80 yo mother just dx with base of tongue cancer spread to 4 lymph node

To my knowledge, the treatment for BOT squamous cell carcinoma is pretty standard and straightforward, at least the treatment that is standard of care and has been found to be most effective. Chemo-radiation is most certainly pretty tough to get through, but could actually result in a cure, especially if the cancer was caused by the HPV virus. As for using a feeding tube, it isn't always necessary, but is felt to be the best way to avoid malnutrition throughout the period of treatment and the several months following when the throat is just too tender and sore from radiation. So I suppose the question is how motivated and prepared your mother is for an upcoming challenging 6 months. It could save her life and, these days, an 80 year might expect at least another good decade of quality life.

Having said all that, I also want to add how sorry I am that your mother has to go through this. It does seem that, at age 80, she should be able to enjoy her elder years and not face such a beast.

Marin

My husband was dx 2/2017 with BOT/SCC, stg 3, no lymph nodes involved. We did routine recommended 7wk daily radiation with weekly chemo, we had PEG feeding tube with port installed shortly after biopsy results as he was unable to swallow anything within a 6-wk rapid tumor growth period. He was so malnourished with 30lb weight loss he could not have weathered the aggressive treatment regiment without feeding tube. However since therpary completed May 2017, I’ve since learned approx 50% all HN patients have swallow disorders-dysphasia- post treatment. Sadly my husband’s therapy regiment totally collapsed his upper esophagus, fried it shut, and he is still 100% dependent on feeding tube. Patients typically suffer voice disorders too since throat muscle all can suffer damage from radiation. I highly recommend a HN Oncologist managing any treatment you elect, and demand swallow study tests before, during and after therapy as they have no other way to monitor internal damage to throat. It is not a standard regiment in community oncology and never was discussed with us; post treatment when clearly we had new challenges, I did consults with 2 different cancer specialty centers to have both state they would have monitored treatment better to ideally manage collateral damage. I agree that a healthy 80yr old with no other medical challenges should have many quality years ahead, but know this is a grueling treatment regiment with lots of damaging side effects. If you see HN specialist that has less invasive options, I’d consider vs suffering 7wks aggressive treatment with burns on exterior of neck and unknown internal damage to then possibly find yourself 100% dependent on feeding tube ... and to have oncologist and ENT simply say: “well you are cancer free”. Living physically weakened and 100% dependent of feeding tube diminishes one’s quality of life, trust me. As a cancer warrior myself managing 3cancers with 2 adults under 1 roof, I send our hugs, positive strength and smiles to help each day.

Oh my goodness, Dotti, I had no idea that treatment such as what you describe is still being offered! I guess I was just plain lucky in having had my treatment at a highly-advanced cancer center where IMRT was used so that the radiation was targeted and didn't go anywhere near my esophagus, vocal chords or any other unaffected tissue. I also had my swallowing monitored and regularly saw a specialist who gave me daily swallowing exercises to perform. So how right you are in providing this warning. It is shocking to me that there are medical facilities that still use outmoded treatment approaches. I am so sorry that your husband had to be one of their "victims."

Marin

Good morning, not being familiar with the term IMRT radiation, I went back to treatment center for verification of what we had to learn yes everything they followed was under the IMRT regiment for HN disease; the only thing I believe missed was swallow studies pre and during in order to track their therapy vs it’s damage. It is critical to remember that though therapies might be “standard” for HN-throat-cancers, the location of mass does vary. I know ours was not orally visible upon exam, meaning very low and centered on stationary base of throat muscle, therefore they radiated 8 precision points from ear to ear with focus on front. We can’t change these results and yes grateful he is “cancer free” and has his voice; we are under new GI specialty team at Shands/Gainesville FL to penetrate scar tissue and slowly re-create lumen opening, this is a slow and now monthly repetitive surgical progress. The PT requires daily swallow exercises with the goal to stimulate all those internal damaged muscles to regain muscle swallow function. I advocated w/nutritionalist to secure quality natural feeding tube products vs the standard low-cost, high corn syrup/sugar based products insurance mandate, believing quality nutrition is critically needed to rebuild his damage cells during this recovery journey. We are truly grateful for each day disease free, and encourage all to be your own strong advocate as you research, ask and understand disease and your treatment option. Our experience along these disease journeys since 2012 confirms that doctors share little with patients to not overwhelm us, I believe a patient will fare better with knowledge of disease, it’s challenges, complications and expectations. Sending strength to remain a strong warrior to accept, evolve and learn to thrive again post disease.

Dotti,
You and your husband have had a rough time, but your attitudes are good. You're an inspiration for many others, the definition of a great caregiver. Thank you for the sharing you do here.
Carol