Husband diagnosed Nasal Cavity SCC

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nikolaf
nikolaf Member Posts: 50
edited August 2017 in Head and Neck Cancer #1

I am new here.  Please forgive the copy/paste but I don't have the strength to type this out again.  Any advice at all is appreciated.

________

For the past year, he has been having severe nose bleeds.  For the past 8  months he has seen multiple Dr's without answer.  His last Dr. biopsied his nose (in May) and said he did not have cancer but possibly Wegener's (which is fatal but possibly manageable) but all tests were coming back negative for that.  He said it was a mystery.  He went to yet another DR. At first, they thought it was also Wegener's....  but when pathology came back it was determined he had cancer.  This was a week ago Monday.  Thursday he had scans.  Friday he saw the man who would be his surgeon.  

He has Nasal Cavity Squamous Cell Carcinoma (NCSCC) which is extremely rare >1% of all cancers.  However, that -while advanced- it was not intruding into 'adjacent' areas (no ocular, brain, sinus involvement at all), and no thyroid/ nodal involvement.  It is classified advanced because of the size and because there is bone destruction in his nasal bridge.  He said -despite this- it is not as awful as it sounds.  Because of the lack of additional involvement, this means it is manageable, according to the dr.  He will have to have *extensive* surgery, nasal reconstruction, and about 5 weeks of radiation (no chemo). The doctor said there is a surprising amount you can remove from the nasal cavity and it isn't a big deal with this cancer.  He believes he will make a full recovery.  Surgery will be in the next 2 weeks.

________

I am cautiously optimistic...? But still nervous.  Today he had a break down worried it is worse than they thought maybe in the lymphnodes or eyes and he has been misdiagnosed again.  We are supposed to hear more today about surgery and an MRI.

 

Thanks for reading.  I've been looking here for the past week suspecting this is what he had.....  You all seem very supportive. I hope I can lend support back.

 

 

«13

Comments

  • CivilMatt
    CivilMatt Member Posts: 4,722 Member
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    Welcome

    nikolaf,

    Welcome to the H&N forum, I am sorry that you are here.

    Just from your words it sounds like you have a current doctor with somewhat good bedside manner and a plan is forming.  That is good.  It is all a bit scary, but what you said sounds safely doable.  For peace of mind you may seek the advice of someone who specializes in this rare cancers and its location.

    You both just need to try and stay focused and keep moving forward.  Other H&N members have dealt with cancer in the same location and have had surgery and are doing well.  While this is a trip to test you, you can do fine.

    There are things this forum can be helpful with along your journey, just ask.

    Matt

     

     

  • nikolaf
    nikolaf Member Posts: 50
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    Thanks so much for the

    Thanks so much for the response....  I'm trying to cling to the hope the dr would not say he can get it all out and post-radiation he should fully recover and have good prognosis long term if he didnt really mean that....?

  • macmanrick
    macmanrick Member Posts: 16
    edited August 2017 #4
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    nikolaf said:

    Thanks so much for the

    Thanks so much for the response....  I'm trying to cling to the hope the dr would not say he can get it all out and post-radiation he should fully recover and have good prognosis long term if he didnt really mean that....?

    Nasal Cavity SCC

    Hi - there is always fear of the unkown, but lett you tell you my story.

     

    Last Novemeber I was diagnosed diagnosed with Nasal Cavity SCC and it was also advanced.  My cancer  spread to one lymph node.  I had surgery on Nov. 28 and a bilaterral neck disection a week later.  The pathology report showed clear margins (the cancer had not spread to surrounding tisssue, sinuses or bone) and of the 98 lymph nodes removed only one  was cancerous and it was totally enscapsulated (limiting the chance of spreading).  The tumor board at the hospital reviewed the case and all concluded the the surgeries were successful and no additonal treatment (radiation or chemo) was required.

     

    9 months later I am still cancer free and generally recoverd.  My surgeon was also confident, so far his treatment appears right.  The treatment plan I had was not only the opinion of the surgeon, but a collection of surgeons, radiologists and specialists at the hospital.  All backed with scans and tests and constant monitoring.

     

    Keep the faith and ask all the questtions you want to make the right decision for your husband.  The cancer is rare and there are not too many of us out there to discuss with.  If i can help with information I will.

     

    Keep the faith and good luck!

     

     

  • nikolaf
    nikolaf Member Posts: 50
    edited August 2017 #5
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    Nasal Cavity SCC

    Hi - there is always fear of the unkown, but lett you tell you my story.

     

    Last Novemeber I was diagnosed diagnosed with Nasal Cavity SCC and it was also advanced.  My cancer  spread to one lymph node.  I had surgery on Nov. 28 and a bilaterral neck disection a week later.  The pathology report showed clear margins (the cancer had not spread to surrounding tisssue, sinuses or bone) and of the 98 lymph nodes removed only one  was cancerous and it was totally enscapsulated (limiting the chance of spreading).  The tumor board at the hospital reviewed the case and all concluded the the surgeries were successful and no additonal treatment (radiation or chemo) was required.

     

    9 months later I am still cancer free and generally recoverd.  My surgeon was also confident, so far his treatment appears right.  The treatment plan I had was not only the opinion of the surgeon, but a collection of surgeons, radiologists and specialists at the hospital.  All backed with scans and tests and constant monitoring.

     

    Keep the faith and ask all the questtions you want to make the right decision for your husband.  The cancer is rare and there are not too many of us out there to discuss with.  If i can help with information I will.

     

    Keep the faith and good luck!

     

     

    Thank you so much for sharing

    Thank you so much for sharing your story!!! So comforting!!!

     

    did you have your nose removed or partially?  Did they do the neck disection as an elective treatment?  As well as the other lymphnodes??

     

    how much radiation did you need? Or do you mean you never had any radiation?

  • macmanrick
    macmanrick Member Posts: 16
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    nikolaf said:

    Thank you so much for sharing

    Thank you so much for sharing your story!!! So comforting!!!

     

    did you have your nose removed or partially?  Did they do the neck disection as an elective treatment?  As well as the other lymphnodes??

     

    how much radiation did you need? Or do you mean you never had any radiation?

    Experience

    Glad to share my experience.

    I had a complete rhinectomey (whole nose removed).  Prior to the rhinectomy I had multiple CT scans, multiple MRI's and a PET scan.  I also noticed a lump my neck right before the PET scan.  The PET scan indicated activity in the lymph nodes in my neck prompting the bilateral neck disection. 

    To elaborate, the PET scan showed activity (not necessarily meaning cancer, inflamation of lymph nodes has many causes) on both sides of my neck.  This is why the surgeon recommended the bilateral disection removing groups of lymph nodes on boh sides commonly associated with the SCC cancer and location of the tumor.  The surgeon explained this to me, i also researched and it made sense.

    I did not have any radiation treatment for a couple of reasons.  The surgeon classified my cancer with the Tx Nx Mx method rather than the traditional staging method.  I was clasified as T2 N1 M0 meaning:

    1.  T2 - the tumor was advanced (larger size)

    2.  N1 - there was lynph node involvement in one node, on the same side of the neck as the cancer.

    3.  M0 - no metastisis to other parts of the body.

    In addition, The patholgy report after the surgeries indicated the tumor was well differentiated (meaning the tumor cancer cells and the surrounding tissue cells were very different).  This is a good sign indicating the margins were clear and the tumor may have been completly removed.   The other "good" part of the pathology report was that the cancerous lymph node was totaly encapsulated (meaning the cancer probably has not spread). 

    My underrstanding of raditiation treatment in the head and neck (beared out by many memebrs here) is that it has physical concequences and can be dangerous to surrounding tissue, nerves, eyes, teeth...etc.).  In addition, because of the risks the radiation dose (streght) has to controlled and the area can only be treated a limited number of times. Becauuse of all of the above the tumor board recommended no radiaiton so that if the cancer returns, it can be treated with a full dose of raditation at that time.

    It all made sense to me, but not without listening, researching and asking questions

    I am offeering this informattion to hopefully help you make the best decision for your case and comfort you that there are reasons and variables  for treatment based on tests and the information available.  Every case is different  (the fickle nature of the disease), don't be persuaded by my story, use it to arm yourself with information and ask enough qurstions to you feel comfortable making a choice.

    Feel free to ask more qquestions, I am happy to help.  

     

  • nikolaf
    nikolaf Member Posts: 50
    Options

    Experience

    Glad to share my experience.

    I had a complete rhinectomey (whole nose removed).  Prior to the rhinectomy I had multiple CT scans, multiple MRI's and a PET scan.  I also noticed a lump my neck right before the PET scan.  The PET scan indicated activity in the lymph nodes in my neck prompting the bilateral neck disection. 

    To elaborate, the PET scan showed activity (not necessarily meaning cancer, inflamation of lymph nodes has many causes) on both sides of my neck.  This is why the surgeon recommended the bilateral disection removing groups of lymph nodes on boh sides commonly associated with the SCC cancer and location of the tumor.  The surgeon explained this to me, i also researched and it made sense.

    I did not have any radiation treatment for a couple of reasons.  The surgeon classified my cancer with the Tx Nx Mx method rather than the traditional staging method.  I was clasified as T2 N1 M0 meaning:

    1.  T2 - the tumor was advanced (larger size)

    2.  N1 - there was lynph node involvement in one node, on the same side of the neck as the cancer.

    3.  M0 - no metastisis to other parts of the body.

    In addition, The patholgy report after the surgeries indicated the tumor was well differentiated (meaning the tumor cancer cells and the surrounding tissue cells were very different).  This is a good sign indicating the margins were clear and the tumor may have been completly removed.   The other "good" part of the pathology report was that the cancerous lymph node was totaly encapsulated (meaning the cancer probably has not spread). 

    My underrstanding of raditiation treatment in the head and neck (beared out by many memebrs here) is that it has physical concequences and can be dangerous to surrounding tissue, nerves, eyes, teeth...etc.).  In addition, because of the risks the radiation dose (streght) has to controlled and the area can only be treated a limited number of times. Becauuse of all of the above the tumor board recommended no radiaiton so that if the cancer returns, it can be treated with a full dose of raditation at that time.

    It all made sense to me, but not without listening, researching and asking questions

    I am offeering this informattion to hopefully help you make the best decision for your case and comfort you that there are reasons and variables  for treatment based on tests and the information available.  Every case is different  (the fickle nature of the disease), don't be persuaded by my story, use it to arm yourself with information and ask enough qurstions to you feel comfortable making a choice.

    Feel free to ask more qquestions, I am happy to help.  

     

    Thanks again.  I read

    Thanks again.  I read everything you wrote when  you did but I've been overwhelmed.  My dad was in the hospital with a life threatening heart condition, I'm trying to finish my PhD (done Aug 29th) and we have 2 kids.  It really feels like it was just a few days ago I last posted. 

    His surgery is scheduled for Friday-- moved up from the 23rd.  We are nervous but anxious to get it out.  He is classified Stage IV (because of Boney intrusion on nasal bone-- but he's N0 M0 grade 2 tumor). Tumor isn't too big 3.4x1.7 cm.  

    He had an MRI Friday and was told today it is clear but they want to do a PET scan tomorrow because they want to save as much of his nose as they can.  Personally-- if he loses the whole thing, I'm fine with that.  Only his life matters.

    I'm very glad this board exists.  Thanks again.  :) 

  • nikolaf
    nikolaf Member Posts: 50
    Options

    Experience

    Glad to share my experience.

    I had a complete rhinectomey (whole nose removed).  Prior to the rhinectomy I had multiple CT scans, multiple MRI's and a PET scan.  I also noticed a lump my neck right before the PET scan.  The PET scan indicated activity in the lymph nodes in my neck prompting the bilateral neck disection. 

    To elaborate, the PET scan showed activity (not necessarily meaning cancer, inflamation of lymph nodes has many causes) on both sides of my neck.  This is why the surgeon recommended the bilateral disection removing groups of lymph nodes on boh sides commonly associated with the SCC cancer and location of the tumor.  The surgeon explained this to me, i also researched and it made sense.

    I did not have any radiation treatment for a couple of reasons.  The surgeon classified my cancer with the Tx Nx Mx method rather than the traditional staging method.  I was clasified as T2 N1 M0 meaning:

    1.  T2 - the tumor was advanced (larger size)

    2.  N1 - there was lynph node involvement in one node, on the same side of the neck as the cancer.

    3.  M0 - no metastisis to other parts of the body.

    In addition, The patholgy report after the surgeries indicated the tumor was well differentiated (meaning the tumor cancer cells and the surrounding tissue cells were very different).  This is a good sign indicating the margins were clear and the tumor may have been completly removed.   The other "good" part of the pathology report was that the cancerous lymph node was totaly encapsulated (meaning the cancer probably has not spread). 

    My underrstanding of raditiation treatment in the head and neck (beared out by many memebrs here) is that it has physical concequences and can be dangerous to surrounding tissue, nerves, eyes, teeth...etc.).  In addition, because of the risks the radiation dose (streght) has to controlled and the area can only be treated a limited number of times. Becauuse of all of the above the tumor board recommended no radiaiton so that if the cancer returns, it can be treated with a full dose of raditation at that time.

    It all made sense to me, but not without listening, researching and asking questions

    I am offeering this informattion to hopefully help you make the best decision for your case and comfort you that there are reasons and variables  for treatment based on tests and the information available.  Every case is different  (the fickle nature of the disease), don't be persuaded by my story, use it to arm yourself with information and ask enough qurstions to you feel comfortable making a choice.

    Feel free to ask more qquestions, I am happy to help.  

     

    Mac (or is it Rick?!) :) I do have one question.

    Mac I do have one question.  Well two.  

     

    1) did you wait for pathology before reconstruction?

     

    2) how long did recovery from reconstruction take?  Did you need more than 1 surgery?

     

    thanks so much for your help and kindness! 

  • macmanrick
    macmanrick Member Posts: 16
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    Wow, you guys have allot on your plate.  Please call me Rick. Hope your Dad is OK!

     

    I did not have reconstructive surgery.  I have a prosthetic nose.  That process took 6 months to get the prosthetic, and I am still seeing the Doctor having another made.  The reovery time from surgeries to my first appointment was 5 weeks.  I cannot speak for reconstructive surgery, but imagine the recovery is similar before your first appointment.

    The pathology report will be back before then.  I understand there are several surgeries involved with reconstruction.  Honsetly, the rhinectomy surgery was not that bad physically, the recovery was prettty quick.  I had the bilateral neck discection 1 week after the rhinectomy, that recovery was much worse.  Mentally,there is an adjustment, but you have the support to get through it!

     

    Best of luck with the surgery, you'll get through it fine!

  • Fluffydog63
    Fluffydog63 Member Posts: 27
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    nikolaf said:

    Mac (or is it Rick?!) :) I do have one question.

    Mac I do have one question.  Well two.  

     

    1) did you wait for pathology before reconstruction?

     

    2) how long did recovery from reconstruction take?  Did you need more than 1 surgery?

     

    thanks so much for your help and kindness! 

    Biopsy of your husbands nose

    i am scheduled for a biopsy. Just would like to know if the lesion was large or small or just a rough area. Where did they biopsy? at least they found it and now he is on his journey. He has you by his side. 

  • nikolaf
    nikolaf Member Posts: 50
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    Biopsy of your husbands nose

    i am scheduled for a biopsy. Just would like to know if the lesion was large or small or just a rough area. Where did they biopsy? at least they found it and now he is on his journey. He has you by his side. 

    I replied to your PM.  

    I replied to your PM.  

  • nikolaf
    nikolaf Member Posts: 50
    edited August 2017 #12
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    Wow, you guys have allot on your plate.  Please call me Rick. Hope your Dad is OK!

     

    I did not have reconstructive surgery.  I have a prosthetic nose.  That process took 6 months to get the prosthetic, and I am still seeing the Doctor having another made.  The reovery time from surgeries to my first appointment was 5 weeks.  I cannot speak for reconstructive surgery, but imagine the recovery is similar before your first appointment.

    The pathology report will be back before then.  I understand there are several surgeries involved with reconstruction.  Honsetly, the rhinectomy surgery was not that bad physically, the recovery was prettty quick.  I had the bilateral neck discection 1 week after the rhinectomy, that recovery was much worse.  Mentally,there is an adjustment, but you have the support to get through it!

     

    Best of luck with the surgery, you'll get through it fine!

    Thanks so much for this info.

    Thanks so much for this info.

    He is about to go into surgery any time now.  He's in the bed and we are waiting.  It was supposed to start at 12:45 EST.

  • macmanrick
    macmanrick Member Posts: 16
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    nikolaf said:

    Thanks so much for this info.

    Thanks so much for this info.

    He is about to go into surgery any time now.  He's in the bed and we are waiting.  It was supposed to start at 12:45 EST.

    I hope the surgery goes well.

    I hope the surgery goes well.  Best wishes to you and your husband.

  • nikolaf
    nikolaf Member Posts: 50
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    I hope the surgery goes well.

    I hope the surgery goes well.  Best wishes to you and your husband.

    Pain post-surgery.

    They were able to save his nostrils, the tip of his nose but they cut through his nasal bone and removed the maxillary spine. Clear margins everywhere. He's in a lot of pain.  They gave him Percocet.  I'm having him alternate with prescription strength ibuprfen.  Any other suggestions?  How long should it last?

     

    i hope you're well.

  • macmanrick
    macmanrick Member Posts: 16
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    nikolaf said:

    Pain post-surgery.

    They were able to save his nostrils, the tip of his nose but they cut through his nasal bone and removed the maxillary spine. Clear margins everywhere. He's in a lot of pain.  They gave him Percocet.  I'm having him alternate with prescription strength ibuprfen.  Any other suggestions?  How long should it last?

     

    i hope you're well.

    Post-Surgery

    The pain will subside, day by day it lessens.  Sounds like the surgery went well.  Monitor to the chnages it will improve.  I had percocet also, it worked temporarily.  Nothing wrong with taking the meds, they provide relief, even if for a short time.

     

    I guess I forgot about the post -op pain, think of this as a positive sign, it wil improve.

     

    Glad you made it through the surgery, best wishes.

  • nikolaf
    nikolaf Member Posts: 50
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    Thanks so much.... dr

    Thanks so much.... dr recommending radiation.  not entirely surprising given the size.  Still waiting on final pathology.  :( 

     

    the dr was so hopeful before but today he was being wishy  washy.  Before he said his survival probability was very very good.  Today he wouldn't say that.  I don't know why and we are scared.  I'm trying to remain positive.

     he is getting radiation now.... what if it comes back? I need to look to treatments for reoccurrence to get my head around this.  

     

    Hope all is well with you.  

  • nikolaf
    nikolaf Member Posts: 50
    Options

    Post-Surgery

    The pain will subside, day by day it lessens.  Sounds like the surgery went well.  Monitor to the chnages it will improve.  I had percocet also, it worked temporarily.  Nothing wrong with taking the meds, they provide relief, even if for a short time.

     

    I guess I forgot about the post -op pain, think of this as a positive sign, it wil improve.

     

    Glad you made it through the surgery, best wishes.

    Thanks so much.... dr

    Thanks so much.... dr recommending radiation.  not entirely surprising given the size.  Still waiting on final pathology.  :( 

     

    the dr was so hopeful before but today he was being wishy  washy.  Before he said his survival probability was very very good.  Today he wouldn't say that.  I don't know why and we are scared.  I'm trying to remain positive.

     he is getting radiation now.... what if it comes back? I need to look to treatments for reoccurrence to get my head around this.  

    i really appreciate your kindness.  I hope you're doing well. 

    (I replied in the wrong place!) 

  • macmanrick
    macmanrick Member Posts: 16
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    nikolaf said:

    Thanks so much.... dr

    Thanks so much.... dr recommending radiation.  not entirely surprising given the size.  Still waiting on final pathology.  :( 

     

    the dr was so hopeful before but today he was being wishy  washy.  Before he said his survival probability was very very good.  Today he wouldn't say that.  I don't know why and we are scared.  I'm trying to remain positive.

     he is getting radiation now.... what if it comes back? I need to look to treatments for reoccurrence to get my head around this.  

     

    Hope all is well with you.  

    Healing

    I'm sorry you are going through this.  My experice was similar.  Prior to surgery the surgeon was optimistic for a cure.  Post surgery during my visits the optimiism was not there.  I was scheduled for radiation as well, they wanted to wait until the surgery sites healed.  I had to wait +/- 4 weeks for my appointment to get fitted for the radiation mask.

    During that span the pathology report came back, it was reviewed along with my case history by my surgeon, the radiologist, and the hospital tumor board.  The day of the mask fitting I was a wreck.  At the apointment I was told evryhting looked great and they all agreed that radiation was not needded.

    Emotions swing, it is normal.  Wait for the final pathology report, I hope it is good news.  I also hope your husbands pain is reduced and he is healing well.

    Hang in there!! 

  • nikolaf
    nikolaf Member Posts: 50
    edited September 2017 #19
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    Healing

    I'm sorry you are going through this.  My experice was similar.  Prior to surgery the surgeon was optimistic for a cure.  Post surgery during my visits the optimiism was not there.  I was scheduled for radiation as well, they wanted to wait until the surgery sites healed.  I had to wait +/- 4 weeks for my appointment to get fitted for the radiation mask.

    During that span the pathology report came back, it was reviewed along with my case history by my surgeon, the radiologist, and the hospital tumor board.  The day of the mask fitting I was a wreck.  At the apointment I was told evryhting looked great and they all agreed that radiation was not needded.

    Emotions swing, it is normal.  Wait for the final pathology report, I hope it is good news.  I also hope your husbands pain is reduced and he is healing well.

    Hang in there!! 

    How long did you have to wait

    How long did you have to wait for pathology?  Ours has been back but they won't say anything.  

  • macmanrick
    macmanrick Member Posts: 16
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    nikolaf said:

    How long did you have to wait

    How long did you have to wait for pathology?  Ours has been back but they won't say anything.  

    I had to wait 4 weeks until

    I had to wait 4 weeks until after the tumor board met.  I found out the day before my radiologist appointment to get fitted for the mask.  At the radiologist appointment I was told that he board all agreed that radiation was not needed.  I know it is hard to wait, but keep positive thoughts.

     

    I hope the recovery is going well.  Is your husband coping OK?  The reality of the surgery physically is difficult. 

  • Sinus2016
    Sinus2016 Member Posts: 36
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    For what it's worth

    In 2016 I was diagnosed with undifferentiated adeno carcinoma of the ethmoid sinus, IVA, T3, N2, MO, G4. Happy to say that after endoscopic surgury, nearly 8 weeks of radiation with 6 chemo treatments and 1year behind I have a greater appreciation for life.Yes it was traumatic celebrating my 30th anniversary in chemo with my wife, unable to eat and drink because he affects of radiations on my salivary glands, taste buds, etc. But I'm a survivor and I give credit to the support I had from family, friends and church. For those receiving treatment stay strong, be optimistic and enjoy the support of those that are special. The tunnel may seem long but there is light at the other end so and your not alone.