I have only just found this site and am quite the newbie, but I am having angst over a radical neck dissection scheduled for the 5th.

I have poorly differentiated squamous cell carcinomo (PDSCC) with an unknown primary. I have a lymph node that is 3cm in size that was biopsied and came back positive for the PDSCC. I have had my tonsils removed and tongue and throat biopsies, but they came back negative, hence the lack of a primary source.

I am an HMO member and the "tumor board" had me meet with a surgical oncologists who informed me that a radical neck dissection is in order. Since then, he has had to opt out of the surgery and I am to meet with an ENT surgeon in the morning (who removed the tonsils and did the biopsies).

I understand the reasoning behind removing the lymph nodes, but there had been discussion that they may be able to save the nerve that would involve my ability to use my right arm. However, they plan to remove the muscle tissue. They also plan to follow up with radiation. I don't understand why they can save some areas of the neck and not the muscle. The only answer I have received is it is their protocal to insure they get all of the cancer even if it isn't present in the muscle. I am tempted to insist they do a modified neck dissection and remove only what they know to be cancerous. They can take all of the lymph nodes on the right side of my neck, but leave the nerves. veins, and muscle tissue alone and follow up with radiation. But, I wonder if they will adhere to my wishes and if I am making a huge mistake.

Thanks for listening.