After two surgeries the past year to excise a tongue lesion (Squamous T1)it's back. The choice confronting me is radiation therapy vs what's known as free flap surgery, in whioch a large chunk o tongue os removed as well as the floor of my mouth and replaced with skin taken from my back or forewarm, whichever is less hairy I suppose. Naturally I'm freaked by either, but freaking is a luxury for which I have little time to indulge. Any insight out there from people who've experienced either? Specifically, what's the best case-worst case scenarios for either, what are the likely complicatins from either, how long does it take for either to "normalize," and if and when normalization actually occurs, what kind of mouth function will I have left? Taste? Swallow? Spit? Energy? My surgeon clearly prefers the free flap option, arguing that once you've radiated, it's harder for surgeons to clean up the mess afterwards should further reciurrence take place? To that end, he argues it's better to cut first and then radiate as a fall back rather than the other way around. Any reaction out there?

Many thanks

Nick Welsh

Hi Nick. I had a free flap surgery in March of 07.I had almost all of my tongue removed and I'm doing well now. My tongue was rebuilt but it doesn't move. You tongue will and you will get most of your speech and taste back- will take a bit of rehab though. Another woman has stage one and the free flap and her speech is near perfect now- 6months out...Her tongue is still very swollen form radiation but its going down. Its a tough recovery- I won't lie but you will get through it... I can eat most everything and taste most everything. A lot of of taste has to do with your sense of smell-- which mine is very very strong..so I guess I'm lucky. It will take a while to recover and everyone's body is a little different but you will do great.

This disease spreads very very fast and is very difficult to control and or cure if it is left to metastisize which is why your Drs. want you to be aggressive. I don't mean to frighten you but the most aggressive treatment to eradicate the cancer from your body is the wisest choice.

Please contact me if you have questions!

Good luck with everythinga dn I'm so sorry you are going through this!

Hi Nick,
11.00 am here and at work so can add more later.
As you can see had the free flap since September 2006. Have had 4 operations since (mostly day surgery with general) to fine tune where the flap was joined to the tongue . My feeling is that too much flap was used. Still have one more op. to go.
On the positive side around 2 weeks after every op (of course not the original one) was able to eat reasonably well. No steak but fish OK. Have not lost taste.
Dry mouth overnight but saliva not too bad during day. Not sure but I think this becomes a problem with radiation.
I guess a lot depends on how much tongue you will lose. Have lot's of photo's taken of the months which would explain it better. More later.
Gabriele

Hi,I had the free flap your talking about 5 years ago.I did not have radiation because they had to rebuilt jaw and all. They were in so often they just kept checking for cancer then.THAT SURGERY MADE A BIG DIFFERENCE TO MY TALKING AND EATING.I am so glad i had it.My mouth did feel like it was full of marshmallows for quite awhile, but it all settled down with time.My plastic surgeon said it was easier to work with tissue that had not had radiation.The scar on my arm is odd, but I needed a mouth more than I needed to worry about the scar. Good luck to you.Ps I thought the recovery from this was rather quick compared to other surgerys I had had.

Hey Nick, It's not easy. I had the free flap done in addition to doing radiation and chemotherapy. Mine was a hemiglossectomy so I lost about half the tongue. After the free flap surgery I went into chemo and radiation finishing up on November 7 2007. i was at the end of my rope at that time. I wasn't able to taste anything and all this mucus kept clogging my throat. My energy level was pretty much nonexistant. However with a good spirit and knowing that patience is is the key i got through it. I now pretty much have all my taste back and am running, swimming, biking, and lifting weights I even signed up for a half marathon in march and am hoping to do a triathlon a few months after that. So it's certainly possible to regain what was lost if your willing to work and have good support. I wish you the best-Kurt