My oral cancer consisted of two seperate lesions, one on the inside of my cheek and the other behind my top molar. One was moderately differentiated, the other well differentiated. No lymph nodes at all involved, so no neck disection. Due to the location of the tumors, I was given radiation with 2 rounds of cisplatin. The third round of cisplatin was cancelled due to my tolerance and both tumors shrinkage. This treatment was given to avoid the reconstruction of my jaw and taking bone from my leg. Both my tumors were stage 1. Just goes to show you how different we all were treated.

Cookie,
The practice of Medicine is considered an "Art" not a "Science".

Here's a link to the science part:
Here is another link to the book I referenced in post #88838. It is truly a stunning body of work and exceptionally comprehensive.

http://www.amazon.com/gp/product/pr...ddesc_0?ie=UTF8&n=283155&s=books

It is a textbook and covers it all from A-Z. 3rd edition, published in 2008

WARNING: It may be very disturbing for some and I urge great caution when opening the link in my earlier post.

You will have to highlight, copy and paste the link to your the address window of your browser to open it.

Editors summaries:

Review
This textbook represents a wonderfully comprehensive approach to every aspect of the science, treatment, and rehabilitation of head and neck cancer patients. This single thousand-page volume would be my choice if I could have only one book on the subject. Purpose: The purpose of presenting a multidisciplinary approach to the subject is unique and well met. Audience: I believe this book is an absolute must for any physician or health professional involved in the care of head and neck patients. Features: Every conceivable topic in head and neck cancer is addressed, and some chapters deal with topics that are usually only alluded to at best. For example, there are two chapters on orbital malignancies. Additionally, the ethics of treatment and outcome research and cost analysis are well covered. The attention to technique, whether it be surgical, radiation, or medical is appropriate but not overdone. The references are current and extensive. Assessment: I have never used the word "exciting" to describe a textbook before, but it fits here. My practice is limited to head and neck cancer and I find this book a most current and complete treatment of this subject from a multi-specialty perspective. Reviewer: Harold Pelzer, DDS, MD(Northwestern University Medical School)

Product Description

This book employs a two-part approach to treating patients with head and neck cancer: maximize the chance for a cure while maintaining a strong emphasis on quality of life. Although not seen as commonly as other aggressive forms, head and neck cancer is a devastating disease that has tremendous implications on the overall health of the patient, as well as their appearance and quality of life. The goal of the editors was to create the first truly multidisciplinary book in this field that addresses all aspects and treatment options. The book was designed to be a comprehensive textbook crossing all disciplines and representing a wide spectrum of specialists throughout the country, including surgical, radiation, and medical oncologists, as well as dentists, pathologists, radiologists and nurses.

PS If you are still drinking or using tobacco product it is a must read. The link in the earlier post will tell you what you need to know, without purchasing the entire book.

Hi Mark,

My interest is to better understand treatment protocols. I am curious about others' treatment plans with/without ECS, specifically administration of chemo with/without ECS.

I guess there's a tiny question mark in the back corner of my mind wondering why I didn't get chemo while so many others have. I had a "small" primary tumor (1.8 cm), one positive node (3.2 cm), and no ECS.

Regards,

Oscar

Stage IVa, SCCa, T1N2a, rt tonsil, rt neck dissection, 33x IMRT

I see from your signature oscar that you were N2a rob was N2c i have never been 100% certain what the c stood for or indicated.If you read my post you will see rob had no chemo.

I had two positive lymph nodes, 1 obvious at about 3 cm, and 1 with no enlargement, but microscopic evidence of SCC, both on the right. No extracapsular spread was seen in pathology, and my tumor was graded as well-differentiated.

I had the full chemo course, as the team at the James and I decided to pursue the course with the greatest chance of eliminating the cancer.

Hope that helps some.

Cookie,
everything you have ever wanted to know about Staging H&NC is on the main pages.

Go to the main site, do a search on NCCN and select the third item.

Click on "staging" on page 3

N2c Metastesis in bilateral or contralateral lymph nodes, none more than 6cm in greatest dimension

N2b Metastesis in multiple ipsilateral lymph nodes, none more than 6cm in greatest dimension

Like Oscar, as a significant prognosis factor, I was told ECS of the nodes is a major consideration, but in absence of ECS not so much the degree to which the cancer cells have differentiated.

In my case, two small nodes were removed before Tx. No Chemo, no ECS but since no primary was found, extensive areas received RT. So I was transfered from a satellite to their main Cancer Center for Tomo rather than standard IMRT.

Oscar,

My husband did not have chemo, as the docs said there wasn't any evidence of ECS and they were able to get clear margins, but not without a lot of cutting. After surgery he was treated with 6 weeks of radiation he and had his first post-treatment scan on Jan. 2nd, and it was clean.

I too was very concerned about the fact that they didn't think chemo was necessary, but given all the other problems he has had, I don't think he would have been able to withstand chemo at this time.

His reconstruction (free flap) failed and they had to do a pectoral flap, and since then he has had healing issues and chronic infections due to a fistula.

Hopefully, that will be helped by Oxygen treatments which he starts on 1/26.

His cancer was already at stage 4 because of the size of the tumor and because it had spread locally from the floor of the mouth to the mandible and the tongue, yet the docs felt that radiation alone would be effective.

Karen