Surgery vs CRT

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Hi all, 

I met again with my consultant on Friday there. She suggested the route of further surgery in the tonsil area and neck dissection (2 nodes) as being a good way forward. The further surgery I understand is due to them only having a small margin from the first operation in which I had my right tonsil removed (this contained the primary site). Surgery would be part of PATHOS. 

I then met with oncology who indicated that CRT would take care of the cancer and that surgery was not required. 

I’m really stuck as to what option to go with as I have been told that both are good options. My tonsillectomy and tongue base surgery was pretty rough in terms of recovery but I managed in the end. 

I have a few more questions to send to my cancer nurse to answer but I was wondering what anyone might think in terms of the best way forward? My consultant did indicate that her preference would be surgery, especially as I’m 39 and would hopefully be able to recovery well from it. 

I’m just a little confused 

  • Hi, Chris, this really does make it hard to know what to do for the best. You could consider having the surgery, then you would always have CRT in reserve if it was needed. All the best whichever way you choose.

    Ray.

  • I’m just a little confused

    Hi Chris. 
    I’m not surprised. 
    if you are in the pathos trial who is in charge of decision making going forward? The surgeon the oncologist or both?

    I must say that if my surgeon was pretty sure r that good margins were achieved and the was no cancer in the nodes after dissection I would abandon CRT for now as well. 

    Dani 

    Base of tongue cancer. T2N0M0 6 weeks Radiotherapy finished January 2019

    I wrote a blog about my cancer. just click on the link below 

    https://todaymycoffeetasteslikechristmasincostarica.com 

    Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm

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  • Hi Chris, my situation sounds very similar to yours.  Only my cancer started in my left tonsil and then went into a lymph node on the left side of my neck.  I had a Bilateral Tonsillectomy on the 29th August and in my consultation last week  the surgeon said that there wasn't enough margin and so they have to take some more out and he wants to do a Neck Dissection to remove the lymph node.  He asked if I would like to go on the PATHOS Trial (which he told me aims at reducing the amount of Chemo/Radio therapy to lessen  side effects.) 

    I wasn't given the option of no surgery.  It was surgery and the full amount of Chemo/Radio therapy or surgery and the amount of Chemo/Radio therapy would be 'tailored to my needs'.  For me, it was a 'no brainer' and I have chosen the PATHOS Trial.  I have my 2nd surgery on the 23rd September.

    Good luck with whatever you decide.

    Hugs

    Hazel x

  • For me, it was a 'no brainer' and I have chosen the PATHOS Trial. 

    Do you know whether you will have CRT? Or does that depend on your surgery pathology? 

    Dani 

    Base of tongue cancer. T2N0M0 6 weeks Radiotherapy finished January 2019

    I wrote a blog about my cancer. just click on the link below 

    https://todaymycoffeetasteslikechristmasincostarica.com 

    Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm

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  • Do you know whether you will have CRT? Or does that depend on your surgery pathology?

    It depends on the pathology results Dani.  There are 3 groups, A, B, & C.  The people in group A are the 'lucky' ones who do not have to have chemo/radio therapy, group B has to have some radio/chemo therapy and group C the most chemo/radio therapy.  I'm keeping my fingers crossed that I am in group A.

    Hugs

    Hazel x

  • I'm keeping my fingers crossed that I am in group A.

    Mine are crossed for you too xx

    Dani 

    Base of tongue cancer. T2N0M0 6 weeks Radiotherapy finished January 2019

    I wrote a blog about my cancer. just click on the link below 

    https://todaymycoffeetasteslikechristmasincostarica.com 

    Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm

    Community Champion badge
  • Good evening Chris, i would go with what your consultant has recommended, and then as old biker has said you can keep the treatment for later if required. All the best.

                                                                                 Chris 

    Its sometimes not easy but its worth it ! 

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  • Hi Chris,

    I went down the surgical only route.  A different case to yours but I wanted to keep the CRT in reserve in case my cancer made a reappearance, which it did a year ago.  There is no way to tell if I had had CRT after surgery if that reappearance would not have happened.  However, I am comfortable with the choices I made.

    One thing to remember is that surgeons are trained to perform surgery and cure that way.  Oncologists are trained in CRT and that is their preferred method.  Neither is right or wrong it is just their preferred method of working.

    Peter
    See my profile for more details of my convoluted journey
  • Hello again, 

    I wanted to provide an update. I emailed my cancer nurse last night and she phoned me first thing this morning and asked if I could come in to meet face to face with my consultant today. I duly did and she allayed my fears and put my mind at ease. 

    Surgery is my chosen route to proceed, followed by radiation (likely pathos group B) depending on pathology but my scans suggest that this would be likely. 

    CRT is always an option for me post surgery and good to have in the back pocket if needed. Surgery pencilled in for Wed 25th Fingers crossed 

    thanks for the replies 

    Chris