The tongue cancer patient from Indore did visit me today. She was operated in May and took radiation after surgery. They had brought lot of medical documents but only few had relevant information.
I could not make out from the records what was her pre therapy staging, what kind of operation was done etc. From the histopathology I learnt that the cancer was of squamous cell type infiltrating one-third of tongue. The radiotherapy paper let me know that she has received 6000cGy. Apart from this there was no greater detail.
I could not decipher why a neck dissection was not done and why even though the patient was on regular follow up the neck node was allowed to grow to a size of cricket ball. The surgeon at Indore , supposed to be very reputed and above 60 years, adviced endoscopy for her complaint of inability to swallow. His attention on side effects of radiotherapy prevented him from addressing the neck nodes. Ofcourse I counselled the patients that the treatment at Indore was appropriate and the situation is bad becuse biologically the tumor is bad.
The patient had come with great hopes of getting treated at Mumbai but as she is having advanced malignancy,because of a large matted neck node engulfing the carotid , I adviced them palliative care at Indore itself. It is much better to be at home and take treatment than to struggle in an alien city. I tried to guide them to the best. Hope they heed my advice and take supportive care at Indore or at the maximum palliative cisplatin based chemotherapy.
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