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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severe Tongue, Neck Pain, Squamous Cell Carcinoma. On Radiation, Chemotherapy. Underwent Hemiglossectomy. Treatment?

hi, I was diagnosed with squamous cell carcinoma of tongue . I underwent hemiglossectomy with neck dissection in Jan 2012. Then i underwent radiation therapy and cetuximab chemo . It has been 3 months since conclusion of radiation therapy. now i experience severe pain over the area of the tongue where i had the surgery that radiates to my ear. I also have tenderness over the same side of the neck. The pain is not constant, it is aggravated by chewing. I have started going to work now but i never have any pain while at work. I usually get the pain while at home in the afternoons and also early in the morning. what coukd be the probable causes of this pain.
Mon, 30 Sep 2013
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Oncologist, Surgical,  's  Response
There could be a number of reasons for your pain and a thorough clinical examination is necessary to rule them out one by one. It could be simply related to your surgery and radiation therapy as it can sometimes lead to inflammation of the nerves in this area leading to a neuritic pain that commonly radiates to the ear. It could be a local infection in the operated site compounded by the radiation. Worst possible, it could be a recurrence of your cancer. I would have liked to know the stage of your cancer as that would have helped me assess the risk of recurrence. I suggest you start on Tab Ciprofloxacin 500mg twice daily + Tab Paracetamol 650mg thrice daily + Tab Ranitidine 150mg twice daily + Tab Gabapentin 1 tab twice daily. That should take care of the pain and infection. Meanwhile get an appointment with your treating oncologist and let him have a look.
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Severe Tongue, Neck Pain, Squamous Cell Carcinoma. On Radiation, Chemotherapy. Underwent Hemiglossectomy. Treatment?

There could be a number of reasons for your pain and a thorough clinical examination is necessary to rule them out one by one. It could be simply related to your surgery and radiation therapy as it can sometimes lead to inflammation of the nerves in this area leading to a neuritic pain that commonly radiates to the ear. It could be a local infection in the operated site compounded by the radiation. Worst possible, it could be a recurrence of your cancer. I would have liked to know the stage of your cancer as that would have helped me assess the risk of recurrence. I suggest you start on Tab Ciprofloxacin 500mg twice daily + Tab Paracetamol 650mg thrice daily + Tab Ranitidine 150mg twice daily + Tab Gabapentin 1 tab twice daily. That should take care of the pain and infection. Meanwhile get an appointment with your treating oncologist and let him have a look.