I just found this Board and like all others think it is great. I was diagnosed with SCC after a biopsy of a lump in my neck. Search for primary included CT scan, petscan, xrays and 2 surgical biopies. No luck finding primary!! Next Thursday I will have a radical neck dissection and a salivary gland relocation. The relocation is a new technique to save the gland. The take the gland from the non-cancer side of the neck and "flip" it under your chin - just what I need more chins!! When i start radiation and chemo 4-5wks later, the proceedure should help protect the gland. '

I have read that some neck cancer patients have had their radiation &/or chemo first, then the radical - I would love to hear about that choice - or was it a choice. My oncologist seemed to be leaning toward taking pills to stimulate the saliva gland, then radiation/chemo and then surgery. I decided on the suggestion of my surgeon.

My teeny tiny lump is less than 1cm and stage 2.

Best wishes to all, thanks for the very helpful site and your openess to share. Although I too have great supports I think they can only understand so much - plus i think they might be sick of my whining.

Good luck and welcome to the forum...
Darrell

Hi Kanada and welcome. Best wishes for your surgery and impending treatments. My husband has an unknown primary as well. He is having surgery (modified radical neck dissection) this coming week. He has already completed his chemo and radiation as of this past week. The reason they did not do surgery first is because the lump on his neck was very large and the surgeon (ENT) advised that it would be difficult to do surgery before the lump was reduced in size. However, it is interesting to hear of the procedure to move your saliva gland. I wish that would have been presented to us as an option. Please keep the board informed of your progress. Good luck!
Michele

Goodmorning Kanada,
Ihad radiation and chemo first then waited about three weeks until I had a neck dissection. My Ent said all along that this would be my plan, how he knew that the one cancerous lymph node would not totally disappear after radiation I will never know, but it did not. Just last week I was at a head and neck cancer support group at the University of Rochester, Strong memorial Hospital in Rochester and I asked their Head ENT/Oncologist Surgeon your same question, he replied that it has many factors, your general health, size of tumor, number of lymph nodes involved dental issues and that each individual is treated differntly and it is usually after your team of doctors comes up with a specific plan for you, type of radiation etc. So hopefully they are taking this approach for you. I think that this approach gives us, the patient, the best possible care, I think the more heads talking about my cancer the better, more ideas more expertise etc. I hope that this helps a little, best of luck my dear Hang in there.
Always Lenny

Hi Kanada and welcome as well. My Father has an unknown primary and had his neck dissection first and is now in the process of chemo and radiation. His lymph node ended up being 4 cm but they thought it was slightly smaller prior to surgery. We were not presented with the option of treatments first and then surgery. Radiation for an unknown primary is pretty extensive compared to a known primary. I also like Michele am interested to hear about the salivary gland procedure, but it was not presented to us as an option. My father is so far successfully taking the amifostine and hasn't had problems with it.
Wish you all the best and please continue to posts as you progress through treatment.
Just an FYI - they also took my father's tonsils out during the surgery.

Thanks for the replies, I am very lucky to be a patient at the Cross Cancer Centre in Edmonton and have a Dr and Surgeon who are known world wide for their work. Dr. Jha and his partner Dr. Seikaly developed the "Submandibular Salivary Gland Transfer" and there is some stuff on the Alberta Cancer website under Research and Education : cancerboard.ab.ca I had a choice to participate in this proceedure or one where I would take medication to stimulate the saliva gland (and other wet producing glands in my body) then have the chemo/radiation done first - then radical neck dissection. Although I appreciate the opportunity to make decisions in my treatment - it sure is alot of information to process and then make an informed decision. This is why I am really thankful for this site and all of your sharing. All the best.... terry

Kanada

Welcome and will be thinking of you next week.
To me the surgery was the easiest part. Except for the pain and disconfort, but the pain Med. takes care of that.

I am really interested in the relocating the Saliva gland. If that works it will help you alot when you are done with treatment.

Take care..... you will be fine.
DM

Hi,
I'm another unknown primary with a met to one node in the neck. I had the neck dissection first, then 36 XRT treatments 8 weeks later. No chemo but that was back in 1997. I took Salagen for saliva. Hope this new procedure works for you. The neck dissection is the easy part and I had no pain. Wasn't even on pain meds the next day. You will probably need PT starting about 3 weeks after the surgery so ask about it. Good luck on your surgery and we will all be thinking about you. I'm curious. Will you be getting XRT or IMRT?

Take care,
Eileen

Hey Eileen - surgery tomorrow so glad to read your post about the pain. I heard from my Dr. yesterday and he said he's decided against chemo - I was so excited I forgot to ask why so going to call him back. I don't know about the XRT vs IMRT - still have to go to radiation school to learn stuff - not booked in there for two more weeks. The other thing is - this whole surgery/radiation came up really fast and I have found that the only way I have been able to deal with my diagnosis is to read up on the issues that I am currently facing. So two weeks ago it was about the hunt for primary so now I have to learn all about radiation!!

I will update when I get home from the hospital!!

Good luck with your surgery.

Terry, I hope everything is going well! When you feel better I would like to hear more about the tecnique your doctor used to spare the salivary gland. Frankly I asked my ENT about this kind of thing 4 years ago. (it was a crazy idea I had as a non medical professional)

Take care