Thanks again for your responses.

My ENT's office scheduled my biopsy for 11/23/09 with a follow-up scheduled for 12/01/09. This does not sound as if they are in any hurry. I've been thinking more like doing the biopsy, and getting the results, all by early next week. They were able to move this quickly on a biopsy they did last March (when they were initially trying to diagnose me), so I know my expectations aren't unreasonable. Their lack of any rush makes me think my ENT is just a "guy with a knife", and he's looking for a place to use it.

Thanks to my nurse, I got a copy of my recent PET/CT report. (I also have a copy of my previous PET/CT report from 4/22/09, before I had any chemo or radiation treatment.) These reports don't use terms like "positive" or "negative". The older report talks about "intense FDG uptake" in the large nodal mass on the left side of my neck while the recent report says this "intense FDG uptake" is now significantly resolved. I'll reserve final judgement awhile longer (at least until after I've heard from my medical oncologist), but this sounds very close to a "negative" result for this nodal mass and makes me more comfortable with the notion of deferring surgery. The recent PET/CT notes a few new areas of FDG uptake, but none of these make me concerned; for example, the left tongue base shows "nonspecific" uptake which "may represent physiologic muscle activity" and I know I have a sore there (from radiation treatment) which hasn't fully healed.

My ENT also responded to a few follow-up questions that I sent him last night (via email). One was whether the recent PET/CT report and images would help him be more precise/definitive about the possibility of sparing the SAN, IJV or SCM muscle; his answer was basically "no". Another was whether I should keep the PEG to help with recovery from surgery (or can I have it removed now, since I'm no longer using it); his answer was that neck dissection shouldn't interfere with swallowing unless the vagus nerve is involved or injured. Great... now I need to find out what a vagus nerve is, whether its involved, and whether its likely to be injured by this surgery.

Well, I feel better having a little more information. Especially since it makes me think there may not be a need for surgery... at least not right away.

Rob

PS) To answer some questions: I'm being treated at Mass General Hospital (MGH) in Boston. I think MGH is among the top-four treatment centers for head & neck cancer in the USA; the other three being Dana-Farber (Boston), MD Anderson (Houston), and Johns Hopkins (Baltimore). I have a colleague who got ND at Johns Hopkins many years ago and he felt his surgeon there was top-notch; there is no reason to restrict myself to Boston-area surgeons for a 4 hour operation (plus a couple days inpatient stay) so I may consider traveling for this.

Charm: Who was your ENT and which issue of the Washingtonian has that "top doctor" report?