Second go 'round w/ SCC

Story45

My FIL was diagnosed with SCC and underwent a supraglottic laryngectomy on 9/19.  Unfortunately, he went through SCC 15 years ago in which they did a radical neck discectomy and he received his full dose of radiation at that time.  His current pathologic stage is pT4aN0.  Clean margins, but his pathology report indicates vascular and perineural involvement.  Met with his radiologist that treated him 15 years ago and he said that he would consider re-radiating, but is concerned that his swallow ability would be permanantely impacted if they do.  Concerned, any advise, similar stories.  I can provide further info if any questions.

 

He still has a trach and PEG from his surgery on 9/19, but has been told that he should be able to lose both at some point.  I guess the big decision facing him is whether or not to re-radiate and possibly lose his swallowing function permanately or cross his fingers and pray that the cancer does not come back.  He is 70 and was/is in great health otherwise.

Kent Cass

This is a good question that the majority of us should be concerned with. 

1) The big problem with the initial C&R not totally getting rid of the C is that follow-up tx options are less: more radiation is typically prohibitive, due to the damage the rads do, and typically only more chemo is an option, or an Op. 

2) How much time must pass before one is considered okay for more rads? I'm 6-1/2  years out from rads being applied in 20 places/session, and still deal with neck spasms with the help of a top Neurologist, and a couple prescriptions. Because of these spasms, does that make it so that more rads cannot be given to me? And how many others of us still deal with rad side-effects, and do those symptoms keep them from getting more rads?

3) Do advances in rads technology play a part in if we can get more rads, and maybe sooner? 

 

Hoping and Praying for the best for him.

kcass

wmc

I'm confused......

You said he had a laryngectomy 9/19 and has a trach that will be removed. He didn't have a full laryngectomy? Because it he did he would have a stoma not a trach and It never gets removed, I have one. Full laryngectomee and am a neck breather. It was in my superglottic T3;N0;MO; Laryngectomee removes your larynx  [voice box]

Wishing him the best.

Bill

Story45

Kent Cass said:

This is a good question that the majority of us should be concerned with. 

1) The big problem with the initial C&R not totally getting rid of the C is that follow-up tx options are less: more radiation is typically prohibitive, due to the damage the rads do, and typically only more chemo is an option, or an Op. 

2) How much time must pass before one is considered okay for more rads? I'm 6-1/2  years out from rads being applied in 20 places/session, and still deal with neck spasms with the help of a top Neurologist, and a couple prescriptions. Because of these spasms, does that make it so that more rads cannot be given to me? And how many others of us still deal with rad side-effects, and do those symptoms keep them from getting more rads?

3) Do advances in rads technology play a part in if we can get more rads, and maybe sooner? 

 

Hoping and Praying for the best for him.

kcass

I don't want to scare anyone

I don't want to scare anyone with the fact that his cancer is back.  They are considering it a completely new cancer.  Unfortunately he had the full shebang of radiation treatment the first time.   His radiologist was really surprised to see him this far out of treatment.

Story45

wmc said:

I'm confused......

You said he had a laryngectomy 9/19 and has a trach that will be removed. He didn't have a full laryngectomy? Because it he did he would have a stoma not a trach and It never gets removed, I have one. Full laryngectomee and am a neck breather. It was in my superglottic T3;N0;MO; Laryngectomee removes your larynx  [voice box]

Wishing him the best.

Bill

Sorry Bill, I should have

Sorry Bill, I should have said partial laryngectomy. His worst case scenario would have been a full laryngectomy, but the surgeon was able to do a partial laryngectomy.

Story45

Story45 said:

Sorry Bill, I should have

Sorry Bill, I should have said partial laryngectomy. His worst case scenario would have been a full laryngectomy, but the surgeon was able to do a partial laryngectomy.

There was BOT involvement

There was BOT involvement too.

 

Ladylacy

2nd radiation

My husband was diagnosed with laryngeal cancer in Juy 2010.  He under went 35 rounds of radiation and 3 rounds of chemo.  In February 2011 we found out that the treatment didn't get the cancer and he had a complete laryngectomy, partial neck dissection and reconstruction of his throat due to the radiation, no cancer was found anywhere else.  Eight weeks later he was able to eat, albiet slowly again and his PEG tube was removed.  In April 2012 he was having a procedure done to help him talk again and our specialist found a tumor at the cervical of his esophagus and said  it was a 2nd primary of SCC.  He said surgery was out and that another round of radiation and chemo was the course of treatment.  We had heard a second round couldn't be done but the radiologist said yes it could, the consequences could be a rupture of the caritoid? artery, something that would be watched carefully.  His second round of radiation was basically in the same spot as the first.  He did fine with the second round (37 radiation treatments) except for some radiation burn where there was new skin on his neck.  Yes it affected his swallowing but once again they were able to stretch his throat and he could eat some but still relied on a new PEG tube.  Sadly the 2nd primary came back within 4-6 months and spread to one of his lungs.  He said he had had enough and stopped all treatment.  Only thing offered was chemo and we were told up front it would only prolong, not cure and possibly hasten his time.  He was 73 when the cancer was found the first time. 

There are others who have gone thru radiation more than once without any problems. 

Wishing you and your family the best -- Sharon

BarryChen1010

It's really surprise it come

It's really surprise it come back after 15 years. Sorry for that. Like kcass mentioned, you may check with the doctor on some new tech, like proton therapy, which may help in this case. But I am not sure.

Barbaraek

I'm sorry your FIL has

a second go 'round with SCC. Once in a lifetime is bad enough! I hope you find some answers and encouragement here. I know that my husband's doctors were making contingency plans if the chemoradiation didn't work the first time through. Some of those plans included the "gamma knife" which is a more precise, pinpoint type of radiation. I don't know whether it would be a consideration in your father-in-law's situation. Also, some centers offer proton beam radiation and that is indicated for some and not for others.

It also sounds like some people are able to tolerate a second treatment plan of radiation.

In any case, it sounds like you have some tough decisions to make - I hope you seek out more than one opinion and that you take the time to need to make the best choices for your situation. I will put your family on the "head and neck" prayer list I have going!

Barbara