Update on Radiation Oncologist

I had my meeting with my radiation oncologist today. Went very well. Basically we reviewed the results of my surgery and discussed my treatment plan going forward. I’ll just make a list of bullet points because I have a lot of little points to make:

• I go back on the 31st of this month to get “simmed.” Getting simmed means a couple of CT scans and getting a face mask molded and marked. marking the mask means I won’t have to be marked in person. I will don the mask for each treatment and the marks on the mask will guide the radiation. I will start radiation treatments a few days after that.

• There is a small, very small, risk of the radiation affecting my brain stem and causing a stroke or of permanent jaw bone damage . This is so unlikely that the doctor even hesitated to bring it up. He knows me, however, from our previous meetings and knows I want ALL information. The big risk is my teeth. He is proscribing a bunch of treatments and fluoride molds for my teeth to protect them through this.

• He will take great care to protect the major salivary glands on the right side of my face as he will definitely be hitting the ones on the left side.

• I can expect some redness on the outside of my face as treatment progresses.

• I can expect to have severe difficulty swallowing – pain maybe worse than the tonsillectomy itself. I am not happy about that.

• I have been told to “pack on” the pounds because I will almost certainly lose weight through this.

• I will have radiation 5 days a week for seven weeks.

• I will also have chemotherapy at the same time. Most likely that will be 1-2 times a week, but I need to meet with my medical oncologist to determine that schedule.

• The combination of radiation and chemo is very effective against squamos cell carcinoma.

• Radiation will be targeted on the right lymph nodes as well as there is a 20% chance there are microscopic cells there as well.

• The tonsillectomy removed the primary but there is almost 100% certainty that more cancer is there. A tonsillectomy is a glorified biopsy and not a deep invasive removal. It’s too close to the carotid artery for that. For that reason, the doctor is sure all the cancer was not removed and hence, the need for targeted chemo and radiation.

• I can expect some side effects such as weakness, dry mouth, difficulty swallowing, etc through radiation.

• I can expect to be immune-compromised during chemo and side effects are the side effects we’ve all heard of. I may get sick. I may lose hair. Only time will tell.
  

Anyway – that’s my status update. I should not miss too much work (depending on the side effects) – but the timing of the daily radiation/chemo still has to be worked out. I am trying to get early morning treatments, but it all depends on what the schedules look like. I may have to settle for late afternoons.