Recurrent throat cancer - 1252964

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hulrich
Recurrent throat cancer - 1252964

My uncle was diagnosed with a stage 2 tumor that extends from a swelling on the front of his throat all the way to his spine last week and found out today that he will be going through a 20 hour surgery next week for it's removal. Six years ago he was diagnosed with throat cancer as well, which was treated with radiation. Four years later, the cancer returned and he underwent a neck dissection, more radiation, and creation of a tracheostomy, and his doctors did not find any signs of cancer in the remaining nodes. Now, his doctors told him that this is a very aggressive, new form of cancer. So, this surgery they are going in and removing his esophagus, the tumor which extends back to the spine, and all remaining vessels and nodes. They will be grafting skin from his legs and forearms to reconstruct his blood vessels and esophagus.

My questions are, what kind of prognosis do patients with recurrent neck cancer, in new forms, have? What complications should we be looking for with the creation of a new esophagus? He was told he should not expect to talk again after the procedure, is there anything we can use to communicate soon after? And, what kind of pain control should he expect, as he is anticipating a lot of pain. Basically, how can he find a way to not feel powerless at this point?

catdander
Reply To: Recurrent throat cancer

Hello hulrich, I'm very sorry to read about your uncle. It sounds like he's been through a lot already and this sounds very difficult.

I will ask a doctor to comment on your post. I may take a day though.

Very best of luck,
Janine
forum moderator

Dr West
Reply To: Recurrent throat cancer

hulrich,

I think that his situation is really a very specific, unique situation, so the people who will really be able to answer your questions are his own doctors. There is not enough information out there in the world about what to expect for someone with his history, so I think that the only people who would be able to say anything of value are the ones directly involved with his case and ongoing care.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

dr. weiss
Reply To: Recurrent throat cancer

As Dr. West notes, there is not nearly enough information here to say a lot particular to your uncle's case. This is not a failure of any kind on your part--no non-physician (actually, no none cancer physician) would be able to give enough information to approach that level of detail. That said, I will attempt to share a few general principals that I hope may help.

Most cancers of the head/neck and many esophageal cancers are squamous cell cancers. These squamous cell cancers in this region tend to recur locally more than spread distantly. This is in contrast to, say, lung cancer, which, when it comes back, very often comes back all over the body. That said, before considering a heroic-type surgery, full body imaging to rule out spread is standard of care. New second primary cancers are also a big problem with smoking-related squamous cancers. This happens not because the old cancer comes back, but because of an effect that we call "field cancerization." In field cancerization, the smoking has caused healthy cells to acquire mutations. In addition to the one cell that acquired enough mutations to go bad, there are other nearby cells with almost enough mutations--any further mistakes in the DNA (whether b/c of smoking, drinking, environmental exposures that are all around us, or just plain bad luck) can push these cells that are on the edge over into cancer.

Your question about speech is a good one. The answer depends on the anatomy of what is planned. I encourage you to ask his doctor.

Every patient is entitled to good pain control. If it is not adequate, you should tell the doctor and he/she can adjust pain medicines. If this approach does not work, a pain specialist can often be helpful.

Has your uncle seen a cancer counsellor? In my center, and many others, there are specialists in the emotional needs of cancer patients who can help with both counseling and practical suggestions.