In general, painless nodes are a bad sign. Cervical metastasis of oral cancers are a not good, and if you have fixated hard, painless nodes in your neck, I believe that you should ask him to FNB those nodes while you are right there in the office. One of the real dangers of oral cancers in general is that in its early stages it is mostly painless. I was a stage four patient when diagnosed, and I had no oral discomfort though I had a lesion on my right tonsil as big as a nickel. I went to the ENT after a node on my neck became enlarged and was painless and hard. If you have an infection draining into the cervical nodes from a tooth abscess, or an ear infection, those nodes hurt like hell. I could flick mine with my finger and didn't feel a thing. I wish that more doctors would realize that when a patient presents with painless swollen nodes the WRONG thing to do is get out the Rx pad and write a prescription for antibiotics. THE FIRST DIFFERENTIAL DIAGNOSIS FOR AN ENLARGED PAINLESS NECK NODE IS ORAL CANCER. That is what they should be eliminating from their list of possibilities FIRST. Too many people's diagnosis have been unnecessarily delayed while they gave patients antibiotics for a perceived, undetermined source infection. Infections produce painful nodes. Too many doctors who do not do a good job of differential diagnosis, do the lazy easy thing, Write an Rx for antibiotics when they are not even sure what is going on.