In a Quandary: Surgery or No Surgery Before Radiation and Chemo

Colibrí

I'm now facing my 4th battle with oral cancer since 2008.  Have had 3 prior partial R glossectomies and a R modified radical neck dissection.  In January, I found a swollen lymph node under my chin.  The needle biopsy was negative but the surgical biopsy was positive as well a biopsy of small ulcer on floor of my mouth. PET scan also showed suspicious node in the left neck.  I've consulted with my ENT who has followed me for 9 years as well as Radiation Oncologist, Medical Oncologist and Speech Therapist for swallowing eval.  The Radiation Oncologist recommended fairly extensive surgery, including L neck dissection, prior to Radiation and Chemo while my ENT, who knows my desire to be able to continue my passion for photography as much as possible during treatment, believes I can be treated with just radiation and chemotherapy.  Radiation Oncologist is concerned about the impact of needing higher dose of radiation.  My ENT has been consulting with other oncologists and, of course, their opinions are split 50-50.  It took me about 6 months to rehab from the RRND (meaning to the point I was able to play golf again) and, of course, I'm concerned about my ability to engage in what I enjoy most while undergoing treatment; i.e. I couldn't tote and use 5 lbs of camera gear with a weak L shoulder.  Although from what I've learned from reading and meetings thus far (I'm a retired psych. clinical nurse specialist), I may well find it difficult to be photographing birds while being "fried and poisoned".   I find myself paralyzed with indecision as well as periodically depressed and scared to death about what is ahead of me.  When I'm out with my camera I'm able to escape from all the questions and fears swirling through my mind.  So I find myself here at this forum, not seeking necessarily an answer to my question, but to learn others experiences in making this decision and how you all arrived at your  decision.

corleone

my 2 cents

I don’t believe surgery is a great option at this point. First of all, surgery CAN’T get rid of all tumors; if it did, you wouldn’t be in this predicament at this point. There are cancer cells all over the place, (cancer stem cells), and they cannot be located with the technology used today. In a few years these will grow again to a sizable volume. Surgery cannot eradicate all these tumors, esp. those smaller than imaging resolution. What’s worse, surgery creates conditions (microenvironment) for microscopic tumors (cancer cells) to grow at a much higher speed. Radiation and chemo are probably the better option. HOWEVER, please check first if you can participate in a clinical trial with newer targeted therapy (like for instance immunotherapy). They should be able to offer you something that might work (usually very effective in lower number of cases ~30% - but you might be the lucky one) with fewer side effects. If that doesn’t work, you can switch to “classical” chemo.

BlacksuitDC

Radiation & chemo FIRST

Kill all the cancer cells first - then the surgeon can remove the dead cancer bed.  Plus radiation /chemo shrinks the tumor.  Less to cut.  You have to live with the quality of live after treatment which can be more of a nightmare problem than the cancer.  Protect your quality of life after treatment.   Don't be scared of the radiation and/or the chemo. That's short term. You can do this. It's not fun but you can do it.  If you want to be scared to death of something...worry about your Q of L after the treatment.

Ladylacy

Radiation

My husband had radiation and chemo first, to no avail.  When referred to a H&N specialist he was very concerned about where or not my husband would heal properly due to the radiation.  He did thankfully.  But when his cancer spread to the cervical of his esophagus, the specialist ruled out further surgery due to the previous radiation and surgery because it would have been basically in the same spot. 

I would ask how more radiation would affect surgery in the future if needed.  There is only so much radiation they can give you.

Wishing you peace and comfort

marijan

because

I believe verdosing on nutrition is the real cure on all cancers. 80 percent Raw diet 20 percent cooked, vit c ivs, s grass powder, supplements, no sugar, no carbs, no red meat, no processed foods, herbal teas, frankincense oil, apricot seeds, laetrile, alkaline water, barley powder, wheat grass, all sprouts, almonds, walnuts, beans and seeds, turmeric, lemon water with baking soda, juicing all greens and carrots and all purple fruits and veggies, berries, viirgin coconut oil, flaxseeds, quinoa, coffee enemas, goji berry, ashitaba leaves, mangosteen, dandelion root tea, exercise 30 minutes twice a day, deep breathing, staying happy and creating your circle of peace, no chemicals in the house or on your body,...overdose on all nutrition you can think of and let all the cancer cells shrink and be gone. Watch the truth about cancer and chris beats cancer, it might help.. 

AnotherSurvivor

marijan said:

because

I believe verdosing on nutrition is the real cure on all cancers. 80 percent Raw diet 20 percent cooked, vit c ivs, s grass powder, supplements, no sugar, no carbs, no red meat, no processed foods, herbal teas, frankincense oil, apricot seeds, laetrile, alkaline water, barley powder, wheat grass, all sprouts, almonds, walnuts, beans and seeds, turmeric, lemon water with baking soda, juicing all greens and carrots and all purple fruits and veggies, berries, viirgin coconut oil, flaxseeds, quinoa, coffee enemas, goji berry, ashitaba leaves, mangosteen, dandelion root tea, exercise 30 minutes twice a day, deep breathing, staying happy and creating your circle of peace, no chemicals in the house or on your body,...overdose on all nutrition you can think of and let all the cancer cells shrink and be gone. Watch the truth about cancer and chris beats cancer, it might help.. 

A guy by the name of Steve

A guy by the name of Steve Jobs tried that.  He had billions to spend on alternative therapy, he's still dead.  I did radiation and chemo with an HMO, I've been pronounced clear.  Go figure.

https://www.quora.com/Why-did-Steve-Jobs-choose-not-to-effectively-treat-his-cancer