Catch 22 Need advice ASAP
I have a dilema and will appreciate advice from anyone who has been in a similar situation:
My swollen left neck lymph node appear on July 16, 2016, followed by the right on the 25th. I had a PET CT scan on 8/17/16 and
was diagnosed with H&N cancer stage 4b HPV+, primary : base of tongue.
Yesterday 9/15/16 I had my first appointment with Radiation Oncologist and his MSN. The doc and I did most of the talking.
My big question is about teeth?
He said before he can statrt Rad therapy, I should see my dentist ASAP and ask him to check out all my teeth and if any tooth is
hopeless ask him to extract it right away. The Rad Onco said we will then delay Radiation therapy (which will naturally delay the Chemo
as well), until the moth has completely healed. I asked him if this takes another week or so, will my cancer go to stage 4 c? He said yes it may
and actually it may already be in stage 4 c, and us not knowing it, since the PET does not show anything in the lung.
I called my dentist yesterday and he was shocked by my news and rescheduled a patient to see me today. He is great, extremely caring person
and I have been his patient since 1993. He knows that I have Periodontal disease since 1989 and it is not curable. After a deep root cleaning he took
both a full mouth series X-Ray as well as X-rays of molar, premolar and canine teeth. He stated there are no cavities that he can see visually or
on the X-rays, but then he showed a tooth to me on the full mouth series and I could see that most of the bone aroun that tooth have disappeared
and it is supported by very little bone. He told me he can guarantee that tooth for 6 months, but not for 1 year. I asked his opinion and he realized
how much I am concerned that due to his extraction my cancer may go from 4 b (Curable) to 4 c (Incurable), he told me if I did not have this dilema,
he would stongly suggest for extraction so that I will take no chances my cancer treatment and afterwards. But given my circumstances he would
recommend not to extract it, as we know for sure that it will delay my treartment at least by 1 or 2 weeks and perhaps a bit more.
Unfortunately when I asked either my Chemo T or my Rad. T, how long it takes for my cancer to go from 4b to 4c, I was given the answer
that We don't know. I could have already happened it could happen in a week or 2 months. For the first time my dentist gave me a compromised
answer based on what my Oncos have told me.
I have been tenatively scheduled for a PET CT Simulation for radiation planning (to make the MASK). On 9/20/16. I am the one who goes with it
or cancels it. Another problem is discrepency between what my Radiation Onco and his MSN told me.
He told me: After my 32 sessions of radiations are complete any serious wound in my mouth (He said such as the site of an extraction), will take
many times longer to heal than that same wound before my radiatin. When I got the appt. with my dentist on 9/15/16, called his MSN
to double check and she told me on 2 ocaasions that the MD told me this will be the case 6 months after my radiation treatment is over
and not for rest of my lif. I listened to the tape (I record my sessions with my onclogists with their permissions), he told me on 2 ocassions
the same thing that I originally heard! He dod not specify any time frame after my Radiation treatment has been over and so I have to assume
he meant indefinitely.
I have a big dilema & a very shot time to make a decision and therefore any help from someone who has had a problem similr to mine or
knows about it will be greatly appreciated.
Thanks a lot
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