I'm glad to hear your due diligence in getting not just a 2nd, but 3rd opinions! To me, the more the merrier, but you'll find you can get different answers from as you found out.

I read through some of your posts, and would be nice to have copies of your surgical reports, biopsy pathology, etc. but you can always get them. I find it can save time, and sometimes money having your own copies, and often show them to all my doctors, plus you know what it says such as tumor margins, depth of Invasion, diameter, tumor grade etc. and can better advocate for yourself.

I wonder why the ENT wanted to do re-surgery on the tongue if the original surgeon got everything, including clear margins? There might be some negative features he or she wants to get?

Elective neck dissection for the oral cavity and tongue in early stage vs watch and wait has been controversial, but I've seen reports where it increase rate of survival by approx 12% and reduce chance of recurrence by 55%, and is being recommended for the new treatment of care. I always recall for head and neck cancer that the key to survival is controlling the nodes.

As far as the neck dissection, there are several types such as the selective, modified radical and radical. I've had five of them, three that were radical, and some of them were the easiest part of treatment I had. I had no mobility issues until my 5th radiation treatment, that's not the 5th day. There is usually more mobility issues from a radical neck dissection, which is used less often these days, whereby the neck muscle is removed. The other surgeries preserve it. As with any, rehabilitation and stretching helps.

I understand you're going to see an oncologist next week, which is good, but chemo is usually not given on its own. It can to reduce tumor burden to sensitize for radiation such as induction chemo, in conjunction with radiation. Maybe your oncologist will be more knowledgeable about the neutrophil to lymphocyte ratio, NLR, in early stage tongue cancer pre-treatment, surgery, and above 2.95 may reveal an invasive tumor, positive lymph nodes, PNI, indicating need for aggressive treatment such as an elective neck dissection.

I hope this helps


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs