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Pet Scan after a biopsy showed cancerous throat. Want to remove larynx and take chemo. Second opinion?

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I had a recent PetScan after a biopsy of in my throat showed it was cancerous. I have incredible docs, yet am floundering over larynx removal first, then (chemo) radiation after, or, aggressive chemo/radiation first w/the possibility of surgery, after.

I would love another thought on it; can you help?

The findings of the scan are written as: High-grade uptake is present correlating with the laryngeal mass, centered a the left larynx. The mass crosses the midline anteriorly, with measurements on the PET images of approx 26 x 23 mm on the axial images, extending approx 31 mm in cephalocaudad dimension. FDG uptake extends to the level of the left thyroid cartilage, suspicious for direct invasion of the medial aspect of the thyroid cartilage. Multifocal positive bilateral cervical nodes are present, with positive XXXXXXX jugular chain nodes at bilateral level II and level III, left grater than right. Left lateral IJ node at the thyroid cartilage level is measured at 13 x 10 mm. Posterior IJ node at the level of the XXXXXXX of the mandible on the left is measured at 13 x 8 mm. Positive uptake at the jugulodigastric node is present, with a 9 mm node on CT. On the right, there is positive uptake anterior and posterior to the XXXXXXX jugular chain at level II, with representative posterior node measuring 9 x 8 mm and anterior node measuring 11 x 12 mm. At the level of the angle of the mandible, there is a positive 11 mm node on the right. Just XXXXXXX to the left clavicle, there is an 8 x 6 mm node, with only low-grade, benign range uptake on PET scan.
On the whole-body images there is (no significant findings.) doc has had my thyroid checked since this, and those results come back normal.

In trying to 'google' for info myself, I see that it is a good thing that nothing is in the Level 4 or lower areas; but beyond that thought, I am soo lost as to what to decide to do (surgery to remove larynx/some lymph nodes first; or chemo/radiation first and see what's up after.)

I am an epileptic that is stable on my current seizure meds, also.

Can you help with some thoughts and/or opinions.

previous cigarette and marijuana smoker until diagnosis
Posted Thu, 14 Feb 2013 in Colon Cancer
Answered by Dr. Jawahar Ticku 10 hours later

I am sorry that you are harboring this advanced disease. Going for surgery might not be the best option as removing this tumor will need very extensive surgery and will cosmetically as well as functionally very damaging. According to me the chemo radiation will be the best option. There are modified methods of radiation like IMRT/IGRT. Surgery can be reserved for residual disease which may be in the form of lymph node dissection. By this you will be saved of cosmetic and function inabilities. The life you will live will be purposeful.

I wish you good luck and quick recovery.

Dr. J. Ticku,
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