Concerns and Seeking Guidance on My Father's Post-Treatment Complications

I'm writing to express my deep concerns and to seek guidance regarding my father's prolonged and complex battle with squamous cell carcinoma. Here's a chronological account of his treatment journey:

1. **Initial Discovery**: Squamous cell carcinoma was detected on his right vocal cord. The tumor was successfully excised using laser surgery.

2. **First Radiotherapy Course**: Following the surgery, he underwent 28 sessions of radiotherapy.

3. **Tumor Recurrence**: Unfortunately, the tumor re-emerged six months later, prompting a total laryngectomy accompanied by a tracheostomy.

4. **Further Relapse and Chemotherapy**: Six months post-laryngectomy, the cancer resurfaced below the lower jaw, measuring 1.9 cm and adhering near the esophagus. Subsequently, he underwent three cycles of chemotherapy (consisting of cisplatin, Taxotere, and 5FU) every 21 days. This treatment regimen reduced the tumor size to 1.1 cm.

5. **Second Radiotherapy Course**: He was then treated with radiotherapy using IMRT technology, spanning 33 sessions. This treatment targeted both the tumor and the lymph nodes on either side of his neck.

Roughly two and a half months post-radiotherapy, my father started experiencing numerous adverse effects. He's in persistent pain and heavily reliant on painkillers, with pronounced pain in the tumor region and dental gums. Tragically, many of his teeth have turned necrotic, and he's lost a significant number. His swallowing ability has transformed; he struggles and the act feels unnatural compared to before. Notably, he's developed swellings on both sides of his neck and underneath his right jaw. These swellings sometimes extend below the jaw, only to recede later. Both our radiologist and neck specialist suggest this might be lymphedema resulting from radiation exposure. Half of his neck region has turned conspicuously hardened and swollen. Additionally, a salivary gland malfunction has caused a persistently dry mouth, with the glands beneath his tongue appearing inflamed and reddened.

Although I've requested diagnostic tests to ascertain the root cause of these symptoms, the doctor advises waiting until three months post-radiotherapy to avoid potential false results. My predominant apprehension is that the swelling, especially on the side opposite the primary tumor, isn't mere lymphedema but signifies another malignant growth. If accurate, this might mean tumors are encircling his esophagus.

The myriad of symptoms, coupled with the periodic swelling reaching up to the ear and then receding, has left me profoundly anxious. I am earnestly seeking guidance, insights, and second opinions.

Thank you for your attention and consideration.

Sincerely,

ALI