Hi everybody. I completed my rads/chemo for tonsilar SCC about four months ago. In many ways I'm doing quite well, can eat more foods, "water blisters" in mouth reacting to acidic foods has greatly reduced, taste has returned, beard has mostly returned.

Mouth is still very dry, and I sleep very poorly still, which may be due to stress.

I recently had my 3-month follow-up (CT-scan, physical exam) and the result was mixed. Mouth looks good, but residual swelling in neck (1.8 cm down from 4 cm) has my RO concerned and I'll get a neck biopsy collected this Friday.

Here's my question. My RO implied that the neck biopsy should be able to distinguish between mere scar tissue, "non-viable" cancer (i.e. dying cancer), and "viable" cancer. If "viable" that would lead to a recommendation for neck surgery to remove the lymph glands.

Via a friend who's about 3-months ahead of me in this process, his RO has stated that my biopsy *will* be positive for cancer, and without having had much more frequent assessments to track trending (shrinking/growing) it will be difficult to determine from the biopsy if the cancer is still viable.

The notion that my RO may recommend sugery when another might not has be concerned.

Any thoughts or experience? Sorry this is rather rambling.

Thank you.

How in the world could any doctor who has not treated you or seen your records even attempt to say the biopsy will be cancerous? A biopsy is the only way to tell if it is cancer or not. Please dont pay any attention to info a doctor gave to your friend. Im surprised a doctor would even comment on something like this without seeing you first.

Different doctors recommend different options. Thats why second opinions are so important. It is very important that you would be seen at a cancer center where they are familiar with head and neck cancers. Better to be seen by a doctor who sees hundreds of cases per year vs one who sees a case or two per year.

Hope it turns out to be swelling from your treatments. It does take time for it to go down. Do you know exactly what is being biopsied? Best of luck with everything.

Hi Christine,

Good points. I need to clarify. My friend's doctor is in fact a specialist in the field of head and neck cancer in San Francisco, California, and based her comments after viewing my latest CT-scan. But you are correct in that this doctor has never seen me in person. And of course there is a very real possibility for miscommunication from my friend. Point taken.

The biopsy will be an ultra-sound-guided needle biopsy of the swelling in my neck, presumed to be my lymph node (presuming the ultra-sound "sees" a target).

Is there a chance that you could see the specialist for a second opinion? Then they could see your full set of records and make their recommendation? Hopefully it will turn out to be nothing more than scar tissue. So often that happens after having all these awful treatments. Please get it checked and let us know that you are ok.

If surgery is the recommendation then get another before you decide. Just make sure you fully understand the whys and the why nots.

Thanks for the thoughts and advice. I had the biopsy collected today. It turned out to be by fine-needle, which is nicer than the core needle (I'm assuming). They gave me a numbing (called freezing here in Canada, eh?!) shot which was very effective and I hardly felt the rest of the procedure, which involved inserting five different needles in sequence through the same spot on my neck but targeting five different areas in my neck, then wiggling the needle around while extracting cells from each location. I was told it shouldn't be painful as the freezing wears off, but I might end up with a bruise. So far so good.

Unfortunately I won't learn the results for most of a week, until next Thursday (it's a long weekend here), so now we're left hanging fire, waiting for the other shoe to drop, and just generally mixing metaphors to pass the time.

Good luck.