RT alone or TORS then some RT?

TORS seems to me to be a far less invasive way to remove cancer as opposed to open surgery. And TORS mixed with radiation (if by RT you mean Radiotherapy) gives you less radiation than 7 weeks of straight radiation, I for one would opt for the combination. TORS usually heals well where as radiation heals slowly and often not completely. Keep in mind every case is unique, every patient is unique. When it comes to radiation we have or should have the option of Proton or Photon and at this, the Pro is much more precise and far less invasive.
The morbidity depends again on each individual and cancer type. Typically these cancers are successfully treated more often than other cancers such as Blood, Breast, Lung, and Prostate cancers. Twenty-three years out for me.
Heck of a way to spend your summer but here you are. Good luck and good healing. You can do this.

Thanks for the response and great news that you are doing well. I’m in Canada so proton is not an option unfortunately. Sounds like the surgery radiation combo would be best option.

@abes1068
I have had 7 weeks of head and neck radiation post surgery but primary tumor in my ear, not oral. I agree with @hrhwilliam concerning the prolonged side effects from more weeks of radiation. The advances in robotic oral surgery recently has made recovery time shorter that the open surgery of years ago. Seven weeks of radiation will be tough and you may require a stomach tube to continue nutrition while you heal. Dry mouth and swallowing issues are common sequelae. I also would opt for the combo treatment if it can be done within a reasonable time. Twelve years survival for me, and though I have had metastases, my cancer is currently under control with an immunotherapy. Best of luck with this.

In 2008 I was officially Stage IVB T2N3M0 on left tonsil caused by HPV and 3 infected lymph nodes. I had 35 rounds of radiation which amounted to 70 Gy and 3 rounds of the platinum-based chemo Cisplatin and had no surgery. Thankfully, cancer free in March of 2009.

Unfortunately, recently diagnosed with Tongue cancer on my left side of my mouth on March 1, 2024, and had a left partial glossectomy with a radical forearm free flap surgery on April 3. Also, included a modified radical neck dissection. This one was not caused by HPV and was most likely from too much radiation from the first cancer as it is literally adjacent to my left tonsil.

One thing I am finding out is this big de-escalation cancer treatments coming about especially for people who got it as a result of HPV. I just talked to my oncologist a few days ago and he said I would have four different options if I had tonsil cancer today. I also attached a couple articles on it here.

You will get better. Hope this helps. Good luck.

Best,
Rob

I had TORS surgery April 2023 to remove base of tongue tumor ( negative margins during surgery). The lymph nodes on one side of Neck were removed and sent off to Pathology. I was considered State 2/ minor Stage 3. I had 30 rounds of Proton Radiation June 2023 to "cleanup" any cancer that may have been left behind from HPV16 base of tongue and Few Lymph nodes on one side of Neck . Also I had NO Chemo. l was very worried about going on a feed tubing , Dysphagia and Not being about to swallow (eat or drink). I started doing mouth,Neck, tongue and swallowing exercises prior to proton Radiation. If you have a Speech therapist they can help you with this. Also, There are tons of Youtube videos on the subject. It was a struggle to eat during radiation and I FORCED myself. You will lose appetite and everything has no taste. Today 12 months out of radiation treatment. I can eat and drink about anything I wish. However, during Treatment I was eating very soft diet. Think eggs, cottage cheese, Milk, Smoothies, bologna, Boost,Shakes, soups, etc. A meal would take an hour. My taste buds were all but gone, I had mucositis with very low saliva production. Hair loss at the radiation site. Mouth Sores and Neck skin burns from treatment. Loss of stamina. Today one year later I would say I am about 90% back to normal on all. Head and Neck Radiation is a real tough deal. I would go for as little of radiation as possible as it is the gift that keeps on giving long after treatment. I understand you cannot have Proton? In my opinion, Proton is more targeted with less side effects. However, It is a battle as insurance companies do not want to pay for Proton when Photon is much cheaper. Also, Proton facilities are far and few in between. In closing you are facing a very winnable battle but make no mistake it is a difficult journey. . I firmly believe if you have faith the Good Lord will get you through anything. Good luck to you. You can and will make it!

@abes1068, what did you decide? When does treatment start?

July 11 surgery then 6 weeks radiation.