As you know, oral and throat cancers can sometimes be quite difficult to treat, and so I think it is great that you have done so well with multiple negative scans over the last several years! Of course, the new problem you are having of a fistula is concerning and needs to be sorted out. I would not jump to the conclusion that this is a recurrence of the cancer, although that is a possibility. Another likely possibility is that you have some complication from the radiation therapy, which can easily lead to scarring and sometimes to fistula formation, or that you have an infection in the area that has caused the fistula.
Your cancer doctors
, together with your other doctors, will no doubt be working through all of these possibilities with you over the next few days and weeks. I am sure that they will want to perform more imaging and possibly a biopsy
to see if this is cancer, as well as looking for infections and the like. Your throat surgeons
will want to advise your other doctors on what the potential therapies for healing up the fistula might be. Good luck with this issue over the next few weeks!