Radiation on one or both sides?

dalaitom

I will hopefully will soon start treatments and was wondering... How many places did you have radiated and number of treatments to each place?

In my case, when my tonsils were removed, there was cancer (HPV+) on the right side and the left side tonsil looked "suspicious". There was metastasis to 2 level II nodes on the right. They have mentioned doing radiation for 7 weeks on the right side and 5 weeks on the left to "clean up" that area. I'm just wanting to put things in perspective to see if that's more, less, or about the same as others.

I'm still waiting to see if I will be a candidate for the proton therapy.

SuzJ

Both

As my Drs said, "you don't want to do this, then find one of the lil B**** escaped to the other side, do you?"

 

Do both.

Twostepr

Depends

Usually by the time you get to radiation, you would have had a PET scan done. That's the scan with the injection of radioactive stuff. They usually write the plan for radiation treatment based on what the scan shows. Usually they won't treat an area that doesn't need it. It's really kind of a crap shoot. If you don't get it treated, there's a chance that it could come back. If you do get it treated, there's the risk of radiation fibrosis which could cause a few other problems, and there's still a chance that it may come back. Ever heard of a "Catch 22"? Best of luck either way. If you are a first time cancer patient, I would say do both. 

dalaitom

Twostepr said:

Depends

Usually by the time you get to radiation, you would have had a PET scan done. That's the scan with the injection of radioactive stuff. They usually write the plan for radiation treatment based on what the scan shows. Usually they won't treat an area that doesn't need it. It's really kind of a crap shoot. If you don't get it treated, there's a chance that it could come back. If you do get it treated, there's the risk of radiation fibrosis which could cause a few other problems, and there's still a chance that it may come back. Ever heard of a "Catch 22"? Best of luck either way. If you are a first time cancer patient, I would say do both. 

I'm not really questioning

I'm not really questioning about whether or not to have both sides treated as I feel that is the wise thing to do. I more wanted to know how this compares to others as far as the side effects. If most people are getting only one side treated, then I feel that I'd be getting more radiation than those folks and possibly more side effects. If most people get the full treatment on both sides, then maybe I'm getting off a little easy with 7 weeks on one side and only 5 weeks on the other. I've done a lot of reading here and I don't recall seeing many who mention amount of treatment on each side, just usually they say they were treated. I just mainly want to put my situation in context with what others here have undergone.

Chris50

Work closely with your team

I am cerainly unable to answer this question.  I recommend you continue to discuss with your treatment team.  In my case I had a left tonsil with one definitively involved node and suspicion of another—all weekend in the left side.  My radiologist aid we could give radiation to both sides but because nithing Ed up in the PET he did not want to overdue it.  He said, “if something how’s up on the right down the road, we’ll radiate the right.  I think the standard of care is to target the cancer as aggressivelay as possible while doing as little damage to other tissues.  

 

Keep us us posted and welcome to the discussion board.  This Forum was such a support to me during and after treatment.

corleone

dalaitom said:

I'm not really questioning

I'm not really questioning about whether or not to have both sides treated as I feel that is the wise thing to do. I more wanted to know how this compares to others as far as the side effects. If most people are getting only one side treated, then I feel that I'd be getting more radiation than those folks and possibly more side effects. If most people get the full treatment on both sides, then maybe I'm getting off a little easy with 7 weeks on one side and only 5 weeks on the other. I've done a lot of reading here and I don't recall seeing many who mention amount of treatment on each side, just usually they say they were treated. I just mainly want to put my situation in context with what others here have undergone.

My 2 cents

If you are getting IMRT (very likely) then the radiation dose is not uniform, it will be highest to the target (tumor) and a minimum dose to normal tissues. So if you get treated only one side, you should get less side effects to the untreated side. I said less and not none, because even the “untreated” side will get a minimal dose. But I think it’s a bit risky to get one side treated, because there may be micro-tumors in the “healthy” side, not detectable with current technology.

OKCnative

I had BOT SCC cancer with

I had BOT SCC cancer with involved neck nodes. I was radiated in three places. Dead center of chin and either side of my neck. 35 rads total.

dalaitom

OKCnative said:

I had BOT SCC cancer with

I had BOT SCC cancer with involved neck nodes. I was radiated in three places. Dead center of chin and either side of my neck. 35 rads total.

Thanks. This is the type of

Thanks. This is the type of response I was hoping for. I guess maybe I should have simply asked "How many places were radiated and number of treatments to each?" I have edited my original post to indicate this.

 

Hygienist97

Husbands treatment

My husband just finished treatment for right tonsil cancer.Both tonsils removed only Found in right tonsil no clean margins but well laterilized to right side , spread to right lymph nodes in neck 1-2. He had 3 opinions, the first which recommended 35 rads to right tonsil fossa and right lymph nodes no neck dissection , he felt if it recurred on the left later on he could radiate it later.Second opinion stated the same protocol except for he wanted to do both sides because he felt it would safer in case any cells spilled over to the left lymph nodes plus he said he was suspicious of an area on the left side Node. Third opinion was Proton Therapy which he was a candidate for but would have to wait another 6 weeks to start treatment. This doctor needed a new ct scan to determine if anything treatment was needed for the left side since some time had passed between tonsil surgery and a couple teeth out. Benefit of Proton therapy would have been no Chemotherapy and 6 weeks instead of 7, but it also would have been a fight with our insurance company to get it approved, the Dr. Recommended starting treatments as soon as possible instead of waiting to see if insurance would approve. So ultimately my husband chose 35 rads right tonsil fossa, right and left lymph nodes with Cisplatin 6 of the 7 Cisplatin completed over 7 week Treatment plan.He chose to do both sides of neck because he didn’t want to have to repeat in future hopefully.He is 4 weeks out of treatment and improving a little each day , the treatment was brutal but doable. I read a lot of the other members journals over the duration of his treatment it was very helpful. If you have any questions please feel free to pm. 

dalaitom

Hygienist97 said:

Husbands treatment

My husband just finished treatment for right tonsil cancer.Both tonsils removed only Found in right tonsil no clean margins but well laterilized to right side , spread to right lymph nodes in neck 1-2. He had 3 opinions, the first which recommended 35 rads to right tonsil fossa and right lymph nodes no neck dissection , he felt if it recurred on the left later on he could radiate it later.Second opinion stated the same protocol except for he wanted to do both sides because he felt it would safer in case any cells spilled over to the left lymph nodes plus he said he was suspicious of an area on the left side Node. Third opinion was Proton Therapy which he was a candidate for but would have to wait another 6 weeks to start treatment. This doctor needed a new ct scan to determine if anything treatment was needed for the left side since some time had passed between tonsil surgery and a couple teeth out. Benefit of Proton therapy would have been no Chemotherapy and 6 weeks instead of 7, but it also would have been a fight with our insurance company to get it approved, the Dr. Recommended starting treatments as soon as possible instead of waiting to see if insurance would approve. So ultimately my husband chose 35 rads right tonsil fossa, right and left lymph nodes with Cisplatin 6 of the 7 Cisplatin completed over 7 week Treatment plan.He chose to do both sides of neck because he didn’t want to have to repeat in future hopefully.He is 4 weeks out of treatment and improving a little each day , the treatment was brutal but doable. I read a lot of the other members journals over the duration of his treatment it was very helpful. If you have any questions please feel free to pm. 

Your husband's case sounds

Your husband's case sounds almost identical to mine. I have gotten to the point with the proton center where the only current step left is getting a PCP referral for insurance. I would really like to at least get to where I can have a consult with the proton doctor and hear what he proposes. If it's like you said, "another 6 weeks to start treatment" then I'll have a big decision but at least I'll have heard treatment options from both doctors (IMRT and proton). I have my consult with the radiation doctor tomorrow, hopefully the proton doctor next week.

yensid683

Both sides....

My primary tumor was on the left base of my tongue and it had extended into the left side lymph nodes.  During my first mapping session, they set up a total of 11 exposures, 7 on the left side of my neck and 4 on the right.  It was explained to me that this was done to target all of the involved tissues.  It seemed a bit tedious to me and I was very concerned about damage to surrounding areas but my RO bulit a great plan, and the IMRT team executed it to perfection.   I had the typical side effects, but did not have a lot of skin damage.  My RO recommended that I treat the skin after every session with clear, unscented Aloe and it worked very well.  A word of caution, make sure you clean you neck of it before your next session.

I'm now more than 6 years since I was diagnosed and have only a relatively few side effects.  My thyroid continues to function well, I can move my neck reasonably well (I hae to keep up mobility exercises), taste fully recovered and saliva is around 70% of normal so all in all, I'm happy with the results. 

 

Peter

Charmit

Chris50 said:

Work closely with your team

I am cerainly unable to answer this question.  I recommend you continue to discuss with your treatment team.  In my case I had a left tonsil with one definitively involved node and suspicion of another—all weekend in the left side.  My radiologist aid we could give radiation to both sides but because nithing Ed up in the PET he did not want to overdue it.  He said, “if something how’s up on the right down the road, we’ll radiate the right.  I think the standard of care is to target the cancer as aggressivelay as possible while doing as little damage to other tissues.  

 

Keep us us posted and welcome to the discussion board.  This Forum was such a support to me during and after treatment.

Hi as I’m reading your post,

Hi as I’m reading your post, I’m also getting radiation to the left side seeing the PET scan showed no signs and my oncologist and radiologist both agreed this is the best form of treatment for my case. I start next Monday April 30th...scared to death!! However can you tell me if they continued with just the one side throughout your treatment???

stevenpepe

The whole "clean up" thing

The whole "clean up" thing didn't work out for me. I had 7 weeks of IMRT on both sides, higher dose on the left as biopsy proved slight metastisis. I also had the suspicious area on the right but my team elected to dissect just the left side. That was a mistake because the right side was a growing tumor and the IMRT had no effect on it. Pretty scary. Had to repeat surgery and rads with proton therapy, which left significant scarring and side effects. Cancer-free but those are the facts. Good luck in your treatments.