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How can recurrent tumour of the palate be managed?

Q: I am a 77 years old male diagnosed with Adenocarcinoma in my upper palate 20 years back. I was operated through requisite radio therapy. It recurred after 10 years and was operated again. Six years back, I underwent another operation. After two years, tumour recurred and my right eye was also extricated along with the cancerous tumour. Now, I have an enlarged tumour in my mouth almost of the size of a tennis ball and I have resorted to liquid-only diet. All my teeth are gone due to radio therapy. My right face is reconstructed with the help of a plastic surgery. An artificial flap was placed in place of upper palate. I was told by the ophthalmic oncologist that there are new techniques and medicines which are available to suppress and condense the growth of cancerous tumour. Kindly help me with whatever such facilities available by specifying the same. I am not suffering from diabetes, asthma and high/low blood pressure. What causes recurrent tumour? How can it be treated?

A:You are having a recurrent tumor and you have been operated 4 times in the past. According to your description you have a recurrence again within the oral cavity which is uncomfortable for you. Let me be very categorical in stating that you stand very little chance of cure at this stage, the only thing that can be done at this stage is palliative treatment to give you a good quality of life. Since you had a single course of radiotherapy for your primary tumor in the post operative setting, I would suggest you consult a radiation oncologist for considering a re-irradiation along with some concurrent chemotherapy if your general condition permits so. Now a days many improved techniques of radiation therapy are available which cause minimal side effects and these were not available 20 years back when you received your radiation. Moreover this radiation can be combined with many new chemotherapy drugs and improved chemotherapy regimes. Meet a radiation oncologist first and let him decide on the future course to give you a good QOL (Quality of Life).

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