The radiation oncologist called me back that evening and I asked him why the sudden change in treatment. He explained that where my cancer was located it could be treated either way, i.e. with or without neoadjuvant therapy. He said that he had spoken with my surgeon and that the surgeon was strongly in favor of doing radiation and chemo prior to surgery. There was a 20% chance that neoadjuvant therapy would be overkill in a case like mine. However, if I opted to have surgery first without neoadjuvant therapy and something was found during the surgical procedure that didn’t show up on any of the scans, they would be kicking themselves for having lost that treatment window of opportunity. In a tough case like this it would be best to err on the side of caution. Ultimately, the burden of responsibility rests on the shoulders of the surgeon and if he feels that pursuing neoadjuvant therapy will make it easier for him to resect the tumor and reduce the risk of recurrence then he was willing to back him up 100%. He said that he was meeting with my oncologist that evening and they would be discussing my case. The next step would be radiation mapping and a port placement.
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