Hi, Hockeydad
If your tumor turns out to be HPV positive, I would look at this analysis of long-term survival - it is posted on the OCF Site here: JCO Article

If they are suggesting a neck dissection as a way of reducing the radiation dose, that's one thing. If they are suggesting a ND instead of radiation (and this is an NCCN approved treatment for T1-2, N0-1 staging), the following statement in the article is one you might want to discuss with them:

[quote]Indeed, we observed better survival among HPV-positive patients who were treated by radiation compared with those who were not, consistent with enhanced sensitivity of HPV-positive OPSCCs to chemoradiotherapy.[/quote]

None of these decisions are easy; that's why it is so important to have the very best doctors available.

Maria

Hi HockeyDad

I will just add that the nodes are broken into 6 geographical regions which are labelled I-VI (although VI is more associated with thyroid issues). SCC is predictable in where it is likely to go dependent on where your primary tumour is so in more recent years surgeons do "selective" or "modified" dissections as opposed to "radical" dissections. Radical is all of the zones except VI.

You have nodal involvement so they have the choice to "nuke" it or remove it surgically and to be safe they will nuke or remove the zone or zones associated with your primary tumour.

Your choice then, is to nuke or operate and only you and your doctors can realistically make that choice with all the information in front of you.

Ask about side effects. Ask about likelihood of lymphoedema and how severe it is likely to be (the more nodes they take the less places the detritus will have to go = more oedema), ask about what structures and nerves would be in the field and what would happen if they were damaged, and would the doctor expect them to recover. Ask the doctor how strongly they feel about one treatment over another and if it were their brother what would they recommend to him? If they recommend one treatment over another, ask them why they think that?