Tumor Board, round #2

Well, it was a long day today. The tumor board meeting went from 1:30 to after 5:30pm (and I didn't get home 'til after 8pm), and it seemed like most of that time was just spent waiting. Only 3 Dr.'s actually physically examined me this time, and it was pretty cursory (unlike the first time, where 5 or 6 Dr.'s all had their fingers in my mouth or on my neck - not at the same time, thankfully ;-), but it was good that Dr. Lueg, my surgeon, was a part of the board this time 'round.

Things just don't seem to be getting any simpler. Last week Dr. Lueg was recommending surgery over radiation. But today, as a result of all the Dr.'s examining my pathology report, they came back with a recommendation of EITHER radiation OR surgery, not one over the other. He said they noticed something he hadn't, and that was that the tumor was thicker than they'd originally thought. Apparently tumor thickness is a risk factor - the thicker the tumor, the greater the chance of spreading or recurrance. That risk factor can't really be addressed with just surgery - radiation addresses it better. (But then the radiology oncologist said that tumor thickness is a debatable point.)

The other major risk factor is the apparent fingerlet of cancer potentially left behind in the posterior section of the tongue. When the pathologist examined the tumor, one of the edges looked like a fingerlet, or tentacle, of cancer had been cut off - meaning it could have left behind some cancer cells. Or not. It could also just be an 'artifact' of how the specimen was prepared (or something like that - I forget exactly how he described it). Surgery could potentially address that by removing another cm of tissue from the rear. The chances of the fingerlet extending beyond that are very slim.

Radiation vs. surgery. 6 weeks of daily (5 days/week) treatment, vs. a 1-hour surgery. Approximately 6-7 weeks of ulcers & sores all over my mouth, tongue & throat, and extreme difficulty in eating or drinking, and a severe sunburn on my neck, vs. a sore throat and mouth for about a week. Long-term side effects like loss of taste for about a year, with recovery of only approx. 70-80% taste buds; possible permanent dry-mouth; and thickening of some tongue tissue, vs. nothing worse than what I've already experienced. Gee... which should I choose?

Radiation seems a bit drastic for something that could possibly be solved thru surgery. Why go thru all that pain & suffering, possibly needlessly? And even though radiation is a more aggressive treatment, reaching a broader area of the mouth, they said there's no 100% guarantee that cancer wouldn't come back. My current leaning is to do the surgery and see what the results are. Hopefully, all would be clear. If not, well... then radiation would be the back-up option.

The more I think about it, the more mystified I am that the Dr. said, when asked what would HE do in my circumstances, that he'd take the more aggressive route, ie radiation. He said the younger the person (and I'm considered 'young' - yay! ;-), the more aggressive he would be. I wonder why he wouldn't try the 'simpler' route first. I'll have to ask him...

Time-line: If I went w/ radiation, I would need to heal up first, so they'd wait 4-6 weeks before starting treatment. It would take a couple weeks to get fitted w/ special protective gear for my teeth & upper palette (they'd be focusing the radiation on primarily the tongue, but the throat & other areas of the mouth would also be affected). Surgery would most likely be done within 4 weeks, depending on their surgery schedule. It's not considered an urgent procedure, ie, I'm not at great risk if there's a delay of a few weeks. But because it would only be about an hour, they might be able to squeeze me in quicker if I wanted it.

Sigh... lots to think and pray about. Need to do some research and try to better understand all my options before making my final decision.

Special thanks to Diane & Cheryl for being my support team today! You gals are the greatest! Thanks for driving me to appt's, asking questions, listening, taking notes, helping bear my burden, praying, running errands, and making me laugh! I'm blessed beyond measure to have friends like you! And thanks, too (again!), to all my friends from church & work, and my family - your support is so deeply appreciated.