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(Squamous cell carcinoma HPV+ Base of Tongue and 1 lymph-node, surgery 7 weeks ago, no margins). Non-smoker, just started radiation

I've just started 30 days of radiation. I have been told that the focus of my radiation will be on where the cancer was (on the base of my tongue and the area on my neck where I had my one cancer-fill lymph-node surgically removed), AND, they are also going to radiate both healthy sides of my neck where there never was cancer "just to make sure we pick up any stray cells"

So... here are my rad "doses" - I am wondering what folks who have been through this, or are in the know about radiation, think about these numbers:

Base of Tongue (where cancer was, clean margins now) - 60 Gy
Neck - (area where cancerous lymph-node was remove) - 60 Gy
A lot of my neck on left and right side where there was not cancer - 54 Gy

I welcome any and all comments. Thank you!

-Mark



Mark
Non-Smoker, HPV+ Squamous cell carcinoma tongue and in 1 lymph node neck, 4.8 centimeters. Surgically removed March 2019. 30 radiation treatments starting May 2019
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Hi Mark,

It seems about right after surgery. They would go to 72Gy, 7 weeks, without surgery or prior radiation, lesser in some trials. I had tonsil with lymph node (2) metasteses, but due to recurrences (6), i was able to do more treatments, radiation and surgeries, and now cancer free, which is more unusual than most.

They usually give the primary the highest radiation, and the effected lymph nodes, The other side and unenvolved nodes get lesser. I had bilateral also. Yours may be on the border to easily matestsizesize or large enough, and number wise where it can metastesise.


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






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Thank you Paul! If anyone else has thoughts/opinions on the numbers I shared, I would really like to hear them. Thank you! Mark


Mark
Non-Smoker, HPV+ Squamous cell carcinoma tongue and in 1 lymph node neck, 4.8 centimeters. Surgically removed March 2019. 30 radiation treatments starting May 2019
Joined: Aug 2018
Posts: 345
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I wish I understood those numbers! I just know my husband was told he was given a lifetime of radiation.


Spouse of 58 yr old with BOT cancer
Stage 4a HPV16 positive
3 chemo treatments cisplantin
35 radiation treatments 7000 cGy
former smoker/chewed tobacco for 38 yrs.
1/2020 diagnosed with cancer near TMJ
4/2020 chemo 5 days every 2 weeks
6/2020 proton therapy
9/21/2020 cancer free
Joined: Jun 2007
Posts: 10,507
Likes: 6
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Administrator, Director of Patient Support Services
Patient Advocate (old timer, 2000 posts)

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On the main OCF website theres tons of info about anything/everything to do with OC. In OCFs Understanding section theres so much info, its not just hours of reading... theres DAYS of reading material thats correct, informative, up to date info. Sub-sections on reirratation, radiation exposure levels, and a detailed comparison of radiation types are just a few of the topics featured in the Radiation sub-section of OCFs Understanding section. Below, Ive included a link to OCFs main site for the Radiation info which will be helpful in everyone better understanding of rads....

Main OCF Site, Understanding section, Radiation sub-section


Christine
SCC 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 smile
Joined: Aug 2018
Posts: 345
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I'm still confused! others list numbers like 60 Gy, 70, etc. What i read for my husband said 7000 Gy. that doesn't even make sense compared to others. oh well. i will do more reading.


Spouse of 58 yr old with BOT cancer
Stage 4a HPV16 positive
3 chemo treatments cisplantin
35 radiation treatments 7000 cGy
former smoker/chewed tobacco for 38 yrs.
1/2020 diagnosed with cancer near TMJ
4/2020 chemo 5 days every 2 weeks
6/2020 proton therapy
9/21/2020 cancer free
Joined: Jul 2012
Posts: 3,267
Likes: 1
Patient Advocate (old timer, 2000 posts)
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Patient Advocate (old timer, 2000 posts)

Joined: Jul 2012
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It’s probably 7000 cGY, which equals 70Grays converted. I don’t know why the conversion, but have seen both. Maybe cGY on radiation reports, which name I forget. You may find radiation very complex as it is for me and many others.

Also, there is no max lifetime radiation dosage. Maybe whole body in one day over a maximum Gray. I thought I heard 100? There are maximum dosage for certain structures before toxicitie limits, but their pushing radiation, and other areas more, if they can. I had total dose of 210Gray to my left neck, but not without some issues like ORN, Brachial Plexopathy to my left radiated neck, if it’s related to that. I had a jaw replacement and left arm complete paralysis, but was worth it to be cancer free.

Last edited by PaulB; 05-15-2019 05:08 PM. Reason: errors

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: Aug 2018
Posts: 345
Likes: 8
Platinum Member (300+ posts)
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Platinum Member (300+ posts)

Joined: Aug 2018
Posts: 345
Likes: 8
thanks Paul. that makes more sense. They said they could not give him radiation in the same area of the previous cancer. He had had too much and after a couple of scares the past few months, it was concerning.

Haha but what do I know? pretty much what I've learned here! I haven't been to all of the doctor appts.


Spouse of 58 yr old with BOT cancer
Stage 4a HPV16 positive
3 chemo treatments cisplantin
35 radiation treatments 7000 cGy
former smoker/chewed tobacco for 38 yrs.
1/2020 diagnosed with cancer near TMJ
4/2020 chemo 5 days every 2 weeks
6/2020 proton therapy
9/21/2020 cancer free
Joined: Jul 2012
Posts: 3,267
Likes: 1
Patient Advocate (old timer, 2000 posts)
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Patient Advocate (old timer, 2000 posts)

Joined: Jul 2012
Posts: 3,267
Likes: 1
Hi Connie,

Sometimes that’s true that no more radiation (Grays) can be fitted in for various reasons. You also need to have a doctor, radiologist, that is exierienced giving more radiation. I guess I was lucky with both parts.


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







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