Hi,

Apologies in advance for the length of this post. It is such a relief to finally find a site such as this, with people who can actually identify first hand with what I am going through. I can't believe that I'm actually sitting here with tears streaming down my face as I write! In many ways though, I feel almost like an imposter here, as my problems seem dwarfed by those of so many of you here.

In May, I went to an ENT specialist regarding a lump under my chin. I had had it for about a year, treated initially with antibiotics, to no avail. The reason I went back was that I thought it was beginning to grow.

He thought it might have been a thyroglossal duct cyst. FNA came back suspecting a neoplasm, which surprised him. He did a Sistrunk procedure in June, removing the mass along with adjacent lymph glands.

The mass (3.5 cm)was diagnosed as an undifferentiated carcinoma. The capsule apparently ruptured during removal at it's point of adherence. The adjacent lymph nodes were fine.

I did some research on the net and found only one case in recorded literature of an undifferentiated carcinoma of the thyroglossal duct cyst. Prognosis for this type of carcinoma was not good (6 months). Needless to say I was pretty devastated.

Spoke further with my doctor and he was pretty good at calming me down. Said he thought that the most likely scenario was a metastatic carcinoma from occult primary.

He suggested a PET scan to try to find the primary (the MRI came back negative). Spoke also with my GP who suggested defering the PET scan and seeking a second opinion in Toronto (I live in Barbados but most of my family live in Canada).

In August I saw a great cancer specialist in Toronto who was pretty sure that the mass was a lymph node carcinoma from an unknown primary. He did a very thorough examination of the oral cavity and found nothing. His pathology department reviewed the slides etc and diagnosed it to be a left submandibular lymph node with a poorly differentiated non-keratinising squamous cell carcinoma.

The specialist in Toronto (as well as my ENT in Barbados) has suggested radiation. I have had a CT scan (though not a PET) and am scheduled for a panendoscopy in a week. After that I guess the radiation therapy will start.

Barbados has facilities to do the radiation, but I am sure they would not be as up to date as Toronto. I guess I need some advice on where I should choose to have it done, as some of my friends (with no direct first hand knowlege of exactly what is entailed) have suggested I have it done in Toronto if I am able.

With all the side effects from the radiation, could it really make a difference where I have it done?

Thanks in advance for any insights you can offer.