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Squamous carcinoma of tongue - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Cancer
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
Doctor :   Hi
Doctor :  
How can I help you?
User :   r u online
Doctor :   Yes

Doctor :  
I am online
User :   oh great
User :   this is my first chat so i dont know how it goes
User :   shall i shoot?
Doctor :  
yes
User :   Hello Doc
User :   i have a cancer related question
Doctor :  
YOu can continue with the query
User :   my sister was diagnosed with squamous cell carcinoma of the tongue. It was T2M0N0. About 2 years back
User :   r u with me?
Doctor :  
Yes
Doctor :  
I am listening to you
Doctor :  
Please continue
User :   ok
User :   she underwent surgery and got the tumor removed and then underwent radiation
Doctor :  
Ok
User :   she is 31 now. she has also been going for regular follow ups. Now the frequency being every 6 months
User :   now i will come to my query
Doctor :  
Good explanation
Doctor :  
What is the query
User :   i want to know whether she is required to do any PET scan/ MRI/ CT of the complete body as a part of the routine check ups
User :   she is under Dr. XXXXXXXX Pradhan at XXXXXXXX Aly Khan hospital
Doctor :  
Which city?
User :   Mumbai
Doctor :  
Ok
Doctor :  
Now may I know which is the exact site of tumor?
User :   the anterior one third of the tongue
User :   on the left
Doctor :  
Ok
User :   was abt 2.5 to 3 cm in diameter
Doctor :  
You said it was T2N0M0 when it was first detected
Doctor :  
so it should have been Stage 2
User :   yes
User :   yes
Doctor :  
Yes T2 reperesents the size of the tumor is more than 2 cm but less than 5 cm
Doctor :  
with no involvement of neighboring lymphnodes and waldeyers ring
User :   true
Doctor :  
Since the prognsois for this stage 2 of the tumor is good
Doctor :  
the doctor first check for various sites for metastasis
User :   ok
Doctor :  
and then come to a conclusion that it is t2n0mo
Doctor :  
with good work up of CT / MRI
Doctor :  
MRI is better than CT
Doctor :  
though
Doctor :  
Positron emission tomography (PET) scan has been proposed as an additional diagnostic tool to improve the accuracy of CT
Doctor :   but practically not implemented yet
User :   MRI of neck was done before the surgery and then decided that no neck dissection is required
User :   dissection
Doctor :   Not to worry then

User :   this was 2 years back
Doctor :  
Frequent follow ups is all required now
Doctor :  
If during the frequent check s the doctor finds the lymph nodal enlargement or at the primary site
Doctor :  
then he will order for the PET scan
User :   my query is regarding now. Shall we be doing any tests after the surgey becos none have been done yet
Doctor :   No

Doctor :  
That is what I say
Doctor :  
No need
Doctor :  
Only follow ups
Doctor :  
are required
User :   what abt the chances of metastases in the other parts of the body?
Doctor :  
If the doctor finds something fishes
Doctor :  
then he might ask you for the PET later
User :   what abt the chances of metastases in the other parts of the body?
Doctor :   Usually not
Doctor :  
M0 says there is no metastases
Doctor :  
distantly
Doctor :   M1 - Evidence of distant metastases

Doctor :   Mx - Minimum requirements to assess the presence of distant metastases cannot be met
User :   ok
Doctor :   So since it is M0 there is no metastases at all
Doctor :  
and MRI has 99% accuracy
User :   but how can arrive at M0 with only a biopsy and neck MRI?
User :   one
Doctor :  
The clinical examination has 75 to 80% accuracy
User :   ok
Doctor :  
MRI has improved to 95 to 99%
Doctor :  
accuracny
Doctor :  
Did the doctor say about the depth of the lesion?
User :   so should we be repeating the MRI since it has been 2 years?
Doctor :  
Follow up physical examination is all required
Doctor :  
No need of MRI
User :   it was deep but i think it didnt cross the midline
Doctor :   How much is the depth

Doctor :  
The prognosis depends on the depth of the tumor too
User :   dont know
User :   ok
User :   no but the doctor suggested that the prognosis was good
Doctor :  
Ok
User :   we are only worried whether we should be undergoing a complete body PET scan and wanted a second opinion
Doctor :   You can always take a second opinion from our Super specialist second opinion channel

Doctor :  
WWW.WWWW.WW Doctor :   Since this chat expires in few minutes I would like to give you a good link to know more about it
User :   ok sure
Doctor :  
WWW.WWWW.WW User :   r u an oncologist doctor?
Doctor :   I am a General Practitioner but I have seen cases of Head and neck tumors
Doctor :  
and few cases of Carcinoma tongue
User :   oh ok
Doctor :  
I hope your sister is neither a smoker nor an alcoholic
User :   she is not. its a very rare case as per the doctor
User :   r u there?
Doctor :   Did you follow what all I said?
Doctor :  
Do not worry
Doctor :  
You will get easy information from the link that I gave you
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