My dad diagnosed with Adeno-squamous carcinoma of vocal cord laser surgery (partial hemilaryngectomy of right vocal cord) in July 2013, surgeon states he had negative margins-since this is laser it is close margins-3 weeks post-op from laser surgery PET scan showed increased uptake in right vocal cord and strap muscles. In july his cancer was T3, N0, Mo. Went to MD anderson for second opinion they said this is Squamous, highly invasive, pooly differentiated-recomdeded close observation instead of post-op radiation and chemo.
Now in Nov 2013, my dad presented with stridor and chronic cough came to ED with respiratory distress-got Trached. Repeat mapping biopsy shows Adeno-squamous in sub-glottic, right hemi-larynx and left false vocal cord. He had repeat PET scan shows no mets but increased uptake in bilateral vocal cord. His ENT sugeon recomended total laryngectomy without neck dissection. I am pushing for bilateral neck dissection/post-op radiation and chemo.
1) Please advise any good ENT surgons we can go now ??
2) Please advise good place where we can transistion his care at this point??
3) we are not very happy with current ENT surgeon, no good coordination of care between ENT and radiation oncology
4) His Ent surgeon does not talk to family vey poor.
5) Please advise places who has seen cases of Adeno-sqamous and experienced and treats this tumour agressively.
Please advise best places we can go from now on. We dont have much time.
There are no experts in adeno-squamous head/neck cancer — that’s too specific for anyone to focus on, so you really need to just identify the right head/neck cancer team. These are scattered around: if it’s not feasible to go back to MD Anderson (so he can get follow-up from people with some knowledge of the case already), perhaps the most helpful approach would be to seek an opinion from a center of excellence in head and neck cancer that is in the same region. So where is he located?
Our head and neck cancer expert here, Dr. Jared Weiss, may be able to provide more specific thoughts.