Dad

I am happy to report mostly good news from dad’s appointment with the radiologist today.  A summary of the visit:

• Actual type of cancer is salivary gland cancer (which has a strong likelihood of being the result of chewing tobacco for most of his life… so those of you who chew, STOP!)
• He has a “garden variety” poorly differentiated carcinoma.
• The PET scan results showed no evidence of cancer anywhere else!  (whew!)
• Based on the PET scan, and a physcial exam, no additional surgery is recommended.
• Radiation is a “must” and it is recommended that he get an oncology consult.  Chemo may or may not be recommended.  The radiologist referred him to the best oncologist around, a brilliant man who he knows will give proper consideration to the situation.
• There are two reasons that he MAY need chemo:
  1) Positive surgical margins.  As it was explained to us, for something like breast cancer, if there were positive margins, you would go do surgery again.  But with head and neck cancers, you typically don’t do that because of the collateral damage, so chemo should be considered.
  2) Perineural invasion.  This refers to cancer spreading to the space surrounding a nerve.  Per Wikipedi, it is common in head and neck cancer, prostate cancer and colorectal cancer.
  Based on these factors, the radiologist indicated that there is good data to believe that chemotherapy will be beneficial, but he will defer to the medical oncologist.
• Radiation will be for 6 1/2 weeks and side effects, because of the location will likely include fatigue, skin sensitivity, mouth sores, and dry mouth.  Keeping hydrated will be critical.
• If chemo is suggested, both chemo and radiation would happen concurrently.

I was quite relieved to hear that the cancer had not spread to lymph nodes or anywhere else.  It seems this is a slow growing cancer, so that’s also good news.  Potentially having to go through chemo was not welcome news, but Dad seems to be taking it pretty well.  (Mom, of course, will worry for all of us, as is her nature!)  🙂