Success of radiation only without any surgery after 2-3 years?

Startoker

Hello,

I have cancer (squamous cell carcinoma) of the larynx on my right vocal cord. I’m about to be treated with radiation. Has this worked for anyone on this forum with this type of cancer? In other words, have you been treated with radiation for this cancer and survived for 2-3 years without having any surgeries? Have you been “cured” with radiation alone?

Thanks,

Startoker

wbcgaruss

Hello Star and welcome to the CSN H&N forum. I have not had the treatment you are referring to. But I was wondering if you could give us some more information on your situation. Like what stage is it. Are you being treated at a major cancer center or hospital? Do you have confidence in your care team and is this the only treatment option or did you have others to choose from?

I did find on the net that they seem to usually treat the type of cancer you have with either or surgery or radiation and usually don't seem to use both. I guess it would depend on several factors.

I did find this--

Radiation therapy uses high-energy x-rays or particles to kill cancer cells. It can be used in many ways to treat laryngeal and hypopharyngeal canc

ers:

• As the main (primary) treatment for some early-stage laryngeal and hypopharyngeal cancers. If the cancer is small, it can often be destroyed by radiation, and surgery isn't needed. This can help to preserve better voice quality.

Here is the link to it from the American Cancer Society--

https://www.cancer.org/cancer/laryngeal-and-hypopharyngeal-cancer/treating/radiation.html

Hopefully, someone who has already been treated for this will have some input. Nothing better for advice than first-hand experience.

Wishing You the Best

Take Care God Bless-Russ

Merry Christmas

Startoker

I have been staged T1bN0M0 (i.e. stage one). I’m a medical professional (Registered Respiratory Therapist and Biomedical Engineer). I believe that radiotherapy is simply a formality and just a prelude to surgical intervention. Surgery makes big money for hospitals and other institutions. I believe that the only reason they do radiotherapy is because Medicare and insurance require it before surgical intervention. Otherwise, they would simply begin with surgical intervention. Actually, it probably would be better to begin with surgery because the surgeon would be working with good vital tissue instead of tissue scarred by radiation. Then he may be better able to perform salvage surgery with superior results.

I defy anyone to show me/introduce me to three patients who fit the criteria described in the title of this post. Prove to me that radiation has “cured” anyone.

Startoker

I am being treated by a professional care team and yes, radiotherapy alone (no adjuvant therapies) was the only option I was presented with. Treated at a major hospital network (Premiere) in my area? Yes. Confidence in my care team? Uncertain.

wbcgaruss

Well, Star as a medical professional I would imagine you have seen a good many of these cases, maybe not close up but have a buildup of knowledge because of it.

If I am reading your answer correctly it looks like you are fairly certain you will be getting surgery after the radiation. You can correct me if I'm wrong. You said "I believe that the only reason they do radiotherapy is because Medicare and insurance require it before surgical intervention." And your follow-up to that was do surgery before radiation because it is not scarred or affected by radiation thus healing better. Which I wholeheartedly agree. I have never heard of the ruling that for medicare to pay you need to have radiation first. Usually, in cases on here people have surgery to remove cancer and then radiation and or chemotherapy or both to mop up any cancer that couldn't be removed and also errant cancer cells. Many cases these days of head and neck cancer are handled with radiation and chemotherapy combo alone instead of surgery if possible because of the disfigurement that many times occurs and has been that way for some time. I had the radiation and chemotherapy route for my first cancer back in 2012/2013 of throat cancer. So I assume you are on Medicare? My opinion would be if I was going to have surgery I definitely would want the surgery before anything else. If you are getting surgery the follow-up is to make sure the small stuff is cleared out. Or else not have surgery and go the other route. I will say again if someone was getting surgery it was always the first step or sometimes it is used as the only step because the surgeon feels they can remove the cancer and have clear margins negating the need for any follow-up treatment. It would be worth it to pay a little more if you can afford it and get the surgery first. I was on medicare in Sept. of 2019 and had lymph node surgery of the neck area and then had follow-up radiation to mop up and had no problems.

Anyway, I am getting long here and I may not fully understand your situation I admit but I see you have a professional medical care team and the only option you were given was radiotherapy, premiere treatment at a major hospital all looks good. Confidence in your care team had a ? followed by uncertain. You are having treatment in an extremely vital area and it can have long-term implications, so I would recommend if you are not comfortable with your situation enough you may want to get a different opinion and maybe even at a different hospital in your area, or if you can travel to a major cancer center or hospital which for many of us is difficult or out of the question.

I hope I have given something helpful here and if I have something wrong please feel free to correct me.

Wishing You the Best

Take care, God Bless-Russ

godzilla1964

As far as my treatment goes I'm getting 3 chemos and 30 rads BUT no surgery. My ENT, Oncologist, and Radiologist said that morbidity rates did not improve with surgery so therefore no surgery on the lymph node. As far as the Base of Tongue (BoT) tumour I have surgery would be very extensive, and again with morbity rates surgery vs non-surgery, not worth going thru. I also have the hpv+ version which responds to the current treatment very well. I am comfortable with my current treament plan thanx to my Radiologist. If I have any question he takes his time to explain it to me. I also crosschecked some of the things the Oncologist told me with him. I see him every Wednesday during the course of my radiations.

wbcgaruss

Mr. Zilla glad your treatment is underway and things are going well so far. It al;so sounds like you are surrounded by a good medical team. That's important.

Take Care God Bless-Russ

THX

Surgery then radiation 33 times for squamous cell in left neck lymph. The return of cancer growth was apparent about ten days after radiation ended.

Quiet

First, I am sorry that you are going through this and facing decisions that will have long term impacts.

You asked whether anyone had radiation without surgery. I am one person that didn’t have surgery

I had radiation treatment/chemo for t3n1m0 squamous cell carcinoma located on my tonsil. That was 2 years ago. Where my tumor was located, it would have been difficult to have surgery. I had multiple surgeons tell me it wasn’t operable. For the radiation treatment, I had proton therapy. 70gy to tumor area and 30 to nonclinical areas from cheekbone to collarbone. My recent mri was clear and I also had the blood dna test that was clear. Not sure if you count that as ‘cured’, but radiation kills cancer cells.

Depending on your situation, docs will suggest what they think will work. Different institutions may have different preferences.

Any treatment will have its cost. I picked proton therapy because I wanted radiation to be more targeted. I was worried about the effects of treatment and did not want IMRT.

Some docs are doing descalated radiation doses for early stages cancers such as you described.

Startoker

Would like to have proton therapy or some adjuvant therapy with the radiotherapy; but the only choice I’m given is radiation alone, followed by surgery if radiation alone is not successful. I believe radiation alone is never successful with this type (vocal cord) of cancer. At least not for a period of two years or more. Surgery means profit. They will do surgery if at all possible. If anyone has had success with radiation alone for this type of cancer, I would like to hear from you.

Startoker

https://csn.cancer.org/discussion/comment/1702595#Comment_1702595

You can thank Ronald Reagan for turning hospitals into businesses. I was working in health care (a hospital) when he took office. Before Reaganomics, it was all about patient care. All hospitals were non-profit organizations before Reagan. During and after Reagan it was all about money. Hospitals were virtually enslaved by insurance companies. Diagnosis related guidelines, HMO’s, and limits on hospitalization prevailed. Before Reagan, you stayed in the hospital until you got well. After Reagan you stayed until the insurance company had you kicked out. However, nobody (democrats or republicans) have done anything about it since.

DarcyS

My husband is 10+ years out from treatment of ssc of the piriform sinus T1N2bM0. His cancer was not in the early stages, it was stage 4 due to the lymph node involvement. His treatment consisted of 6 weeks chemotherapy and then 10 weeks of chemotherapy with concurrent radiation. The doctors at University of Chicago said this was the best treatment for him and surrgery would be plan B but wasn't needed as the treatment was successful.

His primary tumor is close to where yours is. A difficult spot to operate due to the location. We had excellent insurance at the time and he was not old enough(55 yrs) for Medicare. At first, our opinion was just get it out with surgery but after his care team explained their reasons and their success rate, we were confident and trusted them. They didn't let us down and were there for the duration and beyond.

We highly recommend a teaching hospital with a team of doctors who specialize in cancers of the head and neck.

Today, he is healthy with few side effects. Wishing the same outcomes for you.

wbcgaruss

Darcy, I am so glad for you and your husband what a wonderful success story.

I am thankful you added your story in. it is always a Blessing to hear from cases like your husbands who are NED, and cancer free because it gives others so much hope and it is wonderful to share in the joy of a success story like yours Darcy.

I stated earlier to Startoker that surgery is usually the first option with radiation cleanup afterward. Well, looking at your husband's case I forgot that sometimes they keep surgery as a backup. I guess there are a number of ways to approach a cancer situation involving surgery, rads, and chemo, and also immunotherapy.

So I would like to state I was WRONG and stand corrected.

I try to do my best on here and give people solid information but I do really goof up sometimes.

Startoker-My Apologies.

Startoker

Anybody??? Has no one been cured with radiation alone?

steven59

consider yourself lucky that you dont have to deal with the side effects of chemo or surgery. You must be very lucky it was caught early. Don't worry, the radiation treatment will give you more than you ever thought you would ever have to live thru!

KB56

I only had chemo and radiation for head and neck cancer as surgery was not an option. I am still cancer free 9 years later b

Startoker

Still unable to find anybody who has been cured with radiation alone.

wbcgaruss

Star try this search on the internet "head and neck cancer cured with radiation alone".

Lots of results to read through but radiation is mostly used in conjunction with surgery or with chemo but few circumstances is it used alone.

Wishing You the Best-Russ

Startoker

https://csn.cancer.org/discussion/comment/1703390#Comment_1703390

Been there, done that. This gives me (at best) some statistics. However, I have not been able to find a single “real” patient for whom this is the case.

wbcgaruss

I think then that by now we can safely conclude that it is probably considered a poor modality by the medical community to use for H&N cancer and for that matter possibly other areas of cancer. In fact if you have not been able to find a single documented patient that was treated in this manner the conclusion should be self evident.

Take Care God Bless-Russ

steven59

It looks like Dr's are taking a less aggressive look at treating some cancers, like hpv+ scc tonsil C instead of going crazy, Dr's have backed off quite a bit from earlier treatments for less long term side effects.