adenoid cystic carcinoma

chrisuk
Contributor

Re: adenoid cystic carcinoma

Hi. I'm from the UK and after 4 years of being mis-diagnosed I've just had surgery to remove an ACC (stage T3) from my Parotid gland. I've also had 3 teeth removed which was a requirement before 6 weeks of radiotherapy.

I am totally depressed and absolutely terrified. I know everybody is different but can anyone tell me what to expect. This cancer is so rare and some of the articles on the Internet are terrifying.

If there are any other forums that might help could you post links?

Thank you.

 

Lampwork54
Regular Contributor

Re: adenoid cystic carcinoma

Hi Chris from the UK.

 

I read your email early this morning and have been thinking about it for most of the day.  I read somewhere that the average time for diagnosis of this type of cancer is 8 years so you've done well.  

 

I have some questions for you.  T3 is size of tumour. 3mm.  Does that mean you are T3N0M0?  Nodes involved - 0.  Metastases - 0.  I'm T2N0M0.  I was dagnosed within a year so that was pretty good.  I was absolutely sure I did not have cancer as the gland was painful.  After one ultrasound I was given a high dose of antibiotics and the gland reduced in size.  Cancer does not reduce in size with antibiotics.  A fine needle biopsy said a benign cyst.  I was very happy with that diagnosis but the surgeon was not and requested a cone biopsy which unfortunately showed ACC.  

 

How old are you?  I am 64 and had just retired so pretty annoyed that this happened at all. I keep reminding myself that this cancer happens in 15 year old girls.  

 

I will post again but just wanted you to answer those questions if you could.  

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Lampwork54
Regular Contributor

Re: adenoid cystic carcinoma

Completely understand that you're depressed and terrified.  Another question - What was your biopsy report?  Were your margins clear?  

 

My surgeon told me not to research the diagnosis.  I did anyway and you're right the diagnosis is horrible.   I've looked up where the parotid gland is.   "The parotid glands are a pair of mainly serous salivary glands located below and in front of each ear canal, draining their secretions into the vestibule of the mouth through the parotid duct. Each gland lies behind the mandibular ramus and in front of the mastoid process of the temporal bone."

 

I'm assuming that your tumour was taken out via the side of your face and through your gum if you had to have teeth removed.  You can expain that a bit better if you could.  As mine was taken out via the front of the neck and through the gum - surgery was pretty awful.  Luckily, I already had false teeth.  It means I can't wear my lower plate as I have a graft over the left side of my gum.  I will have new dentures made in about 2/12 time.  Soft food diet for now.  

 

I can't point you in the direction of happy research about this tumour.  It's all pretty dire.  I looked for stories about success and survival.  I found a few that gave me hope.  I was told it was fatal, aggressive, always comes back, metastasises quickly by the surgeon.  Luckily, I had no metastases or nodal involvement.  That gives you a much better outcome with this tumour and I think you may be in the same boat.  I asked about immunotherapy treatment but was told that I wouldn't qualify as I wasn't bad enough.  Well, that was good!  The surgeon said he thought I had a cure.  6/52 of Radiotherapy would just ensure that.  

 

 

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Lampwork54
Regular Contributor

Re: adenoid cystic carcinoma

On Radiotherapy - I've just completed 22 treatments and have 8 more to go.  What can you expect?  A strange mask being made for you to keep you in position for the treatment. The treatment itself takes about 2-3 minutes.  It's more the dressing and undresssing that takes up time so wear comfortable and easy to remove clothing.   Unfortunately, it is every day come rain or hail.  They told me that even if the skin on my neck broke open, treatment woud still continue.  

 

I've had no nausea, vomiting, skin breakage, tiredness or any other symptom associated with the therapy.  I have taken an olive leaf tablet every morning before and after surgery, as well as throughout the radiation therapy.  If I didn't feel like taking anything else, that's the one I made sure I took every day.  It boosts the immune system.  On my neck I've used paw paw cream, my own recommendation and sorbilene, the hospital's recommendation.  The skin is quite red now but holding strong.

 

I've had the luxury of not having to go to work or do anything much throughout the treatment.  Just normal housework and small shopping trips to buy fresh chickens.  I have eaten a great deal of chicken broth, made with all sorts of wonderful things in it like ginger, onions, garlic, turmeric, cinnamon etc.   I find it wonderfully soothing for my mouth which seems to have suffered the worst of it.  It often feels hot and burning.  Cold things like yoghurt, jelly and icecream help too.  Lots of mouth washing, secial mouth washes and hydrating mouth washes too as the mouth can become quite dry.  Water made from ginger soaked in boiling water overnight has greatly helped too.  I juice watermelon a few times a week as it is great for getting rid of any toxins in your body.  I am worried that my hair seems to be thinning out, which is quite stressful.  I had hoped to not lose any at all.  It was also one of the first symptoms I had.  Dry, damaged and easily broken hair.  

 

That's about all I have.  When you have your mask put on for the first treatment, speak up if it is too tight.  I made the mistake of thinking it would be alright because it was only 2-3 minutes and I could put up with it.  By the time they took the mask off about 30 minutes later, I was crying.  It was just too long.  You will be in the mask for varying lengths of time.  The 2-3 minutes is only the time that they are actually radiating you.  They put a spacer in it for the next treatment and it was fine.  

 

Sometimes they give you a bell to ring if you need them to come back into the room for any reason.  Whenever they don't give it to me, I get frightened that I'm going to choke.  Today for the first time, I actually asked for the bell.  I haven't had to use it but it just makes me feel a little less panic.  Something awful happened yesterday.  There was a fire drill.  I had just finished my treatment and was about to leave.  We waited around for about 30 minutes or so.  When I went to the lift a lady was complaining that she had been left in her mask on the table and everyone had left her there.  That would be my worst nightmare.  The poor woman!  Always ask for the bell.

 

I hope that helps you Chris.  I hope it doesn't sound too preachy about the olive leaf.  It is the best thing to boost your immune system and right now your body is under attack whilst it is recovering from the surgery, stress and radiation.  I can't tell you how much this has helped me get through this.  Good luck and ask any questions you like.  I hope everything goes well for you and you come through this with flying colours.  Let us know.

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chrisuk
Contributor

Re: adenoid cystic carcinoma

Hi Everyone. Thank you so much for your replies. It's really appreciated. Some of you have asked me for more details so I will tell you all I know. I'll try not to be too boring!! Smiley LOL

 

About four years ago I went to see my GP when I felt a small lump in my neck just under the left ear. I was referred to the hospital and I had an ultrasound and a fine needle biopsy. I was told it was a harmless lump on the Parotid gland and was nothing to worry about, but they would repeat the tests once a year. 

A few months ago I returned for my fourth annual appointment and this time I saw a different Consultant. He appeared to be slightly more concerned and sent me for a MRI scan. When I returned for the results a couple of weeks later he was very concerned and recommended I have surgery to remove the lump asap. He said 80% of lumps on this gland are benign but should be removed and tested quickly. I was a bit shocked but went ahead with the surgery.

At the follow up 2 weeks later I was informed the lump was an Adenoid Cystic Carcinoma, T3 (35mm) NO MO. I just sat there totally stunned. He said parts of tumour had spread so far on the gland they were unable to get complete healthy margins.

30 minutes later I was sent to the dental dept. and was told they will have to remove three teeth. Still in shock I asked why? Apparently Radiotherapy in this area can permanently weaken part of the jawbone and so they remove teeth before the treatment begins. If these teeth have to be removed in the future the jawbone might not heal and cause big problems.

I had the teeth removed 3 days ago. It was carnage! A 30 minute appointment took 2 hours. They had great difficulty removing the teeth and had to drill into the bone. Now my face is very swollen and bruised and I can barely open my mouth to eat. I'm supposed to be having the plastic mask fitted next week but my face is so badly swollen I can't see that happening.

Every doctor I have seen so far has spent 15 minutes telling me about all the terrible things Radiotherapy might do to me and I am now totally depressed. I am also aware that even after the 6 weeks of Radiotherapy this cancer has a 50/50 chance of returning - sometimes years later. People keep saying I must "be positive" but it's not easy. 

I have also lodged an official complaint with my hospital for mis-diagnosing me for so long. Apparently ANY lump on the Parotid gland should be removed as quickly as possible, benign or otherwise, because of the unpredictable nature of these tumours.

So that's my depressing story so far.

 

chrisuk
Contributor

Re: adenoid cystic carcinoma

Sorry, I forgot to add the surgery involved cutting around my ear and removing the cancer from under and in front of the ear. The surgery can often damage the facial nerves. I am slightly paralysed on my forehead and other areas at the side of my head. My ear is also completely numb. My lower lip and chin are also totally numb after the dental surgery. I have been assured that all this will improve over the coming weeks/months.

Lampwork54
Regular Contributor

Re: adenoid cystic carcinoma

Sorry Chris.  It's a tough diagnosis.  The bit I haven't talked about much yet is being told that not if - but when this cancer returns - which it will.  That's what I was told originally but that it might not return for 15 years.  Afterwards, the surgeon said he thought he had managed to get me a cure because of the clear margins.  That definitely made me feel better.  Even though you didn't have clear margins, hopefully the Radiotherapy will kill any remaining cells.  

 

I wondered if your teeth were removed because as you say, the Radiotherapy will kill them.  It's horrible to have a sore mouth.  I think my Therapy started about 2 weeks after surgery and my neck scar and mouth were still healing.  They took a muscle from my neck and used it to lay over the wound in my mouth to close the incision.  I was freaked out about having the Radiotherapy to a partially healed wound.  It's all gone really well though and the only side effect I have so far is a bit of redness to the neck area.   My surgeon warned me that not only would the Radiotherapy be bad but even worse for a few weeks after Raiotherapy stopped.   Again, not too bad so far.   I've seen some horrific open burn wounds on necks following radiation but again, has not happened to me.  Be super careful with your skin.  Keep some cream in you car to put on your neck to put it on straight afterwards on the way home.  I was told that no matter what happened to the neck, burns or open wounds - treatment would continue.  Another reason to take special care.  

 

One way to stay positive is to think about all the ways you could have died - instantly - yesterday.  You still have time to fight today.  You still have a chance of long term survival and that's a good prognosis.  

 

You still haven't stated your age?  Don't if you don't want to.  I was just interested.  

chrisuk
Contributor

Re: adenoid cystic carcinoma

Hi Lampwork54,

Thank you for your reply.

Yes, I have read that this cancer has a 50/50 chance of returning, sometimes in the same place, or the lungs or liver. As you said it could be years in the future. As it is generally a very slow growing cancer it is possible to live with it for many years, but I don't think the doctors really know for certain. I have also discovered that it can affect anyone of any age and the cause is unknown. I have just had a CT scan on my lungs and I am praying it hasn't spread. Hopefully in the next few years they will have discovered better treatments.

All the teeth they removed were capped and apparently the area on the side of my neck where I will have the radiotherapy can cause a problem with the jawbone. If in the future I had problems with those teeth and they had to be removed the sockets might not be able to heal. I was quite upset because the caps on those teeth cost me hundreds of pounds!

I'm so pleased your radiotherapy went well and your side effects were minimal. I have taken your advice and ordered some olive leaf capsules. I have also been researching suitable skin creams. I have also started using Cannabis Oil (legal in the UK) as I have read some good reports about it from cancer sufferers.

I am being fitted with the plastic mask next week and then another CT scan for the radiotherapy people. I also have to see a speech therapist because the treatment can affect my speech and I may have problems swallowing. It all sounds very depressing!

I lodged a formal complaint with my hospital as I have discovered that ANY lump on the Parotid gland should be removed immediately, not monitored for 4 years! I had a reply this morning from the hospital CEO confirming that an investigation will take place.

I am 65 although I was 60 when I first went to the hospital with this lump. I only retired last November and my wife and I were looking forward to some nice holidays. 

I did not have any symptoms apart from feeling a lump below my ear. Did you? I realise your cancer was in different glands.

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Lampwork54
Regular Contributor

Re: adenoid cystic carcinoma

Hi Chris,

 

Thank you for your reply.   It's good that you lodged a complaint.  A lawyer once explained medical negligance to me.  It's similar to you not stopping at a give way sign.  If you didn't crash into anyone, you're not liable for it.  If you did crash into someone, you're liable.  Putting in a complaint will help the next person with this diagnosis.  

 

As my fine needle biopsy was - benign tumour and the ENT doctor believed it, he referred me on as it still had to be removed. It' only because the surgeon didn't like that there were some salivery cells in the biopsy, he insisted on the cone biopsy.  I thought he was horrible and how dare he think that I had a primary cancerous tumour somewhere else.  In hindsight, thank goodness he queried it.  I am very grateful to him.  I've seen cases of 15 year olds being diagnosed with this cancer.  How devastating for them.  I think about all the babies and children diagnosed with cancer and it breaks my heart for them and their families.  

 

My mother died in May last year and it was a very stressful time.  After her death I didn't feel really well anymore.  I noticed a swollen gland in my neck and thought it was stresss related.  She had been in a nursing home for the past 10 years and it had been an exhausting time supporting her and caring for her, a job and a family.  We'd had a family breakdown and my sisters and I had to take power of attorney away from our eldset brother as he had embezzled a large amount of her funds and had her declared incompetent.  We had to get a Geriatrician to certify that our mother was not incompetent, which she wasn't and she changed her will.  My brother did not visit her for the remaining 8 years following that.  I knew that when my mother died all hell would break out, which it did.  My brother started a few days after my mother's death and before the funeral, querying the public trustees as to the will.  He was furious when he eventually received a copy of the will.  My mother left her estate equally to all her children.  She then deducted the amount he had stolen from his share.  He contested the will and that took about a year to resolve and the will was proven and was executed according to our mother's wishes in May, this year.   Long explanation but I wanted to explain the amount of stress involved around my mother's death.  At the same time, we had sold our business and negotiations, legal documents and added stress happened around the same time.  My earliest symptom was hair breakage and brittlness.  

 

I retired too in February of this year and did the rounds of the doctors, investigations and specialists.  It all seemed to take a long time.  I had my final diagnosis in June and was operated on in July.  My husband has to stay with the business that bought us for two years and I thought it was going to be a very peaceful, yet lonely time without him.  When he retired we had plans for travel too.  We still do.  May just have to be shorter journeys in the future.  I was so prepared for retirement.  I had mapped out some classes that I wanted to take, particularly in glass work and a weaving course I've been wanting to do for years.  I even had a retirement wardrobe of track pants, tops and jackets.  Never having to worry about what to wear again.  I've worn the same jacket every day to Radiotherapy.  I take it off as soon as I get home.  Once treatment is completed I will donate that particular jacket to a charity as I will never want to wear it again.  Strangely, I had wanted a year without any commitments.  I stopped doing Tai Chi after 20 something years of it.  No appointments.  Not having to be somehwere on time.  Ha ha!  Jinxed myself.  I now live by the clock to go to so many appointments before surgery and now after surgery - all the time!

 

Ironically, I did give myself time to do this.  I had to have a tracheostomy after surgery because the mouth and tongue would be very swollen and the mouth wound needed time to heal so nothing via the mouth for 6 days.  That was horrendous.  I had myself discharged on the 6th day.  I guess the doctors have to take every precaution.  They said I'd have to go to speech pathology as I possibly wouldn't be able to swallow or speak.  Not a problem at all.  I could swallow and speak and they've been very happy with the mouth all the way through.  Don't be scared.  They just have to warn you of every possibility.  

 

I am really happy that you're going to take olive leaf.  Mny years ago my sister in law wa diagnosed with breast cancer.  I had read up on everything including all the side effects for her of treatment.  She saw a Chinese herbalist who recommended the olive leaf.  She had very minimal side effects and I advised our whole family to be on olive leaf.  When you own your own business, with family working in it, you cannot be sick.  Visiting an elderly person in a nursing home - you cannot be sick.  It worked very well for us.  We only really took it if we felt a tickle in our throat.  We didn't have flu vaccinations and we didn't get the flu.  I was not very good at taking it last year and would often give my bottle of tablets to others in the family who needed it more than me.  (I have 4 children and 11 grandchildren so a very busy household).  

 

Try drinking ginger water too.  Cut up some fresh ginger.  Leave it to soak overnight in boiled water and it will rebalance your inner core, especially emotions.  Also excellent for anti-nausea and natural.  

 

Yes, I am hoping that there are major break throughs in cancer reserch.  One that I really like  is immunotherapy  a type of cancer treatment that helps your immune system fight cancer.  I saw a trial of this for colon and adenoid cystic carcinoma.  I could not participate as my grading was too low but who knows what could happen in the future?

 

I'm glad that you've found CBT oil.  It may help greatly with Radiotherapy side effects.  I have some in the freezer but have not felt the need to go down that track yet.  

 

Whatever gland we have it in, we're still in the same boat diagnosis wise.  I hope your CT scan is clear.  Make sure you update me regularly on your treatment.   I will be very interested in how you manage throughout this.  

 

 

 

 

 

 

chrisuk
Contributor

Re: adenoid cystic carcinoma

Hi Lampwork54.

My word, you have been through it! People have told me that life gets easier when you get older. It's not true is it?

Thank you for all your help and advice. I really appreciate it.

I'm still in a lot of pain and discomfort from the teeth extractions, and Ibuprofen and Paracetamol and salt mouthwashes are a big part of my daily routine!!

On Wednesday I am having the plastic radiotherapy mask fitted and on Thursday another CT scan on my neck so they can work out where exactly to zap me.

The hospital is an hour's drive from where I live so I'm hoping my little old car can take the strain for the next few weeks!

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