Snip It or Zap It

Lots of information learned today, so let's get to it:

Jeanette, aunt Linda, and I met with radiation oncologist Dr. Brian O'Sullivan this morning. Although he was running late, he spent no less than 45 minutes with us examining me, reviewing the pathology report, explaining the treatment options, and answering our questions. We were all impressed with him -- and I'm not easily impressed by anyone who sticks a long nasal-endoscope up my nose and into my throat.


Once my dizziness had passed from that little adventure, Dr. O'Sullivan explained that his main concern was that the thickness of the tumour (6 mm) represented an "unacceptable risk" of the cancer traveling to the lymph nodes of my neck. Therefore, he insists that I undergo treatment both on my tongue and on my neck. It turns out, I have two treatment options: surgical or radiation.

The surgical option involves two procedures: 1) removing a chunk of the right side of my tongue and reconstructing it using tissue from my wrist, and 2) "staging" my neck, which means removing tissue most at risk of developing the cancer. According to Dr. O'Sullivan, the surgical route is less reliable than radiation therapy, and may in fact still require radiation therapy if the cancer reappears. The only side effect of the surgery would be a scar on my neck and possibly a small scar on my lower lip; I would not lose any speech capability.

The radiation option involves several minutes of radiation a day, 5 days a week for 6 weeks (7 weeks if they find anything in my neck). Based on the information Dr. O'Sullivan has on my condition so far, he says the likelihood of success for this therapy is over 90%. Side effects during treatment would likely include burning pain in mouth, tongue, and throat ("like razorblades" some patients report -- yikes!), loss of function of my salivary gland on the right side of my mouth (the resulting increase in acidity means a higher risk of tooth decay), complete loss of taste, and loss of my facial hair. Only the facial-hair loss would be permanent, all other side effects would fade in the weeks and months after treatment ends.

Despite the heavy side effects of the radiation therapy, it's hard to resist that 90% success rate, and I'm currently leaning toward that option. Nevertheless, Dr. O'Sullivan has set up a surgical consult for me with Dr. Irish (do I detect a theme here?) on November 15 to learn more about that option. I'll have about two weeks to make a decision about treatment as I undergo various tests (see below) to learn more (they also took some blood today for testing).

We also received several pamphlets full of information -- I'll post anything relevant here once I've reviewed them. In the meantime, here is a schedule of what's happening over the next two weeks:

• Wednesday, November 15 -- Immobilization mask and Planning CT scan (for radiation therapy); surgical consult with Dr. Irish
• Monday, November 20 -- Dental consult (see side effect of radiation therapy above); radiation therapy review with Dr. O'Sullivan before treatment starts
• Tuesday, November 21 -- CT scan of head, neck, and chest

That's it for today. A great big thank you to Jeanette and aunt Linda for providing moral support and extra ears and brains during today's appointment!