TORS, radiation, and chemo—choices

WWMickey

TORS+ vs Radiation/Chemo

I’ve been diagnosed with p16 (HPV)-positive oropharynx cancer, stage one (cT2N1M0 p16). I have one positive lymph node infected, a likely second positive node, and a questionable third node—all on the same side as my tumor which is at the base of my tongue.

One option is the TORS route. I would have TORS (robotic) surgery done and concurrently a neck dissection to remove the infected lymph nodes. Some people can get by with just the surgery, but my surgeon says that adjuvant de-intensified radiation therapy is “likely expected” about 4 weeks after the surgery, and there is the possibility of adjuvant concurrent chemotherapy. 

On the other hand, I could just choose de-intensified radiation therapy with chemo. They say this treatment has outcomes equal to the TORS. If I choose this route, I’m being treated with two modalities rather than a possible three. The more types of treatment, the more chance there is for negative long term effects with swallowing, eating, etc. One treatment (TORS), is better than two treatments (radiation and chemo), and certainly better than three (TORS, radiation, chemo).

In addition, the TORS surgery sometimes leads to range-of-movement complications in the arm and shoulder.

I’m looking at the University of Michigan cancer program/team for this work because it’s home, and because they offer deintensification treatment.

I’d love to hear your thought on this choice and your experience with any of this.

Thanks for any thoughts you can share—Mickey