At our first meeting with the RO, we mentioned IMRT, the doctor glossed over it and said that "We do that here but in this case we want to cover a larger area."( Dr. is rough around the edges). Does this make sense? My Mom had a tumor removed from her mouth and 11 lymph nodes all came back clean. Some residual cancer remains.
We are going to the radiologist tommorrow to get pretreatment xrays. Should I revisit the IMRT topic.
Thank you

IMRT is external beam radiation therapy where the beam is supposed to be more controlled as to depth and coverage area. It is ideally, more precise, computer controlled. But radiation is radiation. It has side effects and IMRT, as well, is no exception to that rule.
She may require chemo along with the radiation. Almost all the major cancer centers are in agreement that Radiation and chemo are the best approach. But, there are no guarantees.
My RO and MO crossed all he T's and dotted all the I's but I had a reoccurrence. Sometimes it just happens.
Darrell

MK May
Several members have had conventional radiation as apposed to IMRT, and my own understanding is that it is based on the size of the area that they consider needs to be radiated, please try a search of the site as I have not enough knowledge to advise you on this...
Sunshine.. love and hugs
Helen

MK, where is her primary tumor? You also said that after surgery, more cancer was found. Possibly the cancer is multiple locations and they feel IMRT is not the best option. It needs to be said often on here that not all cancers can be treated with IMRT. It would be great if they could, but it's simply not the case.
Good luck with it all.
Minnie

I would certainly revisit the IMRT topic for your own peace of mind but bear in mind that not all are candidates for IMRT.
I had a very large tumor, 3x6cm, but no node involvement. They did bilateral irradiation however and also zapped various other areas that they suspected could cause problems later on. My tumor was well differentiated and focally invasive so I was a good candidate for IMRT. It helped also that my RO is a professor of clinical radiology (specializing in IMRT) at a major CCC. I would get a second opinion from a CCC if you are not already at one.

Thank you all for the replys.
Minniea, my Mom's tumor was on the left side, mandible area. One month after sugery biopsies were done on both sides of her mouth which came back positive for squamous cell.

All of your support means a great deal to my family and me. Thank you.

I would agree with Gary to get another opinion on IMRT -- both the major CCCs at which we consulted use IMRT more-or-less exclusively for their HNC patients, many presenting with extensive and metastacized disease. This allows them to spare, when possible, salivary fiunction and to reduce irradiation of non-target organs, thus greatly reducing long-term side-effects. It is the radiation planning which determines the size and extent of the field; in fact my husband, who had Stage IV SCC with mets to two nodes was given the even more precisely focused TomoTherapy IMRT. But he had an RO whose sole clinical and research focus is oral cancer and who had many years experience with this disease.

In any case, you certainly have the right to ask questions of the RO about the radiaion plan, how much of your mom's salivary function will be spared, impact on jaw and teeth, etc. and to be prepared to deal with the side-effects as they emerge.

Gail

I use a CCC in New york City, Memorial Sloan Kettering Cancer Center, and they still use conventional, 3D conformal and IMRT on their Head and Neck patients. Like Gary says, not everyone is a candidate for IMRT. Newer is not always the answer, just make sure you have all the information to make the appropriate choices and sometimes conventional radiation is the correct choice.

Glenn

Hi Gail,
It is very apparent that you are the number one fan of IMRT, and I can appreciate that. We all wish we could have been fortunate enough to have IMRT.
But, I worry sometimes that you are to gung ho with pushing this as THE best treatment. Please don't take me wrong here, your knowledge is valuable to this board and much needed.
At the same time, if I were a newcomer and had to make a decision, the way you present IMRT would make me feel DISCOURAGED and cheated if my RO insisted on conventional, and it may make me keep looking around until I found an RO willing to give me IMRT..............even though conventional would be better for my type of cancer.
I think we need to find a way to share the knowledge without making anyone feel as if they are the "unlucky" ones if they cannot have IMRT.
Glad Barry is doing so well after treatment, he's been an inspiration to many of us.
Take care,
Minnie

If Gail isn't the number one fan I certainly am. I am very grateful to have my salivary function return to normal AND my advanced stage cancer have a "complete response" for the past three years, with minimal side effects. I actually am having a somewhat normal life again.

When I started researching IMRT 3 years ago many radiation treatment centers didn't have the option on their equipment and wouldn't recommend going somewhere else (so as to not lose the money) - Radiation therapy can be as high as 5K a pop (it is a business after all). Everything that Gail said is based on fact. IMRT has, in fact, become a "standard of care" for H&N patients (as well as for prostate cancer as well).

It is also true that is some cases patients have been told that they are not candidates for IMRT and would be better served with XRT. My head & neck surgeon, although educated at a major CCC wasn't aware of the benefits of IMRT and I had to educate him.

The difference in Quality of Life (QOL)issues are substantial between the two types of radiation and I will always recommend the least healthy tissue damaging approach, IF at all possible. All of us are 'unlucky" to have this disease, in spite of what treatment options are available. Radiation in any way, shape or form is a brutal and extreme treatment and can lead to other serious health issues down the road, but they all beat death. Your comments to Gail are rude, speculative and un-warranted.