Hello, I am new to this post. My father was diagnosed with a cancer in the mouth on Tuesday July, 27th, 2004. That morning his biopsy was reported positive.

Thursday July, 29th, 2004 we had an appointment to see our ear, nose, & throat doctor. He checked his ear nose and throat. He also spray novacaine directly on the lump, which is located on the right side cheek (very close to lips and gums), and up his nostrils and down his throat. He inserted a tube into his nose to check for any other signs. He tells us that the nose, ear and throat were showed no signs and that the cancer on the cheeks was a stage 2 cancer. My father told the doctor that its been about 5 weeks since he first noticed it. The doctor tells us that cancer has been cooking for atleast 6-12 months. He would eventually be the doctor performing the surgery.

Friday, July 30th, 2004, my father had a blood sample taken, and later that day he also received a full catscan. Today we will be calling the office to get the results of the catscan.

Today, Monday, August 02, 2004, we had an appointment with our family doctor. We have asked him for a second opinion at another hospital (Dana Farber Medical Center, New England Medical Center, & Memorial Sloan Kettering). He also performed a full physical examination.

Monday, August 9th, 2004, my father will have a surgery and be placed under anesthesia and the doctors will be taken multiple biopsies from the local areas. This is not the actual surgery to remove the infected region.

Wednesday, August 18th, 2004, we will all get together and meet with the doctors who will be performing the surgeries. They will be providing us with whatever options we have available. We will then set a date for the actual surgery

My questions are:

(1) August 18th is still 3 weeks away, and that isn't even the actual surgery date. Is this wait normal? I mean I do not want him to be in stage 4 by the time he has the surgery. Shouldnt the process be faster? I have spoken to people who have had different types of cancers and they had the surgery performed within 5 days from diagnosed date.

(2) He occasionally bites on the infected area, especially in his sleep. Should he have his teeth in that area removed?

(3) The cancer is about 1 inch. He is in stage 2. Is this considered an early stage detection and what are his chances of being cured?

Please help me through this. I will post any other questions I may have later. Thank you again for taking your time to support me and my father. God Bless!

Hello Paul

Sorry to hear about your father's mouth cancer. You haven't said where in the mouth it is. There are several helpful links at Patient's Guide >Mouth Cancer. A Stage II is based on the AJCC Cancer Staging Manual, a shorthand for (T2 N0 M0) meaning no lymph node spread and no metastases; it is a promising starting point.

Your father appears to be in good hands and things are progressing as should. You shouldn't worry about the delay in surgery, the cancer is not a monster that grows overnight - your specialist has said it has been there for longer than your father has noticed it. A short delay will not reduce the chance that treatment will be successful.

Stages I and II disease at most sites may be treated with either resection or radiation therapy. The best therapeutic approach for the primary tumor depends on the anatomic site. The approach to treatment of the neck also varies with the site and treatment of the primary tumor. More information at: PROFESSIONALS > CANCER TEXT-BOOK 1

Before surgical resection, preoperative assessment of the extent of disease is essential. Complete physical examination and appropriate radiologic evaluation are necessary. Triple endoscopy (laryngoscopy, bronchoscopy, and esophagoscopy) or �quad scopes� (adding nasopharyngoscopy) with an examination with the patient under anesthesia may be helpful to assess the full extent of disease and to search for concomitant primaries. Biopsy for histologic confirmation may also be performed in this setting.

With regard to the biting of the lesion in his sleep, the following advice may be useful. Try it first before taking out teeth! eek:
Chewing the cheek is associated with clenching activity. My patients have found the following technique helpful :

The Relaxation - Autosuggestion Method
===========================================
1. Lay down on your back with the palms of your hands on your abdomen.
2. Close your eyes and breathe in slowly and deeply through your nose.
2. As you breathe out slowly, feel yourself beginning to relax; feel the tension leaving your body.
3. Now breathe in and out slowly and regularly, at whatever rate is comfortable for you. You should feel your abdomen rise as you breathe in and fall as you breathe out. (abdominal breathing). Do this for a couple of minutes.
4. Become aware of your breathing. As you breathe out, say the word, """ONE""", silently to yourself. Breathe easily and naturally.
5. Continue for 10 to 20 minutes. You may open your eyes to check the time, but do not use an alarm.
6. End with a slow deep breath. As you breathe out say to yourself """I feel relaxed."""
7. Tell yourself, �I will get a good night�s sleep�,
�I will not chew on my cheek or clench on my teeth because I don�t want to have a sore cheek or aching jaw.

Do not worry about whether you are successful in achieving a deep level of relaxation. Maintain a passive attitude and permit relaxation to occur at its own pace. When distracting thoughts occur, try to ignore them by not dwelling upon them and return to repeating """ONE.""" With practice, the response should come with little effort. Practice the technique once or twice daily, but not within 2 hours after any meal, since the digestive processes seem to interfere with the elicitation of the Relaxation Response.
- The Relaxation Response, Herbert Benson, M.D.
===========================================

===============How it works===============
Your mind is suggestible when it is in a relaxed state.
Your self-hypnotic suggestion will cause your subconscious mind to monitor any clenching and biting activity at night. When clenching is detected you will wake up alerted to the undesired behaviour. Once awake, you will relax your muscles and stop chewing your cheek and clenching on your teeth.

You will soon learn to stop clenching and have uninterrupted sleep. The sleeping brain is capable of responding to the clenching and modifying ingrained patterns of behaviour. After the first couple of days you will seldom awaken because your response will be so quick you will not be awakened. Patients report better sleep, and being more rested while using this method to control clenching.

This nighttime retraining carries over into the day. You will catch yourself and be able to control any daytime chewing/clenching habit. When clenching is stopped the muscles relax, the joints are off loaded, and the symptoms of TMJ go away as the joint and muscles are allowed to heal.

This method is safe & effective, non-invasive and reversible. It is easy to use and low cost.

===========================================
TREATMENT PROTOCOL
===========================================
Ask your father to practice the method nightly for 6-8 weeks. It will also help reduce the anxiety he must feel.

Hope that helps.

Best wishes
Vinod :coffee:

WElCOME PAUL, I am so sorry to hear about your father. It, unfortunatly, takes time to get the test done and then read and then back to the doctor that ordered them. Then back to the patient. Trust me if they thought this needed to be hurried and rushed, they would do that. They are here to save lives, remember..But that wait is the worst of it all, I think..For up until they tell you your mind goes wild with fear..I wish there was something that I could do for you about this, but we all had to go thru it. Yes it isnt any fun,..If sounds like your dad has a good doctor and is following thru with everything..I wish you the very very best..Please keep us up on your father, God bless him and his family...ALways VICKI

Hello again everyone and thank you for the supportive advice. Dr. Vinod K Joshi, the cancer has occurred on the right side cheek. It is right at the corner where the upper and lower lip meet. The cancer occurred from chewing tobacco for the past 15-20 years and drinking alcohol excessively lately due to business struggles. I have quit my job to spend time with my family. Beginning of September, I go back to college. I am thinking twice about this coming semester. We have 2 family weddings to attend in India this November/December. I just hate to see him in this state.

One other question:
(1) Are there any statistics that show the cure rate for when the stages that the cancer is first detected in? I know the early the better, but I would like to know if there are any numbers.

Thank you very much again!

I also understand that Monday, August 9th, 2004 will be the date my father is having the full endoscopy performed. Is there more information on this procedure? The doctor refers to this procedure as a """surgery""". Will there be any incisions or stitching involved? Thanks!

Paul, I have had one of these done, there were no stichtes involved in mine. I was put out and it was done at a surgical center. They put a snake like thing down your throat, it has a light on it also, so they can see what is going on down the throat. I had ulcers in mine which was causing a lot of problems swallowing..I had no problems with mine. My throat was not even sore. I had to be NPO after midnight was all I had to do to prepare for this..I hope this helps..Always Vicki Lynn

hi paul
my mum was dignosed with mouth cancer just a few months back she refused treatment at first but she is now on the mend after having it cut out at the end of june and she is doing realy well she goes on the 18th of august for a few burst of chemo but you dad is in safe hands and we are here for you when you need us
liz

Hi Paul

quote:

---

Prognosis correlates strongly with stage at diagnosis. For many head and neck cancer sites, survival for patients with stage I disease exceeds 80%. For patients with locally advanced disease at the time of diagnosis, stages III and IV disease, survival drops below 40%. Development of nodal metastases reduces survival of a patient with a small primary tumor by ~50%. Involvement of even a single lymph node is associated with a marked decline in survival. Most patients with head and neck cancer have stage III or IV disease at diagnosis.

---

So, it looks promising for your dad, always hope for the best: """The future is not ours to see, que sera, sera.""" More information at: PROFESSIONALS > CANCER TEXT-BOOK 1 in the Head & Neck Tumors pdf section.
Hope that helps.

Best wishes
Vinod :coffee: (off to bed , got work tomorrow!)

I've been on the phone all day today. I am speaking with doctors at other hospitals, trying to squeeze in a second opinion. Our primary phyisician has faxed all the reports to other doctors for second opinions. Our initial ear, mouth, and throat doctor also returned a call today. He informed us that my father should not remove his teeth and should wait until monday August 9th, the date of his endoscopy. The doctor has recommended he begin radiation. There were spots detected in his throat & lymph nodes from the catscan. They are not definite it is a tumor, but the endoscopy will clear up any uncertainty.

Couple more questions:

(1) Does this mean my father is in stage III cancer?

(2) Would you recommend having a surgical procedure performed for the lymph nodes and the neck or radiation, or would you be unable to determine due to the uncertainty of severity?

(3) Are there any other factors as to why the survival rate is so low? Demographics? Financial status? Obligations towards surgical procedures? It just seems so low to have faith in my father.

I am sorry but I've been bombarded with bad news all day and I am getting extremely weak.

Wow Paul you have had a bad day haven't you. As for his teeth. Unless they are in extremely """GREAT""" shape I would demand them out..You can ask Paul on here about that. His are just brakeing and falling out in pieces. He is in horrible pain with this. However they cannot remove them now because of the radiation. What a mess. It is a dammed if you do, dammed if you don't. As for myself, I had """GREAT""" teeth therefore I didn't have to have mine removed the first time...Nor the second time. However the second time did them in..I had to have the bottom all removed when I had the neck dissection..So that is the question about the teeth,,,now for the other questions..As for the stage of cancer this will be told to you by the cancer doctor...as for recomending,,I cannot really answer that question for I don't know what all is going on with the reports and all that...Listen to the doctor. Ask all the questions you can possibly think of to ask..Your dad is in good hands.as for survival rates, I got cancer the first time in 1986, they told me that the survival rate was 5 years, well I am still here.Paul, as long as there is life there is hope..Don't ever give up, I am sure that he would never give up on you ..Best Always, Vicki Lynn

Yesterday I had scheduled an appointment in Boston, Massachusetts, USA at the Dana Farber Cancer Institute for a second opinion(schedule date: Wednesday August, 11th, 2004). Today I scheduled an appointment in New York City, New York, USA at Memorial Sloan Kettering Cancer Institute for another opinion(schedule date: Tuesday, August 17th, 2004). I understand these are some of the finest cancer institutes in the world. This coming Monday my father has his endoscopy. Both second & third opinion hospitals have required catscan films and biopsy slides. Keep in mind, our current ENT physician does not know about the second and third opinions. Monday, after the endoscopy is performed, the ENT will arrange a date for radiation. I will keep you informed as to the progress of my fathers health. """Live Strong!"""

Paul, Yes those are two of the best places to go. Keep in mind that you have every right to have as many opinions as you think you need or that you can afford. Please limit the cat scans, MRI's, per scans, tho because of the radiation that is in them. Good Luck, God Bless and we will live strong and stay strong. Always Vicki Lynn

I just got back from my fathers endoscopy. It seems like theres just a bunch of bad news. The doctor said there seems to be signs in the stomach. He said it doesnt look like it has spread, but it does seem like there is something in the stomach and then the neck and of course, the mouth. He told us to schedule another appointment for an x-ray of the stomach. His lips are really swollen. Could this be from the endoscopy? Or is the cancer spreading into his lips? What stage does it seem like he is in at this point? Is he still curable? Millions of questions are running through my mind and I feel like this is the only place I can let them out. Thanks for the support.

Oh Paul, what a great son you are. But please don't get yourself into such a state as you obviously are although it is good to be able to let off steam here. But you are taking on too many worries for you to cope with at one time. n All I can say is, as a non-medic, that I think it very unlikely that your father would have bad trouble everwhere all at once. The endoscopy always left/leaves behind some reminders. Swollen lips, throat, whatever.
And there could be masses of acid in the stomach area collecting from the damaged throawt area.
All conjecture. But just as likely as thwe worst-case scenarios you are thinking about.
I am not preaching at all. But try to clear your mind to cope with just one thing at a time.
I wonder if theres any trained counsellor you could have a natter to?
Best wishes to your father and you anyway. Ishbel

Just an update:

Tuesday, August 10th, 2004, I will be picking up my fathers biopsy slides and catscan films for the second and third opinion.

Wednesday, August 11th, 2004, we will be going to Boston at the Dana Farber Cancer Institute/Harvard Medical Center for a second opinion.

Thursday or Friday we will be meeting with the radiology therapist.

Tuesday, August 17th, 2004, we will be going to Memorial Sloan Kettering Cancer Insistute/NYU for a third opinion. This hospital is not covered under our insurance company and the doctors assistant told us it will be roughly $1500 for the initial appointment.

**Does anyone know, if we do not go through our insurance company, how much it will roughly cost from today to the date of the actual surgery?**

Wednesday August 18th, 2004, we will meet with our current ENT to see what options we have.

I will keep you all informed. Thanks for the mentality boost isabel!