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