Mucoepidermoid carcinoma Low Grade - Require Radiation?

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Dear All,

 

My wife is diagonised with mucoepidermoid carcinoma @ Hard palate last Nov 2013. She had undergone surgery and the pathology report has come as LOW GRADE. Post operation report comes as the tumor was removed with all the margins clear. Our Oncologist now giving us two option for further treatment,

 

1. Let to monitior the tumor by doing scans and routine check ups.

 

2. Recommended for radaition even thought its low grade ( all margins are clear), which means to overtreat it reather than under treating it since she 27 years old.

 

We are going to meet the Radaition oncologist next week before that, i would like to know few clarification.

 

1. Which option we can choose among the above?

 

2. For Low grade, is Radiation is recommeded ?

 

3. If Radiation is recommeded what are the things we need to aware of ?

 

4. If Radiation is recommeded what are the side effects expected?

 

5. For Low grade, is Radiation is recommeded ?

 

Please share us ur experince. Any inputs on this would be really appreciated and helpful for us.

 

Thanks,

Guru

Comments

  • CivilMatt
    CivilMatt Member Posts: 4,723 Member
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    what to do?

    Guru,

    Welcome to the H&N forum, I am sorry for your wide’s condition.

    Your doctor sounds confident about surgery only “being enough” , but he(or she) is not 100%, hence the dilemma.

    There is no kidding about it, radiation side effects can be hard, but radiation does kill cancer cells too (if they are there to be killed)

    Because of the conditions you mentioned, radiation can always be a back-up plan.  She will need to be monitored closely.

    I chose to have surgery, radiation and Erbitux, but I was stage IVa, scc, bot, hpv+ and did not have much choice.  I do not know what I would have done if it was low grade?

    You need to get smart fast, read everything here that you can.  Look over the Superthread (at top of page).  Between what you learn and your doctors you will make the correct choice.

    Good luck,

    Matt

  • ValeIT
    ValeIT Member Posts: 23
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    Hello!

    I did not do radiation therapy. 

    In Italy, doctors do not recommend radiation therapy for low-grade mucoepidermoid if the margins are clear and clean lymph nodes. 

    I'm just doing checks every 4 months ... and every 10/12 months MRI with contrast medium. 

    If oncologists recommend therapy, the proton (hadron therapy) is better because it gives less side effects, but there are a few specialized centers.

  • hwt
    hwt Member Posts: 2,328 Member
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    ValeIT said:

    Hello!

    I did not do radiation therapy. 

    In Italy, doctors do not recommend radiation therapy for low-grade mucoepidermoid if the margins are clear and clean lymph nodes. 

    I'm just doing checks every 4 months ... and every 10/12 months MRI with contrast medium. 

    If oncologists recommend therapy, the proton (hadron therapy) is better because it gives less side effects, but there are a few specialized centers.

    Radiation is tough

    Radiation is tough, don't jump into it lightly.

  • gurusank
    gurusank Member Posts: 13
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    hwt said:

    Radiation is tough

    Radiation is tough, don't jump into it lightly.

    Thanks for info.

    Hi Matt,

    Thanks for your quick response and information.

    @Vale,

    Thanks for your information on proton therapy, we will ask about it when we meet the Dr.

    Is there any other things we need to ask radiation Dr which we need to know? Like dose, time of treatment and all? Please advice.

    Thanks,

    Guru

  • gurusank
    gurusank Member Posts: 13
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    hwt said:

    Radiation is tough

    Radiation is tough, don't jump into it lightly.

    Thanks for info.

    @hwt,

    Thanks for ur response. :)

  • SamAct
    SamAct Member Posts: 9
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    gurusank said:

    Thanks for info.

    @hwt,

    Thanks for ur response. :)

    Similar experience

    I may have had a similar experience, on the soft pallet.  Clear margins and nodes, etc.  The recommendation of both my surgeon and oncologist was to not do radiation, with semi-annual MRIs for two years and once a year thereafter.

    I would be inclined to suggest this path only if the oncologist is comfortable with it.  There are no certainties, of course, but this may be advisable given the clear margins and low grade.

    With the scans you can still keep an eye on it and take more drastic action only if something shows up on a scan.  Frequent testing may limit the potential to miss something and, if something does appear, catch it early on so that it may be treated accordingly.

  • gurusank
    gurusank Member Posts: 13
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    No Radiation Suggested.

    Dear Sam,

    Thanks for your inputs.

    We had meeting with radiation oncologist and he suggested to have followups with scans if required. So no radiations required since its come as low grade and margins are clear.

    I would like to know the recurrance rate of this grade and diesase free progress can make ? 

    In any case can Low grade change to intermediate or high grade?

    Thanks,

    Guru

  • ValeIT
    ValeIT Member Posts: 23
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    gurusank said:

    No Radiation Suggested.

    Dear Sam,

    Thanks for your inputs.

    We had meeting with radiation oncologist and he suggested to have followups with scans if required. So no radiations required since its come as low grade and margins are clear.

    I would like to know the recurrance rate of this grade and diesase free progress can make ? 

    In any case can Low grade change to intermediate or high grade?

    Thanks,

    Guru

    Hello!

    recurrences are very rare in low-grade and usually occur if the margins were not clean. 

    I do not believe that a low degree turn into medium / high grade ... sorry for my English but I use the translator online. 

    Good Sunday to you all

  • gurusank
    gurusank Member Posts: 13
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    Nice to hear !!

    Dear Vale,

    Thanks for your response and its really nice to hear the information.

    Thanks,

    Guru

  • kingcole42005
    kingcole42005 Member Posts: 178
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    I had high grade

    I had high grade mucoepidermoid carcinoma so I had to have radiation, my understanding was that with low grade surgery is the "cure" as recurrance is very low.

  • gurusank
    gurusank Member Posts: 13
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    I had high grade

    I had high grade mucoepidermoid carcinoma so I had to have radiation, my understanding was that with low grade surgery is the "cure" as recurrance is very low.

    Thats Nice to hear.

    Dear kingcole,

    Thanks for ur response , i am happy to see the work "cure" which is very nice.

    I will keep you posted on the progress made.

    Thanks,

    Guru

  • tommyodavey
    tommyodavey Member Posts: 727 Member
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    gurusank said:

    Thats Nice to hear.

    Dear kingcole,

    Thanks for ur response , i am happy to see the work "cure" which is very nice.

    I will keep you posted on the progress made.

    Thanks,

    Guru

    Radiation

    Guru,

     

    Even though I had a low grade MEC tumor, mine had spread to my lymph nodes in my neck so low grade radiation was highly recommended.  If they say she doesn't need it, get a second opinion.  If the second opinion is the same, then spare her the radiation treatment.  If she does get it, it should be a lower grade like mine.  My side effects weren't too bad.  Bad, but not too bad.

     

    It is good news to know hers was low grade with clear margins.  She will be fine once the flap is healed.

     

    Tom

  • SamAct
    SamAct Member Posts: 9
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    gurusank said:

    No Radiation Suggested.

    Dear Sam,

    Thanks for your inputs.

    We had meeting with radiation oncologist and he suggested to have followups with scans if required. So no radiations required since its come as low grade and margins are clear.

    I would like to know the recurrance rate of this grade and diesase free progress can make ? 

    In any case can Low grade change to intermediate or high grade?

    Thanks,

    Guru

    Grade has more to do with the

    Grade has more to do with the type of cells and size, I think.

    My oncologist pointed out that there is also a cancer-related risk with radiation treatment itself, the likelihood of which may even exceed the chance of recurrence at times, especially with lower grades and clear margins.

    Also note that an oncologist will often make these judgement after conferring with a cancer board which may consist of the surgeon and oncologist, among others.