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Stily1 Offline OP
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Hi, I'm 5 months post radiation/chemo treatment for right tonsillar carcinoma with metastasis to my right neck lymph nodes. I have not had any surgery at this point.

At my first follow up, at about 4.5 months, I was told that I have residual swelling in my neck, and a needle biopsy was inconclusive but suspicious for residual cancer in my lymph nodes in my neck, and I've been referred for partial neck dissection to remove any involved lymph nodes.

Is there anyone on here who is willing to share their experience with similar surgery? Side effects? Recovery time? Relative to radiation/chemo treatment (as bad, nothing like it?).

In my case I've already had the radiation, so my surgery cannot be followed up with additional radiation.

Thank you,

-Seth


47 yr old male non-smoker, social drinker, fit. Jan'10, Stg3 rt tonsil+rt neck SCC, HPV+, rad+chmo Vancouver Cda. 2yr clear Apr'12 London UK. Apr'13 mets recur to lymph btw left lung & aorta, 3x Cisplatin+5FUchemo+20 rad, was all clear but 6-mo PET-CT shows mets to pleura around left lung, participating in St 1 trial of GDC-0980. GDC lost effect and ended July'14, bad atrial fibrillation requiring hospitalisation, start more standard chemo 10 Sep 2014.
Sadly has passed away, notified Jan 2015.
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Hi Seth. I can only share with you my aunt's experience. The neck dissection (one side only) was not nearly as bad as the after effects of radiation. She came through the surgery very well at age 63 and her only complaints today are related to her speech from the tongue flap (I think she sounds completely normal) and from the radiation. Her only issue related to the neck dissection is a bit of stiffness in the neck.

D


Aunt diag. 2/4/10 with SCC Stage I/II on left side of tongue. Surgery 2/19/10 part. gloss./neck diss. on left side/free flap from chest muscle. TI/II,NO,MO. Clear margins with perineural invasion. Started rads 4/8/10 - 35 treatments, finished 5/26/10.
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Stily1 Offline OP
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Thank you very much. I've just now spoken with my surgeon's office manager and she told me that typical post-surgery pain management is via nothing more than Tylenol 3, which suggests that the surgery is way more manageable than the radiation was. I ended up on, probably too much, Fentanyl (an alternative to morphine) during and following my radiation treatments. I may have reacted badly to that opioid, and the addictive issues are significant.

Thanks again.

-Seth


47 yr old male non-smoker, social drinker, fit. Jan'10, Stg3 rt tonsil+rt neck SCC, HPV+, rad+chmo Vancouver Cda. 2yr clear Apr'12 London UK. Apr'13 mets recur to lymph btw left lung & aorta, 3x Cisplatin+5FUchemo+20 rad, was all clear but 6-mo PET-CT shows mets to pleura around left lung, participating in St 1 trial of GDC-0980. GDC lost effect and ended July'14, bad atrial fibrillation requiring hospitalisation, start more standard chemo 10 Sep 2014.
Sadly has passed away, notified Jan 2015.
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Seth,
I have had two neck dissections, two different surgeons, 4 years apart. In comparison to radiation, this surgery is a walk in the park, although it is still a long surgery. I was in the hospital for 5 days, and had no pain but looked like hell. However, the side effects can be bad depending on what muscles, nerves get cut. Make certain that the surgeon doing this has done so many 'that he can do them in his sleep'. You will most likely need several months of PT following the surgery to get you arm to work properly.

Ask your surgeon what muscles, nerves he will need to cut, if any, and what type of temporary and permanent side effects you will have. Do NOT let them remove your submandible saliva gland unless absolutely necessary. I have no permanent side effects from my second neck dissection, but still cannot get my arm over my head from my first. I also had a neuroma that took about 5 years to resolve which left my ear and neck numb on the right. I still cannot look over shoulder to the right so parallel parking is a problem. It is also possible that the dental surgeon caused my head rotation problem when he extracted my rear teeth. I don't remember complaining about that until after the dental surgery.

So it boils down to which sections is he going to remove and does he need to cut any muscles or nerves that are going to effect your ability to move your arms? That are many variations on neck dissections so find out which one you will have. Keep us posted.

Take care,
Eileen


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
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Seth, agree with everyone that neck dissection recovery is nothing compared with radiation. But there are definitely nerve-related side efx that come into play, and Eileen has sage advice for you. In my case I've been left with the left side of my tongue nearly completely numb. After more than 19 months post-op I have a feeling it's permanent. And neck stiffness too, but that's manageable.

Keep us posted, and courage!
David 2


David 2
SCC of occult origin 1/09 (age 55)| Stage III TXN1M0 | HPV 16+, non-smoker, moderate drinker | Modified radical neck dissection 3/09 | 31 days IMRT finished 6/09 | Hit 15 years all clear in 6/24 | Radiation Fibrosis Syndrome kicked in a few years after treatment and has been progressing since | Prostate cancer diagnosis 10/18
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Good advice from all Seth. I think the Drs aren't really sure what will be cut until they make the 1st one and check things out. Good luck and prayers to you.


Since posting this. UPMC, Pittsburgh, Oct 2011 until Jan. I averaged about 2 to 3 surgeries a week there. w Can't have jaw made as bone is deteroriating steaily that is left in jaw. Mersa is to blame. Feeding tube . Had trach for 4mos. Got it out April.
--- Passed away 5/14/14, will be greatly missed by everyone here
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Stily1 Offline OP
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Thanks everybody. I had my pre-operation assessment this morning and it went fine, no big surprises. It was confirmed that the final extent of the partial neck dissection will be determined once they've zipped my open. I was told this will be a bit more tricky since I've already had my radiation and there is likely to be some scar tissue. Hopefully they don't have to do any significant nerve damage and they can get it all out (if there's any to be gotten out).

I'll have this surgery on Monday, 11 October (4 days from now). They say I'll be in the hospital for 1 to 3 nights, depending.

-Seth


47 yr old male non-smoker, social drinker, fit. Jan'10, Stg3 rt tonsil+rt neck SCC, HPV+, rad+chmo Vancouver Cda. 2yr clear Apr'12 London UK. Apr'13 mets recur to lymph btw left lung & aorta, 3x Cisplatin+5FUchemo+20 rad, was all clear but 6-mo PET-CT shows mets to pleura around left lung, participating in St 1 trial of GDC-0980. GDC lost effect and ended July'14, bad atrial fibrillation requiring hospitalisation, start more standard chemo 10 Sep 2014.
Sadly has passed away, notified Jan 2015.
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And you'll have several thousand of us in there with you in spirit, Seth. So don't crowd the bed, ok?

D2


David 2
SCC of occult origin 1/09 (age 55)| Stage III TXN1M0 | HPV 16+, non-smoker, moderate drinker | Modified radical neck dissection 3/09 | 31 days IMRT finished 6/09 | Hit 15 years all clear in 6/24 | Radiation Fibrosis Syndrome kicked in a few years after treatment and has been progressing since | Prostate cancer diagnosis 10/18
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18 months on from my surgery i still have odema under jawline , more pronounced on left hand side and the leathery tight feel. for 12 months i had pains in my uppper right arm and initially told it was permanent nerve damage and i couldnt move it very freely at all without intense belts of pain , then my surgeon referred me to a pshyio and 3 weeks after doing daily routine exercises its back to about 85 % . havent dont any for a couple of months and its just starting to hurt slightly so will have to get it back into my daily routines again. have nerve damage to lower lip on my left side and may need a minor corrective surgery but dr & i agreed to wait to see what its like when odema fully subsided.


45 yrs. peg tube jan 07/09 TOTAL GLOSSECTOMY jan 12/09
T3NOscc oral(ex smoker )
open tracheostomy , removed oct 12/09
modified neck dissection lymph nodes I to IV
rectus abdominal flap + full dental removal
30 day radiation treatment ,diagnosed with lung cancer oct 2011
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hmm I had no idea about the potential nerve damage - how common is this? I'm trying to prepare myself for a possible neck dissection (will find out tomorrow if I need one or not).


Monica,33 Mum of 3. Former smoker
SCC right lateral tongue. Intially thought to be cell dysplasia and dx as SCC after surgical excision.
Nov 2010- partial glossectomy (1cm in width), partial neck dissection. Margins clear, nothing found in nodes- YAY! Benign tumor on saliva gland.
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