My fatrher (61/M) was dignosed as BoT cancer in April, 2010 and treated by 35 Radiation (IMRT) along with 7 doses of Erbitrux.

He was doing well until Jan 5, 2011 when he started suffering with Ear Pain. He went thru an MRI Scan on Jan 24, 2011 which does not show any growth but pain continues.

A biopsy was done on Feb 28, 2011 and it is established that he developed cancer again.

Doctor said - No Possibility of Radation. And options are:
1- Laser Surgery followed by Chemo
2- Chemo

Would you please care to address: - 1. Do we have any other option? 2. What are chances of survival? Can it be cured now?

Regards
Paras Mishra
paras.mishra@gmail.com

Hello Paras

Sorry to hear about your father. Your father's oncologist is probably best placed to answer your questions. The laser surgery will help remove the lesion without causing morbidity but they can't be sure of removing it all, so the need for chemotherapy. Not all mouth cancers behave the same even if not 'cured'. They can remain quiet for years. I know of patients with base of tongue cancer that had treatment 4 years ago, so it is worth giving the treatment that is advised a try.

Hope that helps.

Best wishes
Vinod

Thankyou Doctor!!

He will under go PET CT tomorrow and later we have appointment with Chemotherapist and Head n Neck Surgen. Will try to update about their opinion.

Thanks again!!

Hello Doctor,

PET CT (11/11/10): Neck: There is focal hypermetabolism (SUVmax 9.96) in base of tongue on the left side of midline. However, no obvious CT demonstrable lesion or abnormal enhancement could be appreciated. There is mild asymmetric bulge in the base of tongue on right side with mildly altered attenuation. However, no abnormal hypermetabolism is evident on the right side.

PET CT (4/3/11): Neck: FDG avid (SUVmax 23.08) hypodense area showing peripheral enhancement is seen at left based of tongue which shows progression in the size as well as metabolic activity since the last scan.

Rest are normal. No locoregional or distanr metasys.

I would like to understand how bad is the case? What is meaning of SUVmax 23.08 as compared to SUV 9.96? As size of growth is not yet revealed by any of test report (MRI/PET CT, what are the options?

Kindly Reply. Thanks.

Regards
Paras Mishra
paras.mishra@gmail.com

Hello Paras

I am not an expert on reading PET CTs. Please ask your father's radiologist to explain what it means. The oncologist is the one to ask abut treatment options.

Best wishes
Vinod

Sorry Doctor! I might asked in eagerness.

However, My Father's Docs (ENT/Radiation/Chemo)rejected the Surgery Option due to high morbidity and they say Tumour is not resectable.

Now, they will start Chemotherapy in a Day of Two. Tomoorow we will visit doc to understand the CT Plan.

However, per your experience, how effective we can control Tongue Cancer with Chemo alone. I know it is tough to answer, but do you see such cases, cancer to be contained (not spreading to other parts) for at least another year.

I am asking this as I am thinking to have another radiation if he survive for another year with similar or lesser tumour.

Thanks
Paras Mishra
paras.mishra@gmail.com

Hi Paras

Each case is different but I do have patients I see who had chemo/radio for base of tongue SCC and are still around after 3 years ....

Hope that helps.

Best wishes
Vinod

Yeah.

He had RT/CT (35 Dose of 60 Grace IMRT and Erbitrux)..

but cancer reccured with in 8 Months at same place....

Now doctors suggested 3 Cycles of TIP (Paclitaxel, Ifosfamide and Cisplatin). And they told me that he has only 1 Year left even after TIP.

Sad! I hope TIP works.

Thanks.