts: 16 | In about 10 days, we're talking with a team of oncologists. Radiation and Chemo.
We've been there before. 35 Radiation Sessions in 2011, which were sadly debilitating. We've dealt with local doctors and hospitals until this latest relapse - when we were referred to a major teaching hospital in Chicago. After the first hemiglossectomy, our local radiation oncologist told us hubby had already had a lifetime dose and was not a candidate for more. The local chemo guy told us this was not a cancer that would respond to chemo, so that was out as well.
Now, at the new hospital and with the new doctors, and following the 2nd hemiglossectomy (done there) - they want us to meet with their oncologists to "make some decisions". I will say, these new doctors are a world above what was available locally - the latest technology and the best trained doctors and nurses.
But we're frightened and don't understand. Are we to brace ourselves for having to choose how to die? From the cancer or from over-radiation? Good grief, it's hard to put this into words. But I've found this group now, and am forcing myself to reach out.
How on earth do you all deal with the fear of the unknown? Or are we blowing this all out of proportion?
Donna Caring for Hubby: Age 73
Radiation, Hard Palate: October, November, December, 2011 Hemiglossectomy (side of tongue): December, 2014 2nd Hemiglossectomy (base of tongue): November 2015
| | | | Joined: Nov 2006 Posts: 2,671 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Nov 2006 Posts: 2,671 | Anytime we deal with the "unknown", it's very easy to think of the worst that can happen - but even the term "unknown" suggests that it could also mean something good. The good I see here is that you have a team approach which means several doctors get together and decide the best approach for the patient. There have been so many advances that can make a big difference in the getting the best care for your husband. Does your hospital have a website? You can find out lots of stuff there about all the doctors, what their experience is, their research and where they received their education. Which hospital are you with? (In case someone else here has had an experience there) So have your questions ready (yours and your husband's) and bring a notepad to write down what the oncology team has to tell you. . . . if you don't understand something, be sure and say so or ask why. It's only 10 days away so try to keep busy. And find some moments to smile with your husband.
Anne-Marie CG to son, Paul (age 33, non-smoker) SCC Stage 2, Surgery 9/21/06, 1/6 tongue Rt.side removed, +48 lymph nodes neck. IMRTx28 completed 12/19/06. CT scan 7/8/10 Cancer-free! ("spot" on lung from scar tissue related to Pneumonia.)
| | | | Joined: Oct 2012 Posts: 1,275 Likes: 7 Assistant Admin Patient Advocate (1000+ posts) | Assistant Admin Patient Advocate (1000+ posts) Joined: Oct 2012 Posts: 1,275 Likes: 7 | My husband had the initial 70 grays of radiation which is the lifetime maximum for the area that was irradiated. Since then he has had two more rounds of radiation, 20 grays each round, on some swollen nodes. So, it depends. Although as our RO told us, there will come a point when John cannot have more radiation without damage to the spine.
My husband has also had Cisplatin, Taxol and Carboplatin, Capcitabine and two clinical trials. So, I think, again it depends, your husband may be able to have some chemo -- maybe not for curative purposes but to keep him stable.
If you are going to a teaching hospital, maybe what you will be asked to consider is whether your husband will participate in clinical trials?
We have decided that we will take this a day at a time. That is the only way to deal with a recurrent cancer.
Gloria She stood in the storm, and when the wind did not blow her way, she adjusted her sails... Elizabeth Edwards
Wife to John,dx 10/2012, BOT, HPV+, T3N2MO, RAD 70 gy,Cisplatinx2 , PEG in Dec 6, 2012, dx dvt in both legs after second chemo session, Apr 03/13 NED, July 2013 met to lungs, Phase 1 immunotherapy trial Jan 18/14 to July/14. Taxol/carboplatin July/14. Esophagus re-opened Oct 14. PEG out April 8, 2015. Phase 2 trial of Selinexor April to July 2015. At peace Jan 15, 2016. | | | | Joined: Jun 2007 Posts: 10,507 Likes: 7 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: 7 | You are being very smart to reach out and ask questions. Im glad to see you have changed to one of the major hospitals (sounds like its a CCC). There have been several members who have had radiation more than once. I even know a few who went thru it 3 times. This is all on a case by case basis with many variables. Usually the 2nd or 3rd rounds of rads its a lesser quantity so its slightly easier to get thru. Plus being experienced with this you already know the pitfalls and what to expect. If doing rads again, focus on what is within your control... intake. By pushing every single day to take in at least 2500 calories and 48-64 oz of water daily it will help minimize the awful side effects. Lean on us and we will do our very best to steer you in the right direction. You are part of our online family  Hang in there! 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: Nov 2015 Posts: 16 Member | OP Member Joined: Nov 2015 Posts: 16 | I'm so glad I posted here about our fears. Your responses are really easing the anxiety for us. Through you, I've been reminded that making decisions can be about things other than life and death, and the term "unknown" could actually lead to something good. I've learned that others have had more than one round of radiation, and lived to tell the story. And the calorie requirements have been firmly reinforced. Sometimes, he feels like it's just too much trouble - so I do need to keep on top of his intake.
The teaching hospital we're using is Rush University, in Chicago. It's not a CCC, but they do have an impressive clinic devoted to head and neck cancers alone. Everything is done as a team there - each recommendation goes to their Tumor Board before it's presented to us. It's a 2 hour drive (each way) from our home, but we deal with it. We were happy enough with our local care, but the ENT finally said he didn't feel qualified to take our case any further. He referred us to Rush, where he said he was trained by the best.
I don't think a CCC would take us, as our primary insurance is Medicare. Our backup insurance is great, but won't cover anything that Medicare doesn't. In any event, we're happy with the care at Rush. So far.
Thanks SO much for your input here. Each time I sit here to type, it gets a little easier.
Donna Caring for Hubby: Age 73
Radiation, Hard Palate: October, November, December, 2011 Hemiglossectomy (side of tongue): December, 2014 2nd Hemiglossectomy (base of tongue): November 2015
| | | | Joined: Jul 2012 Posts: 3,267 Likes: 4 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Jul 2012 Posts: 3,267 Likes: 4 | I've had 7 recurrences in 4 years, including radiation 5x to the same area, which the last treatment ended 1/14, and so far all my scans have been clear since, so I know how these fears are, but had faith that each one was hopefully the last I had to do.
As far as being at a Comprehensive Cancer Center or Cancer Center, there is much confusion about that. Any hospital can call itself a CCC or CC since there are no requirements, restrictions or trademarks for its use, but NCI, NCCN, as well as others, do have criteria for their association or inclusion, which many may be referring too, but not all are associated, and many others are listed as top hospitals in listings like U.S. News Reports Best Hospitals. Rush University is ranked in the top 50 for cancer out of 5,000 hospitals, it's ENT program was highly ranked before, as I know since my first ENT at a top hospital did his residence there upon checking his background, and would consider it a CCC or CC for a simpler term.
Medicare probably do cover all hospitals, I've been to 9 for one thing or another, even those referred to as CCC, CC or associated with NCI or NCCN, but do know that some may only take Original Medicare, not Medicare Advantage, like MSKCC, as I learned, and one reason why I stayed with Original Medicare for more options.
Good luck with everything.
10/09 T1N2bM0 Tonsil 11/09 Taxo Cisp 5-FU, 6 Months Hosp 01/11 35 IMRT 70Gy 7 Wks 06/11 30 HBO 08/11 RND PNI 06/12 SND PNI LVI 08/12 RND Pec Flap IORT 12 Gy 10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux 10/13 SND 10/13 TBO/Angiograph 10/13 RND Carotid Remove IORT 10Gy PNI 12/13 25 Protons 50Gy 6 Wks Carbo 11/14 All Teeth Extract 30 HBO 03/15 Sequestromy Buccal Flap ORN 09/16 Mandibulectomy Fib Flap Sternotomy 04/17 Regraft hypergranulation Donor Site 06/17 Heart Attack Stent 02/19 Finally Cancer Free Took 10 yrs
| | | | Joined: Nov 2015 Posts: 16 Member | OP Member Joined: Nov 2015 Posts: 16 | SEVEN recurrences over four years? Oh my, that's way more experience than anyone should have. I applaud you for your positive attitude, and pray it rubs off on me.
Yes, I am definitely confused about what may or may not be a CCC, or CC. I think of those as the special clinics advertised on TV, but it looks like that's not accurate. I can certainly see why the confusion exists.
I'm glad to hear Rush is among the top cancer hospitals in the country. We were SO impressed with everything there. From the state of the art equipment to the unbelievably attentive staffing, everything was amazing. We thought our local hospitals were great, but we didn't have anything to compare them to. Even though every appointment at Rush is a day-consuming drive for us, we know we're getting the best of care. We go back tomorrow, and the news is predicting riots because of the release of a police shooting video - so we certainly hope we're in a safe area. We're country folk and are easily overwhelmed by big city stuff.
As for Medicare - we do still have the original. We always knew we would want the freedom to choose our doctors, so we never changed. Plus, our back-up coverage is good, once the annual out-of-pocket is done.
Donna Caring for Hubby: Age 73
Radiation, Hard Palate: October, November, December, 2011 Hemiglossectomy (side of tongue): December, 2014 2nd Hemiglossectomy (base of tongue): November 2015
| | | | Joined: Jul 2012 Posts: 3,267 Likes: 4 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Jul 2012 Posts: 3,267 Likes: 4 | If it helps, many cancer centers may have overnight housing available and or with The American Cancer Society, although I don't see any Hope Lodges in Illinois, they may have hotel rooms available though their program with Extended Stay America, which may be free like their Hope Lodges are, and can't say enough good things about. http://www.cancer.org/treatment/supportprogramsservices/patientlodging/indexHere is information on Lodging and overnight stays with Rush University. https://www.rush.edu/patients-visitors/visitors/lodging-and-overnight-stays
10/09 T1N2bM0 Tonsil 11/09 Taxo Cisp 5-FU, 6 Months Hosp 01/11 35 IMRT 70Gy 7 Wks 06/11 30 HBO 08/11 RND PNI 06/12 SND PNI LVI 08/12 RND Pec Flap IORT 12 Gy 10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux 10/13 SND 10/13 TBO/Angiograph 10/13 RND Carotid Remove IORT 10Gy PNI 12/13 25 Protons 50Gy 6 Wks Carbo 11/14 All Teeth Extract 30 HBO 03/15 Sequestromy Buccal Flap ORN 09/16 Mandibulectomy Fib Flap Sternotomy 04/17 Regraft hypergranulation Donor Site 06/17 Heart Attack Stent 02/19 Finally Cancer Free Took 10 yrs
| | | | Joined: Nov 2015 Posts: 16 Member | OP Member Joined: Nov 2015 Posts: 16 | Thank you, Paul. I don't know very much, but doctor did tell us about the Bowman Guest Center there at Rush. I stayed 4 nights earlier this month, while hubby (he has a name, it's Jon) was an in-patient following surgery. It was wonderful - a part of their elevated walkway system, so I didn't have to go out on the streets at all. It wasn't free, but at $125 a night it was a real bargain. All the hotels in the area wanted between $250 and $350, plus I'd have had all the taxi fares. Never in a million years could I figure out Chicago's public transportation systems.
The Center was nice, especially since I'd have been happy with a bed and a shared bath. It was like an efficiency, with small kitchen area, table & sofa, and separate bedroom. I wasn't there much, but it was comfortable when I was. And I loved knowing I didn't have to sleep in a recliner in Jon's room. He needed to see me there, so going home was never in the equation.
Donna Caring for Hubby: Age 73
Radiation, Hard Palate: October, November, December, 2011 Hemiglossectomy (side of tongue): December, 2014 2nd Hemiglossectomy (base of tongue): November 2015
| | | | Joined: Jun 2007 Posts: 10,507 Likes: 7 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: 7 | Donna, Im not sure if you have been on the main OCF pages. But there is page after page of info that can be a great learning tool. Here is a link to places that may be able to offer financial assistance or other things to help make this easier. I dont know if any would help or not but its worth checking out. There could be something to help with lodging when traveling for treatments. Main OCF pages---Financial Help 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 | | |
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