The issue of "dissect or not to dissect" seems clearly to be one of hot debate nationally and the ambigious zone is vast depending on who you speak to in the surgical versus radiation oncology field.

My fiance, Dave, found out he had SCC of the right tonsil with one lymph node involved in August. We made it our mission to interview and obtain opinions from the following people before deciding how to proceed:

3 ENT/head & neck surgeons (One of whom was also a plastic surgeon and one who does research on head & neck ca)
1 radiation oncologist
1 hematologist/oncologist

We tossed, turned,swore,agonized, and compared their views to the point where we even brought up controversial information with each of them just to get the response. If you have seen any of our other posts, you have noticed that Dave and I have decided that we look like bright enough people to sift through and get to the point where choices become ours and we agree that our comfort level is paramount in the process.Sometimes, this involved ruffling a few feathers but we are "politely irreverent" to the point where the medical staff now sees us as inseparable team and that's just the way we like things.

We discovered great disparity among the opinions but ended up choosing to go with the removal of tumor & tonsil, lymph node dissection on the affected side, flap graft from arm to palate(thsi also involved a donor site on Dave's leg), followed by a full course of bilateral radiation.The surgery lasted 14 hours due to the graft but Dave did come through it beautifully and was a healthy 48 year old going in which is key.

The surgery was a piece of cake compared to radiation even with a trach for about 10 days.

We also explored the chemo-radiation only option but deferred entering a study at a world famous hospital here in Boston because we needed the comfort of a tried and true method.We also learned that some folkd in the field were a bit more interested in statistical numbers than people and it is vital to inquire about your practitioners' philosophies about cure.

We were also lucky to have a surgeon who is a national expert in head and neck surgery and this is KEY and you should check that out bigtime because technique of dissection and cosmetic result, although not nearly in the same category as cure, is important.

If you want to hear more about the process of recovering from neck dissection feel free to fire away your questions and we'll do the best we can to give info.

Best,

Kim & Dave