So a long day yesterday, travelling up to London and the Royal Marsden Hospital, where we ended up with a two hour wait to see the surgeon who could potentially perform TORS, or TransOral Robotic Surgery.
We met with Prof. Vinidh Paleri, who is a very nice man, and he explained why he couldn't perform robotic surgery due to the deep extent of the tumour and that I would need a wide local excision via an open route and a free flap construction, one of the points we kind of already knew as the surgery leaves a big gap when the tumour is removed, which through robotics cannot be reconstructed so you would then be left with speech, swallowing and other problems due to the size of the "hole" left.
His advise was to have the open surgery and to have this done by Prof. Winter in Oxford as he would be able to perform this earlier than him and time was becoming of the essence.
The tumour is currently classified as T4a N1 M0
What does this mean: It is a squamous cell carcinoma indicating a relatively advanced stage of cancer with local spread and no metastasis.
T4a means the tumour has spread into surrounding structures which in my case is into the intrinsic musculature of the tongue and into my submittal node (front lymph node. His examination revealed the bulky tongue based neoplasm to the right hand side.
N1 signifies the cancer has spread to one lymph on the same side of my neck and its not larger than 3cm.
M0 means there is no evidence of distant metastasis, which is the good news as meaning it hasn't spread to anywhere else in my body or organs.
In summary, it means it has locally spread into nearby tissue and lymph node, but with no distant metastasis.
I now have a follow up on the 8th May with Prof. Winter to I presume make the plan for the open surgery that he will perform, in the meantime today I was initially at the John Radcliffe for the CT scan to check the stent in my carotid artery and the heart blood flow - hopefully that is all good 👌
Then to the Churchill to discuss the PEG - a tube into my stomach for feeding after the surgery. In this session we discussed the procedure done by endoscopy, tube down my throat, cut through my gut to push the tube out, all under sedation thank fuck! but stay in overnight, all checks done as a number of issues can come up from localised bleeding, to infection in the chest so they organise an overnighter for you, they go through how to keep this tube clean and all the do's and don's! So, I am thinking this bank holiday weekend and then into full flow medical process
I am confident that the team know what they are doing and will do everything they can to get rid of this tumour, in fact I have no doubts, but the stress of thinking about this and trying to remain positive is massive, BUT, you have to keep going, think of what those around you are going through which I'll be honest is difficult when your mind is agog with shit but I realise its important to try and stay calm and try hard not to get irritated by non-issues. It is going to be a big strain on my wife to try and juggle this with looking after our grandkids as she does at the moment and all the other stuff she does and I know that me going through this adds loads of stress and strain on her, as bigger impact on her as on me which is hard to comprehend but as you go through this this I try and think about how to ease that, I am going try and not be to demanding, keep a low profile, have loads of positive thoughts and think of future events, my daughters wedding, my other daughters baby on the way, but I worry a lot about them and my wife, the impact on them and hopefully as I come through this the impact reduces and they along with me can start to relax and look forward to these great events 💙
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