In reading the posts here, I notice that some people have had the radical neck dissection, followed by the Rad/Chemo course, while others have had the Rad/Chemo first, then the dissection.

What factors were communicated to you relating to the reason for the order of treatment? I have my first appointment at the Cancer Center on Tuesday, and want to know what questions to ask.

Thanks.

Jeff,

From what I can tell, if radiation/chemo is recommended first, the doctors usually want to try and shrink the tumor(s) before operating to reduce the amount of tissue that will need to be removed in surgery.

In my case the tumor on my tongue was relatively small 3cm by 3.5cm, so they did surgery first on both the tongue and neck, then I did radiation.

Jim

Jeff,

In my case they first needed to find the primary location. Once located (got lucky) they treated with chem/rad first followed by a modified neck. If primary was not located, they were going to do a radical disection first followed by the chem/rad.

Rob J

Jeff,

My husband's case is basically the same as Rob above. It was always part of the course of treatment outlined to us. The neck dissection was the easiest part of the whole treatment and after chemo and radiation there was still one bad guy lymph node that had dead cells surrounding it but live cancer cells inside.

Jeff,

In my case I had rad and chemo first. My ENT had hoped for nodes on right side of neck to shrink to minimal size but that did not happen. She then did the neck dissection and all right side nodes were removed and tested. . .thankfully came back negative.

Bill D.

my dr. has recommended a neck dissection but i was so shocked about what he explained that i forgot to ask him several things. does it leave the surgery site radically thinner or smaller than the other side? Also does every body have diminished used of that side? what are the side effects and the pain factor?

My husband's incision went from below his ear, down his neck and around to the front of his neck. I know that sounds hidious but after 4 months, you can't see the scar. It has healed beautifully. There is a slight indentation but it is not noticeable. His neck feels tight in that area and he has had some loss of use with his shoulder due to the muscle being cut there but with physical therapy and just using his arm and shoulder, all is good. That would be the only side effects. As far as pain, he had none. He went in for the surgery and came home the next day - they initially said he would come home with a drain for a couple of days, but he did so well, he went home with nothing. He had the surgery on Thursday and spent the weekend resting and taking it easy and was fine on Monday. Had the staples out a week or so later.

Jeff,

I was told by my docs at Moffitt that they didn't do surgery in my case unless it was necessary after concurrent chemo/rad. I had been to 2 previuos docs, the first an ENT that said a Radical must be done first followed by chemo/rad, the second a MO that said a partial must be done followed by chemo/rad. Point is get multiple opinions and listen to there reasons.

Jeff

I had my neck dissection due to the depth of invasion with the tumor on my tongue ..my nodes were all clear so we decided to forog the radiation ,...not before talking to my surgeon, Rad Onc, and the team at Dana farber in Boston. That is just how it was layed out to me ..had to do the neck to see if anything in there was affected.

Shar

I just finished my rad and chemo and expect to have the neck dissection in a few weeks. I had two nodes removed 1 that found the cancer because the fine needle aspiration did not show it. My neck swelled tremendously after the surgery so I was worried that it was bleeding. Went to the emergency room and my ENT thought that I might be as well. I had emergency surgery and turned him down on the Neck dissection then because I had only been diagnosed for 3 days. I had no idea what was going on yet. Anyway I wasn't bleeding so he removed another enlarged node that was also cancerous. I then found a cancer treatment senter and a team of docs. They decided to do the rad and chemo first because after they did a tonsillectomy and took biopsies of my tongue ect. They were trying to find a primary so the rad could be more pinpointed. The found it in the left tonsil. As soon as I healed enough we started the treatment. My understanding was due to the removal of the first and second node concerned them as far as the amount of metastisies as well as spillage. It had also been 3 months since I found the first node swollen. To do the dissection first would have put the rad and chemo even later. They wanted to start killing the cancer and do the dissection to get what was left or atleast remove the places that it would be most likely to return. I asked for very aggressive treatment. I have a 30 month old and a wonderful wife that I want to spend lots of time with. Now this is my understanding of the course of treatment and I may be way off, I haven't specifically addressed this with my docs but intend to at the next meeting with my surgeon next week. Good luck.