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Question about radiation therapy after surgey timeframe

Posts: 15
Joined: Aug 2013

Hi I have a question regarding the treatment window for radiation therapy and chemo after surgery. My husbad has Squamous cell carcinoma of his right tonsil that spread to his lymph nodes on the same side, removal of both tonsils and radical neck disection on June 12th. They removed about 30 lymph nodes from his neck only 1 node was positive for cancer but it was larger than an egg and it broke from the inside of lymph node to the outside,all other pathology was negative. They said the optimal time to start his radiation and Chemo was within 6 weeks but due to dental issues he had a tooth removed and it was not healing well and now he may have to have another tooth worked on (that the dentist cracked on accident and is now bothering him)we are on week 8 now but if they cant fix and have to remove this other tooth we could be at week 10 before they can start. My question is  I would think that this kind of thing happens often where treatment has to be delayed for one reason or another but does there come a point where he has missed his window and treatment is not an option?A nurse practitioner for the surgeon said there comes a point wherethey don't even bother so now he is so filled with anxiety that it may be spreading while we wait. very concerned and confused.Frown


GavinP's picture
Posts: 114
Joined: Feb 2013

They would hold up your husbands life-saving radiation and chemo for something relatively trivial like dental problems.

I mean, everything I've read suggests that if in doubt they just get the teeth removed ASAP and get on with the life saving part of the treatment.

Teeth can be replaced, lives cannot.

I read stories on the internet where people with SCC have their ENITRE set of teeth rmoved in between operations and radiation - The idea of course being that the doctors will worry about replacing the teeth once the patient's life has been saved. 

It's not for me to judge your husbands treatment of course, but to me it seems strange that they don't just whip his teeth out and get on with radiotherapy as soon as they can...

Posts: 15
Joined: Aug 2013

yes they did remove the first one and he went to have it rechecked and it was not healed enough to start treatment they said that the bone was still exposed and if they started it may never heal correctly. So he is supposed to start this week and over the weekend he has another one bothering him this is one the dentist cracked durring the first removal if they have to piull it out tomorrow he will be another 2 weeks healimg before he is aloud to begin.


GavinP's picture
Posts: 114
Joined: Feb 2013

They do have to be careful that the mouth is (relatively) well healed before they can start radiation due to the damage radiation does to the mouth.

It sounds like your husband has a specific problem that he is taking a long time to heal.

Everything in the mouth is so darn slow healing. Ask anybody on here they'll tell you whatever treatment they've had it's taken an annoyingly long time to recover, but if you've got a problem healing that will just make the issue worse.

Posts: 839
Joined: May 2013

I had surgery on March 6 and 15, and started my rads on May 6.  It was just about 8 weeks from my main surgery to my rads starting.  They told me they liked to do it at around 6 weeks but I was so swollen (from having to have a second surgery so close) that I couldn't lay flat on the table.  They had to wait a couple of weeks to make the mask with a less swollen face (knowing I'd lose weight) to start.  I also became very sick during rad treatment and they had to stop for a week towards the end for me to get a PEG and get rehydrated.  

fishmanpa's picture
Posts: 1217
Joined: Jan 2013

Hi Christy,

If I was to have gone with the original local hospital for treatment, I would have started 5 weeks after my 1st tonsillectomy (palatine) and biopsies. I wasn't told about having dental work done prior but that's an entirely different story and one I won't elaborate on. 

As it was, I ended up seeking treatment at a major CCC and having a neck dissection/more biopsies and a lingual tonsillectomy on Feb 7th, 2013. I had to be certified ready for treatment by my dentist and started treatment March 13th, a full 3+ months after my diagnosis. I too felt like it took too long from the time I was Dx'd until I actually started treatment but in the big scheme of things, it was a pretty normal timeline. As it was explained to me, I had most likely had cancer for well over a year. I first noticed it (a swollen gland) in August of 2012. It had already been there for a while and metatasized by the time I noticed it. 

I will say this though. It seemed like the cancer got "angry" after it was discovered and grew rather fast from my Dx in November 2012 until Surgery. It was about 2.5cm in November and by the time it was removed in Feb., it was 5+cm. 

It's vital that your husband's mouth heal before treatment begins or he'll have more issues. The cancer has been there for some time now and a few more weeks won't make a difference. Between the radiation and chemo, they'll be able to eradicate the beast. 

Positive thoughts and prayers


Posts: 15
Joined: Aug 2013

Thank you all for your comments we are very lucky to have The Ohio State University and their CCC right here in town. They are the most wonderful group of doctors/nurses I have ever seen they just surround you from day 1 with so much carring it is amazing! if we can just get these dental isuues behind us and treatment going. I can't pretend to understand the anxiety he is having and he is really fixating on this 6 week time frame. we meet with Dental and Radiation Oncologist again tommorow I hope they ease his mind a little. Once again thank you i am sure I will be checking back here through this journey with questions and advice,my hubby is not a big internet person per say

God bless and keep you all


Grandmax4's picture
Posts: 709
Joined: Dec 2011

On November 2, 2011, I had a radical neck dissection ,done by my awesome Doctor & team,using the de vinci robot. I had a cancerous mass on my epiglottis and it was removed along with lympth nodes. The nodes came back clear so I did not have to have any Chemo or radiation, very blessed.

The Doctors and Nurses at the Center are the best, you truly know they care about you.

I am now 1 year 9 months out, and doing very well. Had a scope and check-up 2 weeks ago, Ned ( no evidence of disease ).

Your husband is being cared for by some of the best in the world, treatment and recovery, will at time seem brutal, but he will come out the end of the tunnel, ready to continue on with his life

Best wishes, a fellow Buckeye!!


Posts: 15
Joined: Aug 2013

They are awesome there and you can call them day or night with questions/concerns and someone is always either there to take the call or returns the call usually within minutes.They definatly show genuine concern. We are blessed to have them right here. I am happy to hear you are doing well, I know we are just starting this journey but it is inspiring to read others experience and outcomes. I am sure I will be on here often I am not the one with cancer but it sure feels like I am going to be a big part of this journey also.


and Go Bucks!!


phrannie51's picture
Posts: 4673
Joined: Mar 2012

By and large the great majority of us waited months (not weeks) from the time we started seeing Dr.'s  until actual radiation and chemo began.....I went to the first Dr. in January 2012 with the ever so common lump in my neck......my first chemo and radiation didn't start till April 26th.  I didn't have to wait for teeth problems, but had to wait because when they put in my port, they knicked my lung. 

Tell hubby to relax.....SCC is a pretty slow moving cancer.  Since he's going to have this free time before treatment starts, he might as well start eating everything his heart desires......fattening stuff (I was into cheeseburger deluxes and Mexican food Laughing)....puttting on weight at this stage of the game is good!!!  It won't be long before eating is a chore from lack of saliva, and the fact that everything tastes like sheet rock....LOL. 


CivilMatt's picture
Posts: 4318
Joined: May 2012


Welcome to the H&N forum, sorry that husband has to suffer the anxiety of starting treatments.

I had a 2 month delay between surgery and the start of  rads, it did not alter my treatment plans and  I would hope your delay won’t matter either.  Chances are that his surgery already eradicated most of the cancer and rads and chemo are just to get any stragglers

As T and P51 said they want his teeth to heal and in the meantime enjoy all the foods he likes.

Best of luck, you will start soon and then it will be over.


Skiffin16's picture
Posts: 8286
Joined: Sep 2009

I too was STGIII Right Tonsil (primary), plus a secondary tumor same side... SCC, HPV+.

Four chemos, and 35 daily rads, over sixteen weeks...

As mentioned, more than likel a few extra weeks won't change things. I was Dx Jan. 2, 2009, started chemo four weeks later... But I was having symptoms since Oct, 2008...

I finsihed up treatment Mid June 2009..., clean and clear since...

Hang in there...

Thoughts & Prayers,


Posts: 15
Joined: Aug 2013

Husbands dental appointment went good today, tooth was not cracked just a small old filling came loose fixed in a couple minutes he did not even need novacaine. So treatment will start this Wednesday with his first of 33 rad treatments and this Thursday will be his first of 3 Chemo treatments.

once again thanks to all for responding to my question!

Christy Wink

Hummingbird3's picture
Posts: 67
Joined: Aug 2013

I will keep you both in my prayers as you start this journey of treatments. Very thankful today was not a setback  and he can get his treatments started  and be done!! Christie

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