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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 26383
Experience:  Over 20 yrs of Family Practice
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I have a question for an oncologist

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I have a question for an oncologist
Hi--there are no oncologists on line right now but I may be able to help you if I knew your question
Customer: replied 3 years ago.

post surgery for squamous cell carcinoma where tissue margins are negative is it always necessary to have radiation therapy?

This was a skin lesion? How large? How long had it been there?
Customer: replied 3 years ago.

Small marble size on the bridge of nose. Under the skin. Slowly grew over 10-12 mo.

OK--can I ask if you were told exactly why radiation therapy was necessary in this case?
Customer: replied 3 years ago.

I consulted with a surgeon who said that it was a simple 20-30 min surgery and said it would require 6 weeks---5 days a week radiation--which has brutal side effects.

OK, Albert. I really don't understand the surgeon's recommendation for radiation therapy because the only time that would be necessary is either if the lesion were in an area where it couldn't be completely removed or, perhaps, if it were extremely large and invasive. With clear margins, basically the excision itself is a completely cure and no further therapy--radiation or chemotherapy--is ever needed. I suggest you consult an oncologist about this, but I'm certain from what you've told me you don't need any radiation therapy
Customer: replied 3 years ago.


My pleasure, Albert--any time at all. Please remember to rate my service to you
Customer: replied 3 years ago.

Lastly-I do greatly respect and honor your opinion---I am just very frustrated with the differing opinions I have had on this. I feel like I am on an island not knowing what to do with various options that can have serious consequences and ultimately it comes down to my choice.

If I go on radiation I am subject to 6 weeks of extreme pain--incapacitating fatigue and nausea-narcotics---the side effects of them alone plus the potential post radiation problems down the line. very frustrating - I mean this is my life we are talking about and I hate to think the doctor recommending this takes all of this into account as if it were him of family member. This sucks.

I understand but what kind of doctor exactly is telling you this and why are they saying radiation therapy is painful?
Customer: replied 3 years ago.

The the doctor that I am scheduled for surgery with on this monday.


OK--I guess I was thinking you'd already had the surgery. But is this a dermatologist or a plastic surgeon, and, again he's telling you that radiation therapy is painful?
Customer: replied 3 years ago.

no---the surgeon doing the procedure has told me this-I have not talked to the plastic surgeon yet but assume he would agree with the 1st one.

Opinions on all of this are all over the place---with the majority saying it is not needed. The last one I spoke to was not a surgeon but a dermatologist and she freaked out saying I could die w/o the f/u radiation.

Because squamous above the shoulders is very aggressive---others say clean margins and you are good to go.

Well, Albert, first off, radiation therapy is not painful. But what first needs to be done is the surgery itself and to see if clear margins can be gotten, which is most often the case. I don't know why a surgeon would be telling you all this, but just get a referral to an oncologist after the procedure is done and the pathology is back. I truly see no reason to suspect that you'll need any therapy beyond the surgery. And squamous cell carcinoma is anything but aggressive
Customer: replied 3 years ago.

Ok---I think I have brought this as far as I can with you & thank you for your help. Just to give me some context to help with my decision process-


What kind of medicine have you practiced and do you have any additional medical experience--I thought I saw that you managed a facility.

I have done general and trauma surgery, surgical critical care, and now family practice so you could say I've been around the block. Please keep in touch and let me know how it goes.
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