Hello everyone. My husband is a little more than halfway through his 35 radiation treatments and second chemo out of three tomorrow. He is really responding well to all of this. Yesterday the doc mentioned for the first time that on some patients they will do a lymph node dissection if they think there are any cells there. Of course we would not know until PET scan some time after treatment. What does the procedure entail?

I think what the doctor is talking about is what we term a neck dissection. The doc goes in and thru the neck and removes some lymph nodes to check for cancer. Ive had it done when I went thru my 3rd round of OC. It was done as a part of the mandibulectomy (removed my lower jaw). Luckily I had no nodes come back positive.

It's not a bad surgery as surgeries go. Mostly it's numbness and stiffness, that is the main problem after treatment. It's very recoverable, and not terribly painful as I found. Everyone is different though. Best of luck

They can also do a FNA, fine needle aspiration, where they just stick a needle into the suspected node and withdraw cells and look at those. That's how many of us with no symptoms, other than a swollen neck, are confirmed with cancer.

Interesting because the FNA did not show any cancer and it was only when they did a CAT SCAN before they went in to get bigger tissue on the lymph node did they find the SCC. They were talking about the dissection rather than the FNA. I hope that either way there is NO CANCER after all this treatment.

That is a weakness of an FNA because unless you suck up cancer cells you won't find them. When they preform the ND, neck dissection, they can just take one (of I believe 28 in the chain) and test that while he's under to see if they need to take more (Partial ND) or they can take them all and a lot more, close him up and test them all (Radical ND).

Ellen,

I had a ND it wasn't bad. The way my surgeon explained it to me; I can either have one or not, but he suggested one because the cancer cells are so small that the CT/Scan wouldn't pick them up until the size of a nickel. I had it done to be on the safe side. I was cut from below the ear to the middle of my neck, he cut in a crease it doesn't show I do have creases because of my age:) I'm glad I had it done I'd rather be safe than sorry. No disfigurement and I have to go looking for the incision.

Take care,
Connie

Ellen, if you look at the NCCN Treatment Guildlines (available on the OCF main site) you can find the decision tree they recommend for your husband's cancer. This will be subject to your team's recommendations; I remember reading somewhere that if the RO was not happy, that was a strong case for a neck dissection. From what my husband's ENT mentioned, there are other protocols besides the NCCN, but that's a good place to start.

Thank you for the information. If the docs recommend the procedure then he is all for it. We would rather be safe than sorry since there was not a diagnosis for awhile and that really made him feel very cautious. We had a yes, no, yes, no problem for a few months and do not want that emotional roller coaster after all of this treatment and effort. So we will go with the idea of being as "certain" as we can.

EllenB

Maybe cause my age they wanted to go with everything they could give me so I went thru with the neck dissection (modified) they removed 10 nodes 1 of which was positive then I went thru the radiation. In my case I would take that surgery 10 times over the radiation. I had everything removed with clear margins and took the radiation as a precautionary measure however I passed on the chemo. I am 2.5 years past my surgery and the numbness and stiffness is still there, I just dont know if a lot of that is from the surgery or the radiation however it is manageable and not that big of a deal. Hope this helps

Still causing trouble out there Jim?

Man almost 2 1/2 years post Tx, how time flies!

Thank you stubborn ass Italian. My husband always tells the doctors that he is from the Bronx and so will ki k the sh-t out of this cancer. I hope he is right. I appreciate your thoughts

Thank you stubborn ass Italian. My husband always tells the doctors that he is from the Bronx and so will ki k the sh-t out of this cancer. I hope he is right. I appreciate your thoughts

Hi Ellen, martin had a modified radical neck dissection where they took a few nodes but left the muscle. There was only one positive node. The scar goes from the back of the ear down the neck and accross to the middle of the neck. After the operation Martin was fine.He was numb but had fairly good movement and no pain. But movement worsened after radiation as did the pain, as it scarred the muscle tissue we are told. Martin has learnt to manage the pain with medication. But not everyone is in pain after a ND. I think it depends a lot on the treatment with it, the aftercare you get (physio) and of course everyone is different. Good luck.

Thanks Cecilia. We are not sure at this point whether he will definitely need the ND so I am just getting as much information as I can.

I had my neck dissection 3 weeks ago today,in addition to surgery on my tongue tumour.I got the impression from my surgeon that a ND was standard practice concerning tumours such as mine under the tongue (mine was stage 2).
I had the CT and MRI scans and nothing untoward showed up on them.However, I had zones 1 to 4 removed during my dissection and 3 of the 30 nodes removed were found to be cancerous,one having burst throught the capsule.
The incision is large and slightly shocking when you first see it - but that 'shock' soon passes and my scar is now healing very well.It's a little tight in terms of movement but my Physio/excercise should alleviate that.I didn't endure much pain at all - so if an ND is needed,it's certainly manageable if that's any consolation.I had 2 drains in my neck for about 5/6 days and they do restrict your movement - removal of one of these made me wince a little,but that was momentary and as my wife says I'm probably getting a bit soft as the years pass.
I've got my 6 week stint of radiotherapy and chemotherapy starting in about a month, so my treatment seems to be the other way around.Doctors eh?

Good luck - I hope it all works out for you both.

Thanks Brendan. I wonder why ours might be in reverse. Good luck with treatment. It is good to know that some of the cancer hAs been removed.

Hope he doesn't need the neck dissection, but if he does, it's do-able.

I had my modified radical neck dissection nine months after chemo radiation ended. Like the others have said, it looks much more painful than it is. Docs did tell me that it would be "harder" because I already had radiation scarring in the area, and I found the pain involved to be very low level. For me, there are some long lasting side effects (firmness, numb spots, extra sensitive spots, altered range of motion for my right arm/shoulder and neck, etc.) Sounds very bad, but it's very manageable. I think with therapy, I might be able to elimate the limited motion issues. Most folks I think are out of the hosptial in three days. I really don't recall pain nearly as much as being irritated at not being able to roll over in bed until the drains came out (three or four days). Oh - and ask about using mouth spray - I was not permitted anything by mouth for the entire first day (surgery and recovery) - even that didn't phase me much (unconscious/groggy).

I had it all, tongue surgeries, modified radical neck dissection, chemo rad's....By far the easiest for me was the neck dissection. They took out 76 lymph nodes (don't have much left there) one was positive in first go round. There was little pain for me because of the nerves there. I do have numbness still in my upper arm and across my chest to midline and my face swells up periodically when I sleep on that side due to the lack of lymph nodes.

Ellen

From your other posts, I thought the neck dissection happened last month. didn't see any bad posts, so hope it all went well.
One aspect of OCF is that relatively new posters resurrect old posts in an attempt to be helpful. Still, it's the thought that counts. I just answered your current post
Keep the Faith
Charm

hi,
Actually we did not have any neck dissection. The doctor mentioned that some people need one if there is anything left in the lymph node. They were going to check after his treatments. So we do not know if he will need it. I was just asking to see how it went or what it involved. We will see if it is something that he needs.

Thanks all,
EllenB