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What Do My Lab Test Results Indicate?

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Posted on Sat, 28 May 2016
Question: Hi,
This is XXXX. This is regarding my father. (aged 64)
He had developed a patch in tongue. We consulted with an oncologist and he advised to undergo biopsy. Biopsy report came out to be negative but he insisted to remove the area from tongue as it seemed suspicious. He had undergone the surgery and partial tongue is removed. He has sent that whole lump for "ontable" complete test while surgery was on. And told us that the virus were found on the edges. And also removed the margins of the affected area in the tongue. And sent that for test as well. He also removed lymphnodes from chin (neck) area and sent those too (56 nodes). The results of margin were completely negative and lymph nodes were also completely free. (0/56).
Now after 1 month of surgery, he is suggesting us to undergo radiation for prevention purpose.
Radiation will happen on tongue as well as neck for 1 1/2 months (5 days a week)
Also asked us to some testing to suggest hormone therapy.
Please advise, is it very natural to undergo radiation or should we seek 2nd opinion? Pls help.

The depth of the area is not there in the report but he says its around 0.5 cm
doctor
Answered by Dr. Indranil Ghosh (1 hour later)
Brief Answer:
yes radiation is often given

Detailed Answer:
Hi
Thanks for your query.

I assume that he has cancer in the removed area of tongue. And the margins and neck nodes are clear. Even then, we often give radiation to prevent further occurrence of cancer. But not always.

This decision depends on risk factors like grade of tumor, depth of invasion, lymph vessel invasion, perineural (along nerve) invasion, etc. Depth is 0.5 cm which is slightly high.

Hormone therapy is not given for tongue cancer.

If you can share the entire biopsy report, I can guide you better.

Hope this helps.
regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (1 hour later)
I have uploaded the reports. Initial biopsy and post op reports are included
doctor
Answered by Dr. Indranil Ghosh (2 hours later)
Brief Answer:
depth not mentioned

Detailed Answer:
all the other factors are ok, ie not high-risk. If depth is 5 mm it is a bit borderline case but often we give radiation in such cases as nobody can predict for sure that disease will not return. Even after radiation it may come back but chances will be reduced. And at least we will know that we did whatever we could.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (9 minutes later)
Thank you Dr.
One more thing. How many doses would you advise in this case after seeing all the reports?
The doctor here is asking to go for 30 doses ie 5 days a week for 6 weeks. I feel that would be a bit much.


And the radiotherapist was saying for both tongue and neck
doctor
Answered by Dr. Indranil Ghosh (29 minutes later)
Brief Answer:
usually both tongue and neck

Detailed Answer:
the standard dose is 54 to 60 gy, which is delivered in 27 to 30 fractions. Below that there is no use. So you have to stick to what the radiation oncologist has suggested.
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1712 Questions

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What Do My Lab Test Results Indicate?

Brief Answer: yes radiation is often given Detailed Answer: Hi Thanks for your query. I assume that he has cancer in the removed area of tongue. And the margins and neck nodes are clear. Even then, we often give radiation to prevent further occurrence of cancer. But not always. This decision depends on risk factors like grade of tumor, depth of invasion, lymph vessel invasion, perineural (along nerve) invasion, etc. Depth is 0.5 cm which is slightly high. Hormone therapy is not given for tongue cancer. If you can share the entire biopsy report, I can guide you better. Hope this helps. regards