Hello all I been away for awhile and all is well with myself since 051805.
Im looking for all your opinions for a freind of mind who has just had surgery for tonsel cancer spread to 2 noyds had full neck disection check all margins looks good,stage it at 2,also was positive for HPV. Doctors are saying he should have radiation. His history been doctoring for 2years with lump on neck and sore throat, he did go to Rochester Mayo whare they took care of him ASAP. He has come to me for my input I said he should go with what the doctors are telling him. But I thought it would be good if I could get your opinions on this I will share them with him.

Dogman, Just as a technical point, I think if it has spread to two of his nodes it is not a stage 2 cancer but stage 3 or 4. There is information on staging you can find if you go to the main site. If the doctors say he should have radiation, he should have radiation, no question about it. This cancer can be very aggressive and very deadly. It is best to hit it with your best shot, even after a surgery with clear margins. The clear margins don't account for the cancer cells running loose in his lymphatic system that caused those nodes to be cancerous to begin with.

By the way, even if he WAS stage 2 and had clear margins and NO nodes, there are times when the doctors might recommend radiation (I fall in that group of folks).

Nelie

I also forgot to state he is thinking about not doing the radiation. Wants to wait and see what happens.
Thankyou nelie.

Nelie is correct -- regardless of the "T Stage" (Relative size of the primary), metastasis to multiple nodes makes this Stage IV disease. I had a primary on my tongue that was at the lower limit of the T2 range for size, but was stage IV because of metastasis to lymph nodes. I had bilateral neck dissection, but they did not operate on the tumor itself -- used radiation both to kill the primary and kill any spread in the neck and elsewhere.

I would certainly not take a chance with disease that had gone to multiple lymph nodes, but again that is a personal decision, so long as he fully understands the implications and risks of not having the radiation.

My husband has stage 4 cancer. When the surgery was over I was told that they got clear margins. However, during his radiation and chemo another positive node popped up in his neck and had to be removed. Prior to the 2nd surgery they redirected the rads to the new node and decreased it significantly. I understand once 2 or 3 nodes are invilved the stage changes. Good Luck to your friend.
Sue

Watching and waiting until this reappears, could leave the patient with a disease that is more advanced when someone finally notices that it has returned, as the lymph system is a highway to the vital organs of the body. Oral cancer never kills you in your mouth. It might take 24 months for some micro met that is undetectable now to prosper into something that will be significantly harder to deal with in the future. Radiation is no walk in the park, and it does induce some life long issues. But too often here we have seen people in recurrences that could have been avoided if the initial treatments were complete/comprehensive.

I haven't heard of anyone on this Board that had nodal involvement where his doctor didn't advocate radiation. Most doctors recommend it even where there is no nodal involvement.

Push at him to have the radiation. Watching and waiting is a dangerous game.

Minnie