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#185650 10-03-2014 03:23 AM
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DavidTX Offline OP
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Hello all. Let me start at the beginning. At the end of July I was diagnosed with testicular cancer. Seminoma. So, I have had multiple ct scans and a pet scan in the last two months, although all of the ct scans were of the chest and abdomen, only the pet scan covered my head. So, since about mid August I have had a palpable lymph node on the left mid posterior of my neck. It feels like it is close to a cm maybe a little larger. It is moveable but is not tender to the touch. I had an ultrasound done on the lymph node where they found it to be benign, but it has slightly grown in size since then. I also feel like I have some not really pain but pressure in my right ear, and I have had some canker sores under my tongue that have come and gone over the same time frame. I also have a section in the floor of my mouth that feels swollen and just different that the left.

So, I guess my questions are is it likely for a pet scan to miss some issues that would've been going on in my oral cavity because they were mainly focused on my abdomen?

Do persistent canker sores that come and go in similar but not the same area indicate oral cancer?

How fast would a lymph node with squamous cell carcinoma take to really enlarge over the 1cm threshold?

Thanks in advance for any advice, I am also involved in a testicular cancer forum and I know how great these forums and their members can be.




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I would suggest going to an ENT (who treats primarily oral cancer patients) to get checked out. Tell them about the ear pain and lymph node. Im one to always err on the side of caution so its a good idea to get checked out.

Cancerous tumors will not come and go so I doubt the caker sores are anything to worry about. But you still want to let the ENT know you have had issues with it. You just never know.

Im sorry but I dont know how quickly SCC grows. Its probably like everything else, everyone is different and in some it will grow faster than others.

Hopefully you have nothing serious going on. 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
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Hi David. Christine is on the money here, I won't repeat her good advice.

Both my PET/CTs were of my head down to my thighs. I didn't think they did PETs of just the head. And if they were looking at your chest and abdomen why do a PET of your head? The radioactive glucose goes right through you, so I would imagine they would scan the whole body? Maybe others can suggest what happened there.

The PET that showed my tonsil tumour and lymph nodes showed up like a Christmas tree. A blind bat wouldn't have missed them. And while they were at it I know they had a good look at something on my spleen, but concluded it was benign.

An ENT will sort you out. Hope its nothing serious. Good luck with the Seminoma.


Cheers, Dave (OzMojo)
19Feb2014 Diagnosed T2N2bM0 P16+ve SCC Tonsil.
31Mar2014 2 Cisplatin, 70gy over 7 weeks (completed 16May2014)
11August2014 PET/CT clear.
17July2019 5 years NED.
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HI there... I would push to have them look at the node. It could very well be reactive but better safe than sorry. Usually a sore that doesn't heal is one that needs a biopsy if you're experiencing cankers and they heal that's okay, but the ear pain and node need to be dealt with - even if they are benign. PETs a great but I think - much like the others - MRI and CT - they only pick up tumors of a certain size and can't "see" microscopic cancers - also the results are only as good as the radiologist reading them.

to ease your mind, ask for a referral to a top ENT within the treatment center you were treated at - hugs.


Cheryl : Irritation - 2004 BX: 6/2008 : Inflam. BX: 12/10, DX: 12/10 : SCC - LS tongue well dif. T2N1M0. 2/11 hemigloss + recon. : PND - 40 nodes - 39 clear. 3/11 - 5/11 IMRT 33 + cis x2, PEG 3/28/11 - 5/19/11 3 head, 2 chest scans - clear(fingers crossed) HPV-, No smoke, drink, or drugs, Vegan
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Hi David,

I have a few around cervical lymph nodes and under my chin that are just over 1 cm. Been to several ENT's, had ultrasounds, an excisional biopsy, and so far, it seems I have viral lymphadenopathy. These lymph nodes have been around for about 2-3 years or more. I can't really say. What I do know, though, is cancerous lymph nodes tend to be sticky. And, they usually grow fast--someone may correct me with an anecdote here. From most cases I've heard about, they usually find a large lymph node, like over 2 cm, which is noticeably growing over a several week time frame.

Anyways, you should definitely see an ENT about it. A biopsy would be important, given your history.


40 y.o., undiagnosed, spitting up blood past 4-5 months at random intervals, several enlarged lymph nodes under chin and neck, biopsy of one showed benign viral lymphadenopathy. Still being monitored by ENT.
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I had a cervical, cancerous lymph node that didn't grow significantly for 6 months. I don't have a clue what a "sticky" node would mean or how it presents. Some nodes are discovered as small as 4 mm. I had a fine needle aspiration done with one that size.


SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
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Hi Uptown,

Sticky being immobile. I hear doctors say that about cancerous lymph nodes. They tend to stay in-place. Your diagnosis is not reassuring for me. I should get my other enlarged lymph nodes FNA'ed then. So, the lymph node they biopsied on you was 4 mm?? That's super small. All the ENT's I have seen, and I have seen a lot already (over 5 now) have said they will not FNA lymph nodes smaller than 1 cm since they can often miss them.


40 y.o., undiagnosed, spitting up blood past 4-5 months at random intervals, several enlarged lymph nodes under chin and neck, biopsy of one showed benign viral lymphadenopathy. Still being monitored by ENT.
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They were image guided. They even took several from it. It would be "sticky", according to your definition. The bigger one was an incisional biopsy. The small one was negative, but it's still there over 3 years later.


SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
Joined: Jun 2007
Posts: 10,507
Likes: 6
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I believe Uptown was treated at one of the coutrys top CCC's which could be the difference in biopsying.


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: Jul 2012
Posts: 3,267
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I had about 10 FNAB's all under untrasound guidance, which makes them more accurate, and some were as small as 3mm x 7mm, and done by a pathologist. Lymph fluid is sticky, so the term can mean differently to others. As far as cancer being immobile, that's not always true. When a cancer is small it can be mobile, and when it gets larger it can attach to structures making it immobile, I had both at times. The doctors also go by other factors such as the shape, thickness, but the only way to tell is through a biopsy.

Good luck.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs







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