There are approximately 300 lymph nodes, mostly microscopic, in the neck, and everyone has a different amount, and location of them, so they may never get them all. For oral cancer, it's usually levels l-lll or with lV, that are removed in a modified radical neck dissection, MRND, so there are four other levels, but they remove where the metastases will likely go in the lymph chain for oral, tongue cancer. There are other types of neck dissection that are similar with more or less like a radical neck dissection, RND, selective neck dissection, SND.

Going into treatment with prior or existing mouth conditions, may effect you more than usual, so prepare for that. I'm sure the doctors will explain all the oral care that is imperative, as some were mentioned here.

As far as teeth, any that are defective, have to be removed before radiation, and will need at least 10 days healing before the start of your treatment. Ask about fluoride trays, fluoride rinses to help protect your teeth, as well as mouth guards to protect your oral cavity from radiation scatter if you have any metal dental filling. After radiation, if any teeth need extraction you will have to do 30 HBOT treatments, 20before, 10 after extraction, to help prevent OJN.

I wonder why no chemo, being its advanced cancer, stage lll or IV, but is debatable with some doctors, and may depend on the patients condition. I had radiation alone for that reason. Chemo acts as a radiosensitizer to make radiation work better, anywhere from 2-20 percent or more, depending on the chemo or targeted drug, and may get at any loco-regional or distant microscopic, although. there are more toxicities with concurrent chemo radiation, than radiation alone, so that could be one reason, and or after surgery, neck dissection you were restaged, and feel it's not necessary having bern down graded with TNM.

As far as recurrences, no one knows, but the surgeries look like it was all removed. For now, I would concentrate, and put all your energies on the current treatment, and your recovery. It's hard to be in two places at once thinking about recurrences.

A post treatment scan is usually done after 3-6 months, no later than a year. After that, there is no standard for scanning, other than for an indication of cancer, and depends on the doctor or hospital. You will follow-up with your ENT 1-3 months the first year, up until 5 years, with each year spaced further apart, who will do a visual, palpable and flex scope exam.

Good luck with everything.