My mother has had a recurring Phase I superficial squamous carcinoma of the mouth. She has had several surgeries, about to have another one.

The opinion of our doctor at the Memorial Sloan Kettering (oral surgeon/oncologist) has been that because of the good pathology reports and lack of involevement of the nodes, no radiation has been necessary (i.e., surgery only for us so far).

Also, the cancer recurred in different places in the mouth after it was removed in one place completely, which is, according to him is relatively rare. He is saying that he is not sure if he'd recommend radiation still because you can do this procedure only once, and because we don't know exactly what part of the mouth to radiate (i.e., what if it reccurs on the other side of the mouth after the radiation?)

I think it would be great if he discussed it with some other doctors at the hospital just to get their perspective. He is a very experienced and good surgeon and doctor and a great guy. But sometimes, other experts may have an opinion or suggestion that may be helpful. I am afraid to suggest it to him, because it would look like we don't trust his judgement, which is not the case.

What do you suggest?

At MSKCC (as well as many smaller hospitals) they have a tumor board which does exactly what you described. Are you saying he hasn't taken your case before the tumor board? Have you asked?

Nelie

NewYorker,

I agree with Nelie -- I would have expected him to have this reviewed by a tumor board, especially in light of the number of recurrences your mother has had. If he hasn't, you should insist on it.

Cathy

No. He referred my mother to the radiology oncologist once. But that's it. he never referred to the tumor board. So should we ask him about it?

This may also be an example of why IMRT is not always superior to conventional XRT -- There are situations where a broadbrush approach may be more appropriate than a more focused solution.

My ENT preferred to go with the radiation as a preventive measure -- He said if cancer reoccurred without having the radiation, likely the first thing we would do is radiation -- He likened it to a double-barrelled shotgun and a bear; having shot the bear once (surgery), do we wait for it to get up or do we shoot it while it's down (radiation)?

My advice is to get the case before a tumor board or at least get a second opinion.