Moving forward

We met with the Radiation Oncologist, Dr. R., Thursday to review surgical results and upcoming treatment plan. He scheduled us to go back next day, Friday, for imaging and treatment prep. Radiation will start Monday, March 5 and Dr. R. is planning 7 weeks, 5 days per week due to the advanced stage of the disease. He'll also overlap with chemo and we're reverting back to the original Med Onc, Dr. W., who James thought was a bit negative but the surgeon and rad onc both think is very good. We're leaning towards two full strength chemo treatments rather than weekly low strength. We have an appt with Dr. W. on Feb 27 to plan it out.

Dr. R. (rad onc) also shared details about the surgery which we hadn't heard from the surgeon... the tumor was over 4 cm (close to 2") and was removed with clean/clear margins. Dr. V., the surgeon, also removed 51 lymph nodes in levels II-IV of the neck and a section of the thyroid (no wonder the surgery took over 8 hours). Several of the lymph nodes were cancerous but there was no sign of "extracapsular extension" meaning that the cancer was contained within the walls of the lymph nodes which is good news. There is one suspicious Retropharyngeal Node remaining which couldn't be removed during surgery as it was too deep and will be part of the focus of the radiation.

Prep Friday involved head/neck mold and mask creation so that each time James goes in for treatment he'll be positioned in exactly the same way quickly/easily. I was sent out of the room but James told me after the fact that it was painful/stressful. He wasn't quite due for pain meds before we'd left so was overdue by the time he was taken back for the appt. In hindsight we should have thought to bring meds and he should have taken something for anxiety. The mask creation is a plastic mesh "plate" which is heated/softened and then pushed/molded over the face til the edges touch the table surface so it can be pinned in place during treatment. It put pressure on his already painful neck. If you have any issues with claustrophobia and/or anxiety about being unable to move I'd highly suggest taking an Ativan before having this done for head/neck treatment. The radiation technician was kind at least.

James treated himself to a Starbucks coffee after all was said/done. His new favorite post-treatment treat is a small dark roast, simple pleasures are key. I think it was being unable to have coffee for a few weeks or was it a month through surgery feeding tube etc. If looking for a gift for James a Starbucks gift card would be awesome for 7 weeks of daily treatments. I should probably check to see if they take traditional Starbucks cards first though since it's a little hospital kiosk. Hmmm.... maybe I'll buy the first card to check :^)

Today is a Saturday and we're relaxing at home waiting for the power to come back on. They're working on supplying internet to our wee town via Comcast (yes, we're one of those tiny towns....) so are doing work today on transformers and lines and poles. Good thing the suction equip has a battery back up! Next week we don't have any doctors appts other than the visiting nurse. Shocking. What will we do with ourselves???

Leaving you with a few thoughts. That was a damn big tumor and we should have caught it earlier. If you still smoke now is the time to quit. James was very excited to check off "former smoker" on his hospital paperwork when seeing the surgeon then underlined it to point out to me when we received the visit summary at the end of the appointment. His PCP, Dr. E., asked if he still thinks about smoking and James replied "every day". He wears a nicotine patch and it does help but the craving is still there and may always be. That being said we only have one life and he has chosen to live it. xxoo Beth and James