Is neck dissection mandatory for early stage tongue cancer ? (physical examination : 2cm *2cm size tumor on lateral border of the tongue for 3 months).which one is the correct treatment partial glassectomy alone or partial glassectomy with neck dissection ? thanks.

Ran...Looks like we have the same tongue cancer. I had the tumor surgically removed plus the ND. Per CT Scan no cancer in the lymphnodes. My surgeon suggested a ND because the cancer cells are so small the CT Scan usually don't pick them up until they are larger. It was a precaution and I took it..it was up to me.

I have posted on here what was done you can do a search if you want. Really there's nothing to the ND it sounds worse than what it is, but I did go to a Cancer Center to have everything done, best move you can make.

Take care,
Connie

I'm not sure what the published guidelines are but without follow up radiation and most likely HPV negative I would want a ND. JMO

Hi,
I had early stage tongue cancer too. Not even a tumor but just cancer cells found. I had a partial ND because my lymph nodes were enlarged- they were clear in the end. but like Connie mentioned - cancer cells can jump and are often so small that they are undectable by MRI or cat scan. Also as one doctor said to me- its better to take out all the cancer pathways so it has no where to go. A benign tumor was also found on my saliva gland which didnt show up on any scans. So as far as I'm concerned the ND was worth it. My scar after 4 weeks has shrunk and faded significantly so it was no where near as bad as what I thought it would be.

Ran

Simple answer: a neck dissection is NOT mandatory. Different doctors have different views and most of us trust our doctor to make the call. My RO and MO were hot to trot for a ND, but my ENT surgeon not so much. A year later when the cancer came back at the original tumor site, of course we did a ND but just necrotic tissue found as the rad and chemo had cleared the lymph nodes of cancer just as my ENT surgeon had predicted. But if I had not had major radiation and chemo, a ND would have made sense.
I'm appalled by all the posts excitedly declaring they had multiple lymph nodes taken out and zero sign of cancer. But again, I went with my doctors call.
Last but not least, if you are going to have a glossectemoy surgery anyway, I wouldn't worry about a ND.
Most of us here at OCF had radiation and chemo in an effort to avoid surgery.
Charm

Your appalled!!!! I'm not appalled I was happy after having a ND and reading about hidden cancer cells in the lymphnodes that don't show until the size of a marble. I had one of the best Cancer Surgeon's at Moffitt Cancer Center and I went with his suggestion he's the doctor not me and he's seen more of this cancer than I have.

Am I excited that I had a ND... NO...I did it so I wouldn't end up back at Moffitt Cancer Center having another surgery because I should have and I didn't.

I certainly wouldn't tell anyone not to worry about it.

All I have to say about it..

I agree connie- with enlarged lymph nodes showing on the scans I didn't want to take the risk. I had 8 specialists on my case- ENTs, maxiofacial surgeons, oncologists etc and they all agreed it was the best course of action. I did find myself wondering whether it was all necessary but I guess you have to feel comfortable with the decision rather than stress out worrying about it forever- in my case I didn't want to live with the 'what ifs'. As I said, the ND wasn't as bad as I thought in the end- scar is fading quickly and only minor nerve damage. THe tongue on the other hand is still sore, swollen and yucky!

Edited to add- what I meant about feeling comfortable about any decision you make in conjunction with your doctors, is that I had to reconcile in my mind that I was going to trust what my doctors suggested and feel ok with that decision - not question it or regret it. does that make sense? otherwise you end up tearing yourself up with 'what ifs'.

Ran

Here is a link to my CCC's website which has plain vanilla information on a neck dissection. As I noted, doctors' opinions vary on this elective procedure and it should be individually tailored to your condition. GT ND
Please note the remarks about neck numbness, we've had posters here who took it as a bad sign instead of common side effect.
It's important to spare the nerves so it doesn't hurt to ask your surgeon how many ND's they do.
Charm

My 2 cents here. I had the ND, and it has given me a sense of security that I don't think I would have had, had I not done it.

The numbness in my neck was explained as a possible, shall we say probable, outcome, but I feel that it was a small price to pay for the comfort level that I have felt for the past 5 1/2 years.

Well, if you're talking with a surgeon it would certainly be suggested, but the NCCN Oncology Practice Guidelines also suggest that radiation and chemo are the prefered method of treatment for early stage BOT cancer - either that or excision of the mass. An ND seems a little severe unless you have a PET scan and it shows uptake in the lymph nodes. Be sure that you have a consult with a radiation oncologist and a medical oncologist and that all three docs are on the same page.

See Orph-2 in the link below. It's the standard of care for BOT cancer. You have three choices. It's up to you to decide what weapons, in the doctors arsenal, you are going to use. I'm not suggesting anything, just laying out your options. BOT cancers can be aggressive and because of the tissue type, more difficult to treat. It's all about risk and benefit. This decision should be made, with the consensus of your medical team. Any treamtent you get is not going to be a walk in the park.

http://www.nccn.org/professionals/physician_gls/PDF/head-and-neck.pdf