Is it normal to have surgery before radiation?

ScaredLilSis,

Sorry to hear that your brother is traveling this road, but you found a very good site for information, Candi covered a good bit already. As Candi mentioned, an extra set of ears is helpful, take notes and ask questions.

I too had my surgery first, had a couple of Lymphnodes involved and had a Radical neck disection to remove any questionable Lymphnodes besides the two that were found. One reason many Doctors do the Surgery first is that the Radiation changes the DNA in our tissue. Causing the healing process to be a little bit longer.

Your brother will more then likely start his radiation about 6-8 weeks after his surgery in order to heal for that period of time before the RAD's start.

Yes, your brother and whole family have had their world's tossed upside down at the moment, but as mentioned already, all of you can get thru this together. It is a bumpy road, but you will see the many people here that have been down the same path and will offer many good suggestions as you ask the questions.

My Best to You, Your Brother and Everyone Here

ScaredLilSis,

Welcome to the H&N forum where many of us started out scared to death (and of death).  The frightened feeling let up (some) once you get your plan and realize people do live (and live well).

I had surgery on the base of my tongue and a Jugular vein dissection to remove the two locations of known cancer.  My surgeon mentioned having surgery last, just encase the Jugular vein was too involved, but it was doable and he did.  I healed from the surgery very well.

How you support him depends if your close enough (distance wise) to be hands on or can offer only moral support from a distance.  Each can be very helpful.  You will just have to evaluate your place in his treatment train.  Some siblings get right in the thick of treatment and care.  For me my wife was my caregiver and “wheel man” (you see I took one Lorazapam for rads and could not drive).

Others here have gone through what you have described for your brother and they are doing well.  I would think your brother will do well too.

Matt

Is the cancer HPV+? If so, many treatment centers are starting to opt for radiation + chemo first, and surgery only afterward if the cancer is still present. That's how I was treated.

It's probably worth getting a second opinion, especially if you have a major cancer center or teaching hospital near you. Hope this helps!

Laralyn said:

Is the cancer HPV+? If so,

Is the cancer HPV+? If so, many treatment centers are starting to opt for radiation + chemo first, and surgery only afterward if the cancer is still present. That's how I was treated.

It's probably worth getting a second opinion, especially if you have a major cancer center or teaching hospital near you. Hope this helps!

My cancer was HPV+. Due to an unknown primary and some rather agressive tumors, my team opted for surgery first, followed by chemo/radiation. It all depends on your situation. A second opinion, as Laralyn mentioned, preferrably from a CCC is prudent.

"T'

Hi Lil Sis.  I happen to be a Big Sis in this journey we are on.  It is not easy loving someone and not being directly involved.  You have to get all of your questions answered either by your brother or his spouse (if he's married).  You will feel like you are bombarding him with questions.  You will worry that you will increase his anxiety with your questions.  He may need to know less than you "need" to know.  Been there.  You have found the right site.  The people on here are amazing, not only in knowledge, but in spirit.  They will lift you up when needed, but not sugar coat things either.  Our whole family assumed that my brother's cancer was related to his heavy drinking and smoking, but he is also hpv+.  Your brother won't know until he is tested.  The prognosis for hpv+ throat caner patients is very good. The treatment will be the same, regardless.  It won't be easy for him, and your heart will break for him.  My brother is 8 weeks post treatment now and is SLOWLY recovering.  Just keep bringing your questions here.  You will get your answers.

There is at least one other person on here that also has had to deal with this with no insurance.  I am sure she will chime in.  From what I understand, it took a couple of months to get approved by Medicare, but she did. There is so much to worry about with the cancer, my heart just goes out to those who have to worry about money on top of everything else.

Hang in there.  Prayer has helped a lot of us here, and we are all willing to pray for others on this site.  I will add you and your brother to my prayers this evening. 

~Shawn~

I too had STGIII Tonsil Cancer with a lymphnode, HPV+...

Tonsils came out first, then nine weeks of chemo (three week cycles), and an additional seven weeks concurrent with radiation. The reason that I can see of having surgery first is to remove infected tissue, then clean up any residual with chemo and radiaiton.

HPV is a biggie as for H&N cancer these days.., though treatment is pretty much the same regardless... If I were to have someone that I know now, that was Dx with H&N cancer, and no mention or suspicions of HPV were mentioned, I think I'd be skeptical of the MD's..., or at least question them.

I think most of us that haven't been exposed to a lot of people with cancer, feel they are going to die.

Myself included, when Dx all I thought about upfront was pale, no hair, no color people that eventually whithered away and died..., far from reality.

This is the best time in history as for treeatment, knowledge and success rates on treating cancer successfully... So get the dying thoughts out of your head..

Speaking of which, a positive attitude is huge, find one, keep it, and stick those nay sayers in your back pocket for later..

Hydrate, hydrate, hydrate....

Many here will help with anything you encounter or question...

Best,

John