The tumor board met this morning and, as expected, recommended surgery as first line therapy. For oral cancers like mine where it is presumed that swallowing and speech function can be preserved, surgery is usually chosen over chemoradiation because cure rates are higher and to avoid the long term effects of the latter option. While my swallowing and speech will likely be impacted to some extent, it is not expected to be at the possible life-changing degree of chemoradiation. Of course, my speech could be drastically altered, but there is a lot of hope that it will not be. On the other hand, if I choose the chemoradation route, I will almost certainly have excessive dry mouth for the rest of my life. Most importanly to the board, though, is that there is more data supporting surgery than chemoradiation in cases like mine.
I met with a radiation oncologist, Dr. Cmelak, who reiterated the board's opinion. He, like all the others, indicated that he would choose surgery if he were sitting in my chair. He did encourage me to speak with the folks at the University of Chicago if I so desired before making my final decision. He ensured me that they are the best at treating with chemoradiation first line, and they would indeed have an ongoing study that meets my needs. However, he stated that he would want to know that the cancer had been cut away cleanly if it were him. Surgery makes that more possible than chemoradiation - of course, neither one is 100%. Dr. Cmelak and his resident, Dr. Yang, were both wonderful as all the others have been.
Some great news: My CT from Friday revealed that the tumor is no larger than originally expected, there is no bone/jaw involvement, and there is only one suspicious lymph node. (Thank God for such great news!) While the board believes this node to be cancerous, they cannot say definitively until it has been removed and viewed microscopically. Keep praying about this. If the node is clear, I might not have to have any radiation therapy post surgery (if I choose that route). If cancerous, I would definitely have radiation about 3-6 weeks post surgery (however, it would be at a much lower dose than in the chemoradiation alone option and only involve my neck).
I have an appointment with a general oncologist on Friday at 2pm. My appointment at the University of Chicago is on May 27th (if I choose to keep it). Ideally, I need to make a decision as soon as possible. If surgery is chosen, they would like to schedule it right away. Please join me in asking God to guide my decision-making process.
One final note: No Rock 'n Roll Marathon this year - Dr. Netterville says it would just be too hard on the body right before surgery - no big surprise there. Brad was really excited that he could slack on his training and starting eating big troughs, I mean bowls, of ice cream every night. I guess we'll just have to run it next year. :)
One of my aunts reminded me today that God truly is my physician - we musn't forget that.
"He delivered me from all my fears." -Psalm 34:4