Hi Kirk,

I think you have everyone confused(or maybe I'm confused) . I believe what you are calling nodes are actually areas of the neck( I don't rememebr the technical term), each contining many nodes. For a neck dissection, the neck is divided in 5 areas. I have had two neck dissections 4 years apart. The first for an unknown primary, with mets to one lypmh node in area III, the took all the nodes from area 1-4. The second one for cancer of rhe larynx with no mets to the neck, they did areas 2-5. Area I contains your submandibile saliva glands, Try to keep those if you can. Let them take the nodes, but try the keep the glands. Area V as you stated if the one that can cause shoulder damage. I have none. My 2-5 side has no problems. My 1-4 side is stiff, can't rotate head as well, right arm does not go all the way up.

Two different surgeons did these surgeries plus I had dental surgery right after the 1-4 neck dissection which I think may have had an adverse effect on my first neck dissection. Both surgeons extremely competent, but the second does this stuff in his sleep(major cancer center) and the first only occasionally. I'd fight for my salivia glands unless he thinks that is unwise. I'd also make certain that this surgeon does this stuff all the time. I told my second one - 'I don't do scars, stitches not clamps', and he did a beautiful job. I didn't even need any PT after that one.

I'm surprised they are giving you a choice. Are you at a major center? Are you going to also have radiation? I think they also can do a modified area V that does not involve the shoulder muscle. I think that is what I had.

Good luck,

Eileen