A Visit to Pill Hill

Nov. 11, 2008

Fred and I went to OHSU to meet our new ENT specialist, who after checking Fred’s throat with a scope again (the tumor was still not visible through Fred’s mouth), told us that Fred probably had squamous cell carcinoma of the left palatine tonsil. At this point, he began to explain what this diagnosis meant. Treatment of oral, head and neck cancer is probably the most difficult of all cancer treatments. It is treated primarily through radiation, but chemotherapy is usually added when lymph nodes are involved. A CT scan showed three lymph nodes on the left and one on the right that are probably involved. The radiation leaves the patient unable to eat due to the destruction of the mucosa of the mouth and esophagus. This requires a tube to be placed directly into the stomach for feedings and medications since the patient would not be able to swallow. The chemotherapy requires venous access, and so a permanent port is usually placed into a large vein for blood draws and chemo. There is no English word to describe our feelings about this information.

While we were in the office, the doctor obtained a small amount of tissue for a biopsy. This left Fred’s throat even sorer. And so we left OHSU stunned.