Tonsilectomy

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At the begging of June I was  diagnosed with ogj cancer I them had a  PET scan which showed nothing except some activity in the tonsils which I was told was probably nothing as it often showed up on the pet scan. However I was referred to ENT as a precaution .The doctor there told me they looked fine but then said he'd talk ro his boss, and he then came back and said his boss thought there was some assymetry and might they be worth removing but it was up to me. I said I wasn't sure as this would delay the. Chemotherapy and would talk to the oncologist about it.. a week later the oncologist seemed to think it was a red herring and we should start the chemotherapy as soon as possible then so do  another scan and maybe take out the tonsils after if they still looked suspicious. However he did agree that for the cancer to spread directly to the tonsils would be extremely rare. So two weeks later after having the PICC line inserted two days earlier was sitting at home ready to set off for the first session when I get a phone call telling me not to come in as they had decided to delay the chemo  untill after the tonsilectomy. So two weeks later i have the preop and the tonsilectomy is scheduled for a week later(next week). Then I will have to wait for the biopsy which if comes.back positive then they will offer some palliative care ( though they keep emphasising they don't expect this)

But there is a bigger risk that it really will spread locally or to the liver making any further treatment pointless.

I can't help wondering why they changed their minds. Is it' a cost issue? Have they decided this gives me the worst chance of survival? So it.willl save them a  lot of money ? I can't see any benefit to me apart from another six weeks of massive stress of not knowing what's going to happen anymore and more pain and weight loss due to bring unable to eat solid foods.

.

I really would like to understand the decision better as.no one I have asked seems to understand it either Has anyone else ever had a tonsillectomy first?

Regards

Joe H

  • Hello Joe H

    Thanks for contacting us, and welcome to the online community. My name's George, and I'm one of the Cancer Information Nurse Specialists on the Macmillan information support line.

    I'm very sorry to hear of your cancer diagnosis and the ongoing complications regarding which treatment to consider: tonsil surgery and chemotherapy. This must be a very stressful and concerning time due to the change in plan and lack of explanation.

    We do not have any access to the NHS and, therefore, cannot review specific cases. Our information is based on generalised support and information in response to your enquiry. We recommend you discuss any questions you have with your Specialist Health Care Team.

    The decisions are not made on such things as cost. The specialists adhere to guidelines implemented by the National Institute of Clinical Excellence NICE. All your results will be discussed at a Multidisciplinary Team Meeting (MDT) where other specialists and consultants will discuss which treatment is best for your situation.

    They must determine if the tonsil is cancerous or noncancerous (Benign), and surgeons will often remove the tonsil for testing rather than a biopsy first. The consultant will want to determine if this is cancer and if it originated from your oesophageal cancer. It's rare, but you can get a second primary cancer, and they will want to know if this is a primary or secondary because different cancer types respond differently to different chemotherapy's and treatments, therefore picking the best chemotherapy to treat you.  

    You can ask your consultant's secretary to arrange an appointment to ask your specific questions to understand better the reason for the change in the original care plan. You can also contact the specialist Nurse at the hospital to help arrange this and answer questions. You can contact Patient Advice and Liaison Services (PALS) at your local hospital if you are not happy with the service and care you are experiencing, and they can help answer any questions or concerns you have regarding your hospital care.

    You can contact Macmillan on the support line to further discuss your concerns and questions. We also offer psychological support via our partner BUPA, which you can read about on our website or discuss on the telephone support line. Please do not hesitate to contact us with any further questions or regarding additional support.

    I hope you have found this information helpful. If you wish, you can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or email us. 

    With best wishes

    George

    Macmillan Cancer Information Nurse Specialist 

    (Our Ref: HG/GHi)