We left the surgeon today still uncertain about the path they want us to follow. She was not reassured by her clinical examination of the node. She recommended we not wait for the 12 week post treatment PET but instead have a 5 week post treatment ultrasound guided FNA biopsy and CT scan, then make a decision about surgery. She indicated the surgery would be 3 hours if uncomplicated and 7+ hours if complicated. She stated it has the potential for considerable morbidity, not mortality :), and should not be taken lightly. We have read conflicting information about the reliability of these studies, or any other, to accurately predict which HPV SCC patients actually benefit from neck dissections. We are just so confused about what to do. Has anyone made the decision to proceed with neck dissection based on these studies? The RO and MO estimated that the original 4cm node had decreased to 2cm. The surgeon estimates it is actually 5cm but agreed that any manual measurements at this point are potentially inaccurate and only imaging studies will tell her for sure. It takes 7-10 days to get results from the studies.

We would like to get a second opinion before agreeing to surgery but she says if surgery is warranted it is time sensitive as the node may attach to other structures if we delay and become difficult or impossible to remove. This makes us concerned we will not feel we have time to arrange a second opinion with a qualified surgeon by the time we get the results. Today, we are planning to go ahead with the two studies but still feel uncertain about the surgery decision. I know some people have breezed through the dissection with no or little longterm effects but others have not been so lucky. If we knew he had active disease we would obviously do it no matter what. It is not being sure he needs it, that makes it so hard.