#41551 07-26-2007 04:25 PM | Joined: May 2006 Posts: 57 Supporting Member (50+ posts) | OP Supporting Member (50+ posts) Joined: May 2006 Posts: 57 | It has been awhile since I've signed on. I've read many entries though, and feel for everyone touched by this horrible disease. Dennis recently had a PET that detected an area approximately one inch below his initial tumor. When he saw the ENT, he immediately scheduled a biopsy that will be done on Monday. My question would be, does anyone know the limit of radiation? Would one inch possible leave enough of a margin for re-radiation to be an option? Thank you all in advance. Love, Mandi
Stage III tonsil, Dx 8/14/2002,chemo and rad...reoccurance 8/3/07,Base of Tongue,vocal cords,stage IVA,total larynectomy and glossectomy 9/4/07 with pec flap...reoccurance Nov. '08 and Feb. '09 (positive margins remained after each operation) Second pec flap May 7, 2009. Still positive margins.
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#41552 07-26-2007 05:07 PM | Joined: Mar 2002 Posts: 4,912 Likes: 53 OCF Founder Patient Advocate (old timer, 2000 posts) | OCF Founder Patient Advocate (old timer, 2000 posts) Joined: Mar 2002 Posts: 4,912 Likes: 53 | I think that Gary should answer this question. In the most general terms, tissues can only recieve a certain amount of grays of radiation then the radiation can cause new problems such as necrosis, loss of vascularization and more. There is also the issue of total accumulative grays that your body gets no matter where you are radiated. There is a maximum liofetime dosage. Given the precise nature of IMRT technologies and seeing the very fine definitions of it that can be used in brain cancers, a measurment as long as an inch seems like a mile to me. But there is still some scatter radiation to surrounding tissues. I will leave a specific answer to your question to Gary who comes from a radiaology background.
Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant. | | |
#41553 07-27-2007 05:13 PM | Joined: May 2007 Posts: 666 "Above & Beyond" Member (500+ posts) | "Above & Beyond" Member (500+ posts) Joined: May 2007 Posts: 666 | Mandi, first of all I am not a radiation oncologist but I will try to help with your question. In my case (IMRT) we had to widen the irradiation volume after the first 3 radiation. At that point they had to recalculate the new radiation schedule (positions/intensity, profile) taking into account what happened before. I am assuming that you had IMRT previously. Are you still in contact with that place? Each tissue and structure has different limits and sensitivities for radiation. Whether they can use radiation again depends amongst many other things what happened to THAT tissue during previous radiation. Specifically, how many grays did that tissue get. That depend on the protocol they used and should be documented. I found a link that might be helpful in getting a glimpse of what is going on. (I am not claiming this is a particularly good article, I cannot judge that, it was just handy) Read especially p 210 http://www.medicalphysics.org/apps/medicalphysicsedit/Ch_10_Ling.pdf Hope that helps, you should talk with the RO you had for your last treatment. Markus
Partial glossectomy (25%) anterior tongue. 4/6/07/. IMRT start @5/24/07 (3x) Erbitux start/end@ 5/24/07. IMRT wider field (30x) start 6/5/07. Weekly cisplatin (2x30mg/m2), then weekly carbo- (5x180mg/m2). End of Tx 19 July 07.
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#41554 07-27-2007 05:50 PM | Joined: May 2006 Posts: 57 Supporting Member (50+ posts) | OP Supporting Member (50+ posts) Joined: May 2006 Posts: 57 | Dear Brian and Markus,
Thank you both for your informative and caring responses.
Markus.....the link you sent is so informative. Thank you so much for your time and effort.
Brian.....You continue to astound me of what a caring and tolerant boardmaster you are. You know I'm a long standing pain-in-the-butt, but you continue to extend your knowledge to me. Thank you.
I sit and pray that I will have another 5 years with Dennis, but reality tells me differently. There is nobody close who will discuss what the outcome may be, so I turn to you.
Thank you for being here, and I will continue to let you know of our progress...........
Love, Mandi
Stage III tonsil, Dx 8/14/2002,chemo and rad...reoccurance 8/3/07,Base of Tongue,vocal cords,stage IVA,total larynectomy and glossectomy 9/4/07 with pec flap...reoccurance Nov. '08 and Feb. '09 (positive margins remained after each operation) Second pec flap May 7, 2009. Still positive margins.
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