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Hi ...Just reading the letter after my husband had his neck dissection and it it says all margins clear, one small positive node anterior to thyroid cartilage....

As he can't have chemo or radiotherapy again due to having had this when he had nasal pharyngeal cancer I am quite worried...should I be?


Thanks Kathy


Wife and carer of husband who was diagnosed 2013 nasal-phyrangeal, clear 2014, second primary diagnosed Dec 2016 Tongue cancer, Feb 2017 neck dissection, full Laryngectomy, Glossectomy plus glands. All nodes clear.
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Kathy not all patients are limited to doing rads once. I know plenty of our members that have gone thru rads twice. I even know a couple who had it 3 times. We usually see multiple rads done when a patient has a few years between each of the rad treatments and their next cancer is in a different location. This is done on a case by case basis and usually only at the major CCCs. Usually the second round of rads is a lesser dose too. Also, there are several different chemos that may be able to be used if he would get chemo with rads.

Im not sure what the meaning of the phrase you posted is. When lymph nodes are taken normally many are taken after the positive one to ensure all the cancer has been removed. Do you know how many nodes were taken? If it was found in one node then that node should have been taken plus several more. At your husbands next appointment please get more info from his physician. Im interested to know the total of how many nodes they took after finding one positive.

Best wishes!



Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
Joined: Sep 2016
Posts: 111
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Kathy -

I agree with Christine regarding the radiation treatments. However, the best place to get answers to your questions is from your doctors / surgeons. Also, I would add that a second opinion regarding treatment options from another ENT specializing in head and neck cancer may be of some use to you. Try to learn as much as possible about your options and never hesitate to ask questions.

Good Luck


1997 SCC Tumor on tongue - Partial Gloss
1997 Met to Lymph
Radical Neck Dissection / 2nd Partial Gloss
6 weeks chemo and radiation
Brachytherapy
2011 Stroke
2014 Recurrence SCC at Base of Tongue / Hemi-gloss
Free Flap reconstr from thigh
PEG Tube
Radiation
Permanent Issues with speech and swallowing
2018 - Bleeding throat / mouth
2019 - Bleeding throat / mouth
2019 - 3rd diag Cancer SCC Base of mouth / jawbone
2019 - Aug remove portion of jaw / right pec det / free flap closure and tongue

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Thank you both for your replies...my understanding was that when Tony had his neck dissection that they removed all nodes. However one ( as explained above) was positive, in my own head because there was one that was positive there is chance therefore that the cancer could have travelled elsewhere?

I know it may seem strange but I only just plucked up courage to read the letter we received some weeks ago, this weekend, which had a written form of what we were told when we went for the results. All I can remember when we were told verbally was that they had got all the cancer relating to the tongue but also found a small area at the back of the thyroid which they also removed. But reading the letter when I read the cancer near the thyroid was found in a node it worried me

I will do as you both suggested and ask the consultant though....

just worried though.
Thanks Kathy


Wife and carer of husband who was diagnosed 2013 nasal-phyrangeal, clear 2014, second primary diagnosed Dec 2016 Tongue cancer, Feb 2017 neck dissection, full Laryngectomy, Glossectomy plus glands. All nodes clear.
Joined: Feb 2017
Posts: 11
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Joined: Feb 2017
Posts: 11
Thank you both for your replies...my understanding was that when Tony had his neck dissection that they removed all nodes. However one ( as explained above) was positive, in my own head because there was one that was positive there is chance therefore that the cancer could have travelled elsewhere?

I know it may seem strange but I only just plucked up courage to read the letter we received some weeks ago, this weekend, which had a written form of what we were told when we went for the results. All I can remember when we were told verbally was that they had got all the cancer relating to the tongue but also found a small area at the back of the thyroid which they also removed. But reading the letter when I read the cancer near the thyroid was found in a node it worried me

I will do as you both suggested and ask the consultant though....

just worried though.
Thanks Kathy


Wife and carer of husband who was diagnosed 2013 nasal-phyrangeal, clear 2014, second primary diagnosed Dec 2016 Tongue cancer, Feb 2017 neck dissection, full Laryngectomy, Glossectomy plus glands. All nodes clear.
Joined: Feb 2017
Posts: 11
Member
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Joined: Feb 2017
Posts: 11
Thank you both for your replies...my understanding was that when Tony had his neck dissection that they removed all nodes. However one ( as explained above) was positive, in my own head because there was one that was positive there is chance therefore that the cancer could have travelled elsewhere?

I know it may seem strange but I only just plucked up courage to read the letter we received some weeks ago, this weekend, which had a written form of what we were told when we went for the results. All I can remember when we were told verbally was that they had got all the cancer relating to the tongue but also found a small area at the back of the thyroid which they also removed. But reading the letter when I read the cancer near the thyroid was found in a node it worried me

I will do as you both suggested and ask the consultant though....

just worried though.
Thanks Kathy


Wife and carer of husband who was diagnosed 2013 nasal-phyrangeal, clear 2014, second primary diagnosed Dec 2016 Tongue cancer, Feb 2017 neck dissection, full Laryngectomy, Glossectomy plus glands. All nodes clear.
Joined: Jun 2007
Posts: 10,507
Likes: 6
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The way I understand about the lymph nodes is to imagine a long bead necklace. If cancer is in one bead it can travel to the next one and so on and so on. Ive been told its a rarity for the cancer to jump over a node and appear in the next one. To answer your question if cancer was found in one it wouldnt necessarily be found a few nodes later, it would be next to the first one, it goes right down the line. Theres around 300 nodes found in the neck area, so its doubtful the doc took them all. Ive frequently heard of over 10 nodes or even up to 20 - 30 nodes being taken. From my understanding, doctors will take many that come after the one they find cancer in to ensure they get it all in one shot.

Please let us know how you make out with the appointment. Best wishes!


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
Joined: Feb 2017
Posts: 11
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Posts: 11
Thank you Christine you have explained that so clearly which is really helpful.
The problem is that when you are going through all this, you can't think of questions at the time, and often it takes a while for you to process the information and of course not being medically minded it can all be very overwhelming...such a steep learning curve isn't it and not one you perhaps would take by choice..

Thank you again.

Kathy


Wife and carer of husband who was diagnosed 2013 nasal-phyrangeal, clear 2014, second primary diagnosed Dec 2016 Tongue cancer, Feb 2017 neck dissection, full Laryngectomy, Glossectomy plus glands. All nodes clear.
Joined: Feb 2017
Posts: 11
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Joined: Feb 2017
Posts: 11
Thank you Christine you have explained that so clearly which is really helpful.
The problem is that when you are going through all this, you can't think of questions at the time, and often it takes a while for you to process the information and of course not being medically minded it can all be very overwhelming...such a steep learning curve isn't it and not one you perhaps would take by choice..

Thank you again.

Kathy


Wife and carer of husband who was diagnosed 2013 nasal-phyrangeal, clear 2014, second primary diagnosed Dec 2016 Tongue cancer, Feb 2017 neck dissection, full Laryngectomy, Glossectomy plus glands. All nodes clear.
Joined: Jun 2007
Posts: 10,507
Likes: 6
Administrator, Director of Patient Support Services
Patient Advocate (old timer, 2000 posts)
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I know exactly what you mean. Every time I leave a doctors office Im driving home and always think of something I should have discussed. My memory isnt what it used to be.

Try writing things down with an ongoing list that you keep in your purse or vehicle so you dont forget it when you take your husband to his follow up appointment. I make lists but then have the bad habit of leaving it home on my fridge. Ive started doing better when I keep it in my car.

Let us know how the appointment goes and how they explain the test results. Remember they are written by people who have medical backgrounds for people with years of medical schooling to read, not for us regular people. When I was in the hospital in Jan. I found the nurses always used medical lingo at shift change. Surprise!!! I think it was done so patients didnt understand what they were talking about. Thanks to OCF, Ive learned lots of medical terms and would ask them questions when I heard things that didnt sound right. The looks on their faces said everything I needed to know. smile


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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