Surgery Prior to Radiation

I was Dx on a Friday, Tonsils came out on Monday...

No dissection though... But it was probably a month before chemo started, after the port, this that and the other. Then after nine weeks of chemo, another seven conccurrent with rads.

John

Your's is very good candadate for surgery first first. Get the tonsil out first, along with the neck dissection, then radiation to get anything left. 

I requested surgery first, the Rad Dr always want's to do rad first. Mine was a tumor above my larynx. I felt remove the tumor and I'll be fine. Had to have my larnyx removed and neck dession at same time. Do rad if needed. I was lucky and they got it all with surgery and didn't need Rad or chemo. From what I have heard on this H&N the ones that had the neck dessection before radaition have it much easier and less neck and sholder problems.

Bill

Shell,

I had jugular vein dissection and bot surgery 1 ½ months before rads were scheduled to begin.

Your doctors have traveled this road; most likely they will make a good choice.

Matt

Goyca said:

Hello Shell, I had surgery

Hello Shell, I had surgery before radiation, waited 4 weeks between surgery and rads.I had a head surgery not neck !

good luck

Then a six week wait!

Hi. I had stage III tonsil cancer and had the exact treatment plan that you describe.  TORS surgery was July 2012 and I started radiation I think it was 3 or 4 weeks later. Surgery was not that bad and I had reduced radiation because tumor was small.   I have very few side effects and can eat most everything.   I did have the PEG tube to help with eating during and after treatment, (mainly because everything tasted horrible and I could not eat).  No swallowing issues at this time.  It took me about a year to get most of my energy back.  I still get fatigued easier than I did pre cancer but I can live with that. You can do this.  Just take one day at a time and look at your recovery as your job now.  Nothing else matters except your recovery.  

Laralyn said:

Just to present another POV:

Just to present another POV: I had Stg. IV SCC in my left tonsil, 2 lymph nodes, and growing out of my soft palate. I had NO surgery at all--just chemo and radiation. My oncologist said the recent clinical outcomes were virtually identical with and without surgery, especially if the cancer was HPV positive (and mine was).

It's a tough course of treatment even without surgery. I think it's worth getting a second opinion from another facility in your area, just so you feel 100% confident in your choice.

Like Laralyn, a number of us have not had any surgery. I did not reference the NCCN HNC standard of care guidelines to see when surgery is recommended but it is a proven path depending in the diagnosis. I had induction chemo TPF (Taxotere, cisPlatin, and 5Fu) first and that basically eliminated all measurable cancer. Then a heavy dose or concurrent chemo-rads ravaged what microscopic remants of the beast.

Listen to the doctors and insist on a tumor board review and get their opinion. Remember there is likely a 100 years of experience behind these reviews and recommendations. It just seems hard for anyone of us to be able to make better decisions. Ask informed questions until the answers and rationale give you the level of comfort you need. Ultimately, it boils down to trust in your doctors. Good luck.

Shell_7801 said:

Ok surgery it is then. Not

Ok surgery it is then. Not that I have a choice. It makes sense that my skin will heal faster prior to rad's. I want the rad's to start right away. Actually I'm making the 4 hour trip to his office right now. I hope I leave there with my surgery scheduled. Odd how life occurs. Two weeks ago I was planning a big trip to see grand baby born. Now I'm planning on saving my life. Thank you all for responding. I feel better now. 

 

Shell

Shell, the good news is that you are planning to save your life!   Always think postive as you can beat this as you've see from many on the site who have done exactly that.  I was like Guzzle in that I went under to find the primary, it turned out to be my tonsil, but no other surgery was done.  I had to wait 3 weeks to start radiation to let the tonsil heal.

Good luck,

Keith

I had reverse of schedule, where treatments were done prior to surgery.  But I did have to have some teeth extracted prior to starting radiation and chemo.  Went to oral surgeon on October 12 and radiation had to wait until Nov 1 to give my gums time to heal after the extractions.