scc nasal cavity cancer

Kent Cass said:

Many issues

"Montreal", so are you in Canada, and part of the "socialist/free" medical system? Are you in Montreal?

"Curie therapy," is a new one, and I did a little research and came-up empty on finding it. Radioactive isotopes sounds like the kinda tx done in Prostate C, where radioactive pellets are put in the prostate, and kept there.

Bottom-line, of course, is that your C/ENT Drs failed you= it came back in only 2 months time, so they never got rid of the C. I understand there could be other factors in play, such as this tx was the best option in trying to save the nose, for instance.

Just about all of us get Chemo and Radiation zappings- the chemo delivering a jab that stuns the C into non-replication, and the rads deliver the knockout punch that gets the C carried out of the ring on a stretcher en route to the county morgue. I was Nasopharyngeal almost 7 years ago, but caught earlier than your husband's was, and the Drs unloaded all their ammo on me in treatment with C&R, making it a bloody hell for some 6 weeks, and not as bad for another 3 weeks (too sick for any rads in weeks 5&6), but I'm still good almost 7 years later.

Did your Drs ever mention the isotopes were a better option than radiation beams/zappings from a rad machine?

I agree with Bill- New York City has 3 of the top C Med Centers in the USA. A trip and opinion gotten from Sloan-Kettering, for instance, might be a very good idea, considering the fact we're talking about the removal of his nose. Do get another opinion at a top C Med Center.

So sorry to read of your husband's bad experience in the ring with Ol' C, and do hope and Pray things will all work-out to the better for him, and you. Truly do.

kcass

Actually, we're just outside of Montreal and yes it is a socialist health care system, but I stop short of referring to it as "free"; "taxpayer funded" would be more appropriate, especially in light of the amount of taxes we pay here!

Curie therapy is fairly new.  It's used mostly for prostate and breast cancer tumors and it has enjoyed very positive outcomes with minimal damage to the surrounding tissue.  This is why they thought it would work for a nasal tumor: kill the tumor, keep the nose.  The radiation oncologist told us there was an 85% chance that it would kill the tumor, end of story.  Looks like my husband fell in that other 15%, but like I said to Bill, this is such a rare tumor, the stats can easily be skewed one way or another with a single case.  The Ent we're working with now, who is well-known and recognized all over the great Montreal area said that this is the first case he's seen of this in 8 years.  

Now we've also working with another ENT who has a specialization in cancer surgery and he will be performing the surgery.  Its a little tougher to recover from a removed nose once its already been radiated, but my husband is otherwise very healthy.  The only problem is that the surgeon usually takes a 1 cm margin from the tumor, but because of the location and size of the tumor, 1 cm would be the straight in his eye.  He says that the pathologist will be present and he will take smaller margins until he reaches normal cells; hopefully, the cells will be normal before the eye.  

Thanks for your support and prayers.  I'll let you know how things turn out.  

Just to follow-up to my first post, my husband had his surgery and it went well.  It's been about a week and a half since the surgery and he's in pretty good shape.  We followed up with the surgeon Wed past and he gave us a few more details on what they found: he confirmed that was indeed a very aggressive tumor, sprouting out in many directions.  Despite this, he was able to remove the full tumor in one piece and leave his eye intact.  The actual removal of the tumor took about 20 minutes but the reconstruction took 5+ hours.  While nothing can be done about the nose (prosthetic will be possible in about 2 months), the surgeon was able to reconstruct the eyelid by pulling up the side of his face, effectively giving him something of a facelift.  He did however go away with part of the cheek bone, a part of the bone above the bridge of the nose (toward the forehead) and below the nose, but above the palette.  Basically, he took a 1 cm margin all around, which came out clear.  The pathologist will do a full report on the excised tissue and come back to us in about another week and a half to confirm if they got everything.  If not, my husband will have the choice of more surgery or radiation.  

While I hate to go straight to the worst case scenario, I feel we must consider it as, up until now everything about this tumor has gone from bad to worse.  Does anybody else with this experience have any thoughts on the pros and cons of either choice?

So, just a follow up.  We got the pathologist report and the margins were mostly clear: the closest was 4 mm on a 1 cm margin, so all in all, a good result.  Turns out there were in fact 2 tumors, not just the original 1, measuring 2.5 x 1.5 cm and 1.5 x 1.1 cm.  Also, with the eroding to the surface, stage 4 cancer was confirmed (IVA -locally advanced tumor).  The tumors were a grade 2, moderately differentiated, and aggressive, and while the tumor was touching the bone, it did not invade it but did invade the septum (no surprise there).  He's healing super-fast but because 4 layers of tissue were pulled up his face, along with the necessary arteries (hence the 6 hour surgery), it may take some time before the surgeon is willing to allow a cast to be taken for a prosthetic, just to make sure it heals properly. 

After 4 weeks of regular weekly visits to the surgeon, we now get a month off before our next visit.  We were informed that the tumor board will advise in time for our next visit as to whether or not radiation is recommended.  The surgeon leans toward not doing so as he feels that the risk is not great enough to warrant the damage caused by external beam radiation, particularly where there's no indication of lymphatic invasion, but we will get the board's advice on our next visit and take it from there.  

Has anybody ever heard of a second tumor showing up in the nasal cavity like that?  And in such a short space of time?  Thoughts on radiation…