Saturday, February 16, 2008

diagnosed with tongue cancer,no treatment

diagnosed with tongue cancer,no treatment?
my sister had tongue cancer five years ago,and had radiotherapy and she has been in remission,but recent biopsy tests have found the cancer is back and worst,she has seen her consultant and he have said the only treatment is surgery,which they are discussing at this moment,has anyone been through or had family member simulare treatment?and what treatment would they offer,genuine answers please thankyou.
Cancer - 2 Answers
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1 :
When I was a nursing student and we had to witness many surgeries, tongue cancer was one of them. One side of the person's tongue was removed with great success followed by chemo. When cancer comes back after remission it always seems to come back with a vengeance. She should do good with surgery but it will be followed with more chemo. People can live normal lives after that surgery. I wish your sister the best.
2 :
Dear wlinda56, While the diagnosis of recurrent oral tongue cancer can be devastating, current advances in medical and surgical oncology offer much hope and reassurance that a cure can be reached. Only 14% of head & neck cancers occur in the mouth, and the vast majority of these (>85%) are squamous cell carcinomas. The presentation of cancer can be varied, with 50% of individuals displaying early stage disease (stage I or II) while the other 50% will present with advanced tumors (TIII, TIV). Tumor staging is determined by the size of the cancer, the presence of cancer in the neck lymph nodes, and the presence of cancer in distant sites, often in the lungs. As you might expect, individuals with advanced disease have a poorer prognosis, while those with early disease have a great prognosis. What then, becomes of those with early disease that has now recurred? In order to answer this, we need to define cure, disease recurrence, and disease persistence. If the cancer is identified within 6 months from treatment at is initial location; then the cancer is described as being persistent; this is not the case with your sister. If the cancer returns after 6 months, it is often labeled as a recurrence. Finally, if the patient achieves 5 years of disease free status, he or she is presumed to be cured from the cancer. How is the above information helpful for you? Let me explain further. Early cancers are usually treated with either surgery OR radiation. Often, chemotherapy is provided along with radiation to enhance tumor destruction. Late cancers are usually treated with a combination of surgery, chemotherapy, and radiation. In your sister’s case, she likely had an early tongue cancer; which is why she was offered only one modality: in this case radiation. If, since the diagnosis, she saw the cancer doctor frequently and was found to have no evidence of cancer, then, after 5 years, she can be said to have reached a cure of her first cancer. A new diagnosis of tongue cancer, at this point, likely signifies a “second primary” tumor. In other words, the old cancer was treated, this is a new cancer in the same location. This is possible because individuals with tongue cancer have a 14% risk of developing a second cancer anywhere, including the original site. Certainly, a second primary tumor can often mean an earlier tumor, because if the original cancer had been growing for all of this time, undiagnosed, it would present at a very advanced stage. The treatment of recurrent cancer depends on prior therapy and whether or not the tumor can be resected, or cut out. Because your sister has had radiation in the past, there exists a significant limitation to the ability to provide further radiation to the same area because of risk of injury to important head & neck structures. On the other hand, because 5 years have passed, the radiation oncologist may recommend a smaller dose in conjunction with other therapies. Chemotherapy can certainly be provided repeatedly, presuming the person is healthy enough to tolerate the side effects. Despite it all, surgery remains the absolute mainstay of management of early oral cancers and recurrent cancers that were once treated with radiation. If your sister’s cancer is resectable, meaning that it can be fully removed with clear margins of cancer-free tissue, then surgery is her best and only chance of reaching a cure. Surgery can be minimal to extensive depending on the size of the tumor, location, and functional loss. Surgery may require removal of anywhere from a portion to all of the tongue as well as a removal of a portion of the mandible (lower jaw). A neck dissection is often necessary and, if the cancer is growing near the midline, bilateral neck dissections may be necessary. Finally, a temporary tracheostomy (breathing tube) may be required, along with a temporary feeding tube. Despite a difficult post-operative course, most patients heal and are capable of regaining good speech & swallowing function after major surgery. In your sister’s case, surgery is certainly a necessary option for cure, but she should discuss in full detail the expected surgical procedure and post-operative course with her surgeon before consenting to the surgery.



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