Surgery Prior to Radiation

Hello everyone,

My ENT is wanting to perform a tonsillectomy and neck dissection on the same day and then start radiation treatment.  How many of you had surgery prior to radiation and how long did you have to heal before the radiation could start?

I of course want all of my treatment to start immediately but am worried about the damage to the tissues in my neck if radiation is started too soon.

I appreciate your support so much.

Thank you!

 

Shell

Comments

  • KTeacher
    KTeacher Member Posts: 1,103
    Surgery before

    All of my surgeries have been before radiation.  Never had to wait very long for radiation to begin, maybe 6 weeks at the most.

  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    Tonsils Out

    I was Dx on a Friday, Tonsils came out on Monday...

    No dissection though... But it was probably a month before chemo started, after the port, this that and the other. Then after nine weeks of chemo, another seven conccurrent with rads.

    John

  • duck1255
    duck1255 Member Posts: 40
    Skiffin16 said:

    Tonsils Out

    I was Dx on a Friday, Tonsils came out on Monday...

    No dissection though... But it was probably a month before chemo started, after the port, this that and the other. Then after nine weeks of chemo, another seven conccurrent with rads.

    John

    Surgery

    From what my doctors told me incisions heal better and stitches can come out quicker on skin that hasnt had radiation. My stitches were taken out after 8 days and would have been about twice as long if I had gone thru radiation

     

  • wmc
    wmc Member Posts: 1,804
    I'm for surgery first.

    Your's is very good candadate for surgery first first. Get the tonsil out first, along with the neck dissection, then radiation to get anything left. 

    I requested surgery first, the Rad Dr always want's to do rad first. Mine was a tumor above my larynx. I felt remove the tumor and I'll be fine. Had to have my larnyx removed and neck dession at same time. Do rad if needed. I was lucky and they got it all with surgery and didn't need Rad or chemo. From what I have heard on this H&N the ones that had the neck dessection before radaition have it much easier and less neck and sholder problems.

    Bill

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

    I'm for surgery first.

    Your's is very good candadate for surgery first first. Get the tonsil out first, along with the neck dissection, then radiation to get anything left. 

    I requested surgery first, the Rad Dr always want's to do rad first. Mine was a tumor above my larynx. I felt remove the tumor and I'll be fine. Had to have my larnyx removed and neck dession at same time. Do rad if needed. I was lucky and they got it all with surgery and didn't need Rad or chemo. From what I have heard on this H&N the ones that had the neck dessection before radaition have it much easier and less neck and sholder problems.

    Bill

    Surgery first

    I had surgery first. If memory serves me right, they pushed the envelope on starting my rads/chemo to let the wound on my leg heal as long as possible. (I had my fibula removed to replace my jaw bone). I think I was almost 8 weeks between the two.  

     

  • CivilMatt
    CivilMatt Member Posts: 4,721 Member
    the time to strike

    Shell,

    I had jugular vein dissection and bot surgery 1 ½ months before rads were scheduled to begin.

    Your doctors have traveled this road; most likely they will make a good choice.

    Matt

  • Goyca
    Goyca Member Posts: 220
    Hello Shell, I had surgery

    Hello Shell, I had surgery before radiation, waited 4 weeks between surgery and rads.I had a head surgery not neck !

    good luck :)

  • Guzzle
    Guzzle Member Posts: 710
    Goyca said:

    Hello Shell, I had surgery

    Hello Shell, I had surgery before radiation, waited 4 weeks between surgery and rads.I had a head surgery not neck !

    good luck :)

    surgery

    Then a six week wait!

  • Shell_7801
    Shell_7801 Member Posts: 71
    Guzzle said:

    surgery

    Then a six week wait!

    Ok surgery it is then. Not

    Ok surgery it is then. Not that I have a choice. It makes sense that my skin will heal faster prior to rad's. I want the rad's to start right away. Actually I'm making the 4 hour trip to his office right now. I hope I leave there with my surgery scheduled. Odd how life occurs. Two weeks ago I was planning a big trip to see grand baby born. Now I'm planning on saving my life. Thank you all for responding. I feel better now. 

     

    Shell

  • lorig01
    lorig01 Member Posts: 83
    Same treatment plan

    Hi. I had stage III tonsil cancer and had the exact treatment plan that you describe.  TORS surgery was July 2012 and I started radiation I think it was 3 or 4 weeks later. Surgery was not that bad and I had reduced radiation because tumor was small.   I have very few side effects and can eat most everything.   I did have the PEG tube to help with eating during and after treatment, (mainly because everything tasted horrible and I could not eat).  No swallowing issues at this time.  It took me about a year to get most of my energy back.  I still get fatigued easier than I did pre cancer but I can live with that. You can do this.  Just take one day at a time and look at your recovery as your job now.  Nothing else matters except your recovery.  

     

  • Laralyn
    Laralyn Member Posts: 532
    Just to present another POV:

    Just to present another POV: I had Stg. IV SCC in my left tonsil, 2 lymph nodes, and growing out of my soft palate. I had NO surgery at all--just chemo and radiation. My oncologist said the recent clinical outcomes were virtually identical with and without surgery, especially if the cancer was HPV positive (and mine was).

    It's a tough course of treatment even without surgery. I think it's worth getting a second opinion from another facility in your area, just so you feel 100% confident in your choice.

  • donfoo
    donfoo Member Posts: 1,771 Member
    Laralyn said:

    Just to present another POV:

    Just to present another POV: I had Stg. IV SCC in my left tonsil, 2 lymph nodes, and growing out of my soft palate. I had NO surgery at all--just chemo and radiation. My oncologist said the recent clinical outcomes were virtually identical with and without surgery, especially if the cancer was HPV positive (and mine was).

    It's a tough course of treatment even without surgery. I think it's worth getting a second opinion from another facility in your area, just so you feel 100% confident in your choice.

    Ditto.. no surgery

    Like Laralyn, a number of us have not had any surgery. I did not reference the NCCN HNC standard of care guidelines to see when surgery is recommended but it is a proven path depending in the diagnosis. I had induction chemo TPF (Taxotere, cisPlatin, and 5Fu) first and that basically eliminated all measurable cancer. Then a heavy dose or concurrent chemo-rads ravaged what microscopic remants of the beast.

    Listen to the doctors and insist on a tumor board review and get their opinion. Remember there is likely a 100 years of experience behind these reviews and recommendations. It just seems hard for anyone of us to be able to make better decisions. Ask informed questions until the answers and rationale give you the level of comfort you need. Ultimately, it boils down to trust in your doctors. Good luck.

  • Guzzle
    Guzzle Member Posts: 710
    donfoo said:

    Ditto.. no surgery

    Like Laralyn, a number of us have not had any surgery. I did not reference the NCCN HNC standard of care guidelines to see when surgery is recommended but it is a proven path depending in the diagnosis. I had induction chemo TPF (Taxotere, cisPlatin, and 5Fu) first and that basically eliminated all measurable cancer. Then a heavy dose or concurrent chemo-rads ravaged what microscopic remants of the beast.

    Listen to the doctors and insist on a tumor board review and get their opinion. Remember there is likely a 100 years of experience behind these reviews and recommendations. It just seems hard for anyone of us to be able to make better decisions. Ask informed questions until the answers and rationale give you the level of comfort you need. Ultimately, it boils down to trust in your doctors. Good luck.

    surgery

     

     

     

     

    Shell, My surgery was decided upon whilst I was under. They had not found the primary but did when I was under. They also biopsied the lump which was also inconclusive until then. It was found to be hpv scc in the tonsil. As you can see here there is more than one way to approach it.

     

    The very best of luck, that sense of humour will help you. G.

  • KB56
    KB56 Member Posts: 318 Member

    Ok surgery it is then. Not

    Ok surgery it is then. Not that I have a choice. It makes sense that my skin will heal faster prior to rad's. I want the rad's to start right away. Actually I'm making the 4 hour trip to his office right now. I hope I leave there with my surgery scheduled. Odd how life occurs. Two weeks ago I was planning a big trip to see grand baby born. Now I'm planning on saving my life. Thank you all for responding. I feel better now. 

     

    Shell

    Surgery

    Shell, the good news is that you are planning to save your life!   Always think postive as you can beat this as you've see from many on the site who have done exactly that.  I was like Guzzle in that I went under to find the primary, it turned out to be my tonsil, but no other surgery was done.  I had to wait 3 weeks to start radiation to let the tonsil heal.

     

    Good luck,

    Keith

  • debbiejeanne
    debbiejeanne Member Posts: 3,102 Member
    shell, i ended up needing

    shell, i ended up needing surgery 2/28/12.  that was after rad tx (last tx 0/22/09).  i had many complications due to radiated skin and spent over a month in hospital trying to recover.  if you must have surgery, it is much better before skin is ruined by rads.  be positive.  you will make it thru this and you may not be there for the birth of your grandchild, but you WILL be here to be part of his/her life!

    God bless you,

    dj

  • SASH
    SASH Member Posts: 421 Member
    Treatment Schedule

    I had reverse of schedule, where treatments were done prior to surgery.  But I did have to have some teeth extracted prior to starting radiation and chemo.  Went to oral surgeon on October 12 and radiation had to wait until Nov 1 to give my gums time to heal after the extractions.

  • Hello :)I had my surgery on

    Hello :)

    I had my surgery on 27 December 2013, and my radiotherapy started early February 2014, just after the PEG was put in. You can see the surgery I had in my profile, but it included a radical neck dissection.

    I started back at work on 18 June, and I have been full time since the end of July.

    Hugs to you. You will get through this. Your body and you inside are stronger than you think x x x Estelle x x x