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Suggest Treatment For Base Of Tongue Cancer

Posted on Mon, 25 Aug 2014

Question: Hi. My husband was diagnosed with base of tongue cancer in January. He passed all the treatments and just recently had a PET Scan done which showed a residual abnormalities which were nonspecific FDG uptake. No new focal hypermetabolic abnormalities were found and there is a significant interval treatment response. He is feeling perfectly fine. No pain or other symptoms besides the dry mouth. My questions are:
How long the radiation continues to kill the cancer cells?
What would you recommend at this time? Do we need to do a biopsy to find out what the nature of the cells in the abnormal areas or can we wait another 3 months?
What is the standard in such a situation?
If there is other information that I need to know but haven't asked, please provide it to me.
Thank you

Answered by Dr. Monish De (30 minutes later)

Brief Answer:
PET Scan after 3 months

Detailed Answer:
Hi

Since your husband was diagnosed with base of tongue cancer in January and he has passed all the treatments and his recent PET Scan is showing no new focal hypermetabolic abnormalities and there is a significant interval treatment response i would suggest 2 months of radiotherapy to kill all the cancer cells.

Since there is a residual abnormalities and he has nonspecific FDG uptake meaning there is no more tumour growth i would suggest he waits for another 3 months followed by a fresh PET Scan.There is no need for biopsy at this stage.

Hope i have answered your query.

Regards
DR De

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Monish De (51 minutes later)

Thank you so much. Can we wait 3 months, do the PET Scan and then radiation if necessary?

Answered by Dr. Monish De (15 minutes later)

Brief Answer:
8 weeks of radiation

Detailed Answer:
Hi

I would recommend at least 8 weeks of radiation to kill all the remaining cancer cells followed by PET Scan after 3 months.

Wishing your husband good health.

Regards
DR De

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Monish De (14 minutes later)

Thank you

Answered by Dr. Monish De (25 minutes later)

Brief Answer:
3 monthly follow up

Detailed Answer:
Hi

Your husband will be absolutely fine after completion of radiation and only a 3 monthly follow up with PET Scan is needed at this moment.

If u have no more clarifications then please rate the answer and close the thread.

Regards
Dr De

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Monish De (9 minutes later)

One(hopefully last) question: How do we know the residual abnormalities contain active cancer cells? Could those be just necrotic cells? Isn't the radiation still working? His last treatment was on April 23rd. What is the risk if he does not do radiation now and wait for the 3-month PET Scan to see what it will show? Thank you

Answered by Dr. Monish De (9 minutes later)

Brief Answer:
Preventive measure

Detailed Answer:
Hi

Your husbands current PET Scan is showing residual abnormalities which has non specific FDG uptake meaning their is no active cancer cells present at this moment.
Radiation is being suggested for 8 weeks more for preventive aspect so that their are no more recurrences in future.

If he does not take radiation at this moment and his PET Scan after 3 months shows any residual features with non specific FDG uptake then he is out of danger.

Regards
DR De

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj