Right, try again – I’ve learned that instead of entering text on the bulletin board itself, and running the risk of losing it all when your ISP/Internet Explorer falls over, its much safer to use a word processing application and paste the message in, so here goes, again…

Why do some people with tumours in the mouth have radiotherapy and some don’t? Is it a recommendation/patient choice issue? Here’s what I understand; please take this in the sprit that its offered: to raise questions that might be answered by some of the people out there and to share thoughts, ideas and/or experiences:

When my husband was diagnosed as having a cancerous tumour in his tongue in Dec 2002, we were advised that the recommended way to deal with this was to cut it out, and a bit more to be on the safe side, and follow this with a course of radiotherapy (RT) to frazzle any cancerous cells that escaped the knife. So that’s what happened. The lymph glands were taken out to see if the cancer was taking this route to spread, we rejoiced when the results were clear.

In December 2003 John had a minor operation to remedy a leakage from his neck, which we all thought was due to an ingrowing hair. Turned out it wasn’t, there was some infection around the jawbone that hadn’t healed as anticipated so the recommended course of treatment was to rebuild the jaw with a graft from the hip bone, and do a course of hyperbaric oxygen to encourage the healing process.

The tissue that was removed during the course of this operation was sent to the path lab, and was reported as being cancerous. The oral surgery team were shocked by this, second opinions were requested, the reconstructive surgery plans have been cancelled and we’ve now been passed back to the oncologist who should be able to advise what sorts of chemotherapy options are available.

So, if the radiotherapy option hadn’t been taken up, might this mean that the healing process would have been more successful and that we’d still have radiotherapy in our arsenal of weapons? A brief trawl around the Internet indicates studies where adjuvant (concurrent-ish?) radiotherapy and chemotherapy have been successfully aimed at eliminating head and neck cancers.

The recognised ‘best practice’ for treating oral squamous cell carcinomas (Marx?) seems to be surgery+radiotherapy, but our experiences tell otherwise. How come some people don’t do RT? Think hard and ask plenty of questions before you decide which route to take; however, it would appear that there are more questions than answers...

Sorry Jenbee,
Replied to this question on """introduce yourself""",so for my experience have a perusal there.

If I knew what I do now would NOT have had Radiotherapy.
Would have taken my chances

Paul

but alan,

• WHY didn't you do radiotherapy?
  

Paul,

• why do you wish you hadn't undergone RT?
  

Dr. J,

• what are the maximum doses of radiotherapy that an individual can stand?
  

• what are the results of undergoing too much?
  

• Are there any up-to-date articles anywhere about locally advanced head and neck cancer?
  

I suspect much of this thread is 'academic' in John's case, but the suspicion that we took the wrong decision when we opted for RT (to be on the safe side!!!) is gnawing away at me.

I plan to start a new thread on this forum in my quest for info about chemo.

quote:

Cancer. 2005 Jun 1;103(11):2320-5.
Retromolar trigone squamous cell carcinoma treated with radiotherapy alone or combined with surgery.

Mendenhall WM, Morris CG, Amdur RJ, Werning JW, Villaret DB.

Departments of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida 32610, USA. mendewil@shands.ufl.edu


BACKGROUND: Treatment outcomes were analyzed for retromolar trigone squamous cell carcinoma.
METHODS: Between June 1966 and August 2003, 99 patients were treated with radiotherapy alone (35 patients) or radiotherapy combined with surgery (64 patients). Followup ranged from 0.2 to 23.8 years (median, 3.3 yrs). All living patients had followup for at least 1 year.
RESULTS: The 5-year local-regional control rates after definitive radiotherapy versus surgery and radiotherapy were as follows: Stages I-III, 51% and 87%; Stage IV, 42% and 62%; and overall, 48% and 71%, respectively. The 5-year cause-specific survival rates after definitive radiotherapy compared with surgery and radiotherapy were as follows: Stages I-III, 56% and 83%; Stage IV, 50% and 61%; and overall, 52% and 69%, respectively. Multivariate analyses revealed that the likelihood of cure was better with surgery and radiotherapy compared with definitive radiotherapy.
CONCLUSIONS: The likelihood of cure after treatment for retromolar trigone squamous cell carcinoma was influenced by the extent of disease and treatment. Patients treated with surgery and radiotherapy had a better outcome than those treated with radiotherapy alone.

Hello Jenbee:

My mother had a similar story. After her tongue cancer surgery and six weeks of radiation, her tongue cancer came back very aggressively seven weeks after her last radiation session. The doctors were surprised that it had come back so quickly, but they expressed her cancer as very agressive.