Anyone have experience with Dr. Eric Moore or Dr. Guy Petruzzeilli?

ratface said:

Petruzzelli
Guy Joseph Petruzzelli is out of Rush University and very well reknownewed in the field. His Bio is on the Rush University website. The head of head and neck at Northwestern Hospital is said to be the best. The Head lady at the University of Chicago, Kerstin Stenson is also top notch. These are the best three in the Chicago area. I can't remember the name from Rush but he is said to be among the best. Check the hospital websites for their bios.

ratface
We haven't heard from you in awhile. How are things going?
PK

ratface said:

Doing Good
Hi PK

Been out of town and away from computer. I'm six weeks out now and doing well. Getting stronger by the day. I'm getting ready for a neck disection at the end of this month which I imagine is what the poster was inquiring about. Asking about that Doctor puts them in the midwest probably Chicago. Best three Cancer hospitals are University of Chicago, rated 1st in the the tri-state area, Northwestern, and Rush. Can't go wrong at any of them.

ratface
My husband, Bob, is also 6 weeks out. I have a question for you - or maybe two or three.
Are you still using pain meds? Bob is but not nearly as much. Why do you need to have a neck dissection-how did you find this out or did you know that this would be a follow up to your treatment before you started? Bob's ENT said that if the PET Scan in Jan. would show any cells left over, he would clean them up. Is that called a neck dissection?
I'm staying confident that he won't have to go any further with this - let's hope. The reason I inquired about you was that I knew you were seeing a doc a week or so ago, and when you hadn't posted, I worried. Everyone seems like family. Talk Soon. PK

Landranger25 said:

white42876
I am 4 weeks out from my treatment. (33 rad, 3 chemo's over 6 weeks) When my ENT (small town guy)biopsied my single swollen lymph node and it came back positive for cancer, he refered me to a surgeon that is part of the Henry Ford Health System in the Detroit area. Within 1 week of seeing the surgeon he performed an exploratory procedure to determine the extent of the primary cancer (base of tongue), a Wednesday. On Friday, he met with the Henry Ford Cancer Board and that group of Doctors agreed upon my course of treatment. On Saturday I had a medi-port and PEG put in and on Monday I received my first chemo, first radiation on Tuesday. My surgeon, oncologist and radioogist were all part of that board and had a say in my treatment and I still see each one of them regularly. Thay each have access to my records and always know what happened when I visit one of them. I feel my care has been top shelf from bottom to top and highly recomend the "board" system. It brings more experience to your treatment. Good luck to your Dad. It's time to get tough! Just my 2 cents worth.

Mike

Some general observations
First to the poster, You must be from the midwest. You are shopping for services right now. You want a hospital that has what landranger describes, it's called a mutidiciplinary approach. That simply means that the doctors sit around a table somewhere and discuss your case. Some call it a tumor board and arrive at a concensus. I was not being treated at one of those and moved my treatment after chemo and radiation were done. It's more difficult so try and start with a top notch cancer hospital first, usually a teaching university. You can use some of the ACS links to see how many head and neck cancers your particular hospital handled in a particular year. For instance the hospital I was at handles about 4 per year. The hospital I transferred to handles about 4000 per year. You want an ENT cutting into your neck that does neck disections or puts tubes in kids ears?

Pk, there are currently two schools of thought for BOT cancer which has spread to the lymph nodes. One approach is to remove the nodes first then treat with chemo and radiation. It's easier to operate before the radiation has caused damage to the skin and tissue. It begins to get gooy some time after radiation and some ENT's avoid it, they are just not good enough or confident enough. Also the early surgery delays the begiining of radiation. You can't radiate if the neck is all stapled together.


The other school is that well we are going to radiate and use chemo anyway and maybe these will kill it all and surgery won't be necessary. BOT surgery is very difficult and surgeons avoid it because of the qulity of life issues associated with it. The optimal time for surgery after chemo and radiation is around 4-6 weeks because again the tissue begins to change consistency. So I had scans done at four weeks which can't really tell if the readings are false positives from the radiation because the optimal time for scans is 9 weeks.

So now what do you do? You have to make a decision. Do you take the watch and wait approach doing scans every 3 months to see if it is comming back or do you opt for the neck disection post treatment and remove some of that possibility at the onset. My personal choice was to have a neck disection done post treatment to clean things up now. I'm into it already. My deductable for the year is paid up. I'm emotionally ready to just continue treatment and decrease the chance of recurrence. I'm in the camp that if you take away the path for this stuff to travel it is less likely to metastisize down the road. There is much more to consider as there are at least a dozen variations of a neck disection. Some have more chance of severe side efffects than others. They range from radical to selective and this will be the surgeons choice. You can actually see one on u-tube but they are not for the faint of heart. So yes the clean-up that your ENT refers to is a neck disection. You want to ask him/her this question, What percentage of cancer is typically discovered to remain in a lymph node post radiation. Again this will depend on the extent of spread, was it 1 or two nodes or multiple nodes on both sides? There are many variables on the disease itself as well as methodology of treatments on both sides and you can drive yourself insane with the possibilities. All I implore you to do is to question every decision your doctors make and ask them to base it on some credible research and then if you are comfortable with their answer you go with it.

ratface said:

Forgot to answer one question
No I am not taking pain medications. I currently take an anti anxiety med, otc prilosec for heartburn that started with the treatment, and a multi vitamin to try and get my anemic red blood cells back to a decent level. I also drink copius amounts of water because of saliva issues. I also still have the peg and port in. My ENT stated the port for chemo will be removed during the operation on the neck? They also stated that they will not remove the feeding tube until such time that they are satisfied that I can maintain my weight. I'm fine with that, I have been maintaining and if the neck disection causes problems eating I'm ready with the tube. Thats one procedure I never want done again! I imagine that after the neck cutting I will be back on pain meds. I hate them, the associated constipation is just not worth it to me.

thanks ratface
Thanks for the answers to all of my questions. Bob will have his feeding tube pulled tomorrow as he has not used it now for over 2 1/2 weeks. We have another ENT appointment next week so I will ask more questions then. PK

white42876 said:

Mike,

We have decided on The James Cancer Center in Columbus Ohio. First, we live in Columbus and it is close so that is great but they also have the "board" system as well. My dad, Tim had 3 appts yesterday one with Dr. Teknos who is the head of head and neck surgery at The James then one with the speech pathologist then one with the dentist. It was a long day but I feel the information we gained in the end was great! All of his doctors are in the same place and they will all have access to his info and will be working for him as a "group". We have also seen some other doctors in the Columbus ohio area but weren't nearly as impressed with the process if you will. I hope we have made the right decision! It was really hard to see my dad as a patient yesterday he has been healthy for all of my life (I'm 33) and now he is sick and needing a little help. I almost started crying in the exam room when the doctor came in and started asking him questions. He was sitting in this chair and looked like a scared little kid. The doctor had asked him if he had ever smoked or drank (which he hasn't) and he started to speak and then got choked up. Anyway, the course of action that was decided yesterday was a course of radiation and chemo. The doctor said the rate of success was excellent. My dad needed to hear that! Thanks for your 2 cents!

Thinking positive!
Lisa

Great choice
You made a great choice, a cancer center that uses the multi diciplinary approach. You have done the best you can for your dad. Also remember that these guys are not "Gods" and if at any point you need a second opnion you politely tell them your going to do it and can even ask them for recommendations. Many of them expect it or even insist on it. Best of luck to your Dad. Your description of him as a "Kid" is so true. This can humble anyone. Take care of your father and keep us informed.