How and why do doctor choose to perform radical neck disection?

Neck Dissections (ND) are preformed to remove any lymph nodes downstream from a primary cancer. The lymph system acts as a natural seize that captures cancers cells that break free of the primary cancer site. Generally they are only done on the side of the neck that the primary cancer was found.
I had a stage one cancer of the soft palet and was borderline for a ND. Both my ENT and RO felt I would not need the ND due to how early the cancer was found. I did radiation only to the primary site with extra doses of radiation to the lymph nodes just in case an errant cell made it that far.
I wish I had insisted on the ND as I did suffer a recurrence of cancer in a lymph node deep in my neck. The cancerous node grew right around the carotid artery before we discovered it. At that point I was no longer eligible for a surgical solution as removing the cancer would involve removing the carotid and instant death.
Obviously I am one who will always advocate for the ND being done although I have no experience with either the procedure or the after effects.
There are many here who can help you with ND�s and there effects. I have heard of a number of people right here on this site who had the ND and multiple nodes removed with no sign that the cancer had spread. But you have to keep in mind it only takes one cancer cell in one node to make recurrence a reality. If I had had one I would be in much better shape today.

Hi Hockeydad

are you asking about neck dissections in general or radical ones in particular?

I had ND but not radical. You can see what type of cancer I had in my signature line.

Kelly is right on what he told you. My surgeon told me no cancer in the lymph nodes, BUT he suggested a ND because cancer cells are so small a CT or PET wouldn't pick them up until the size of a nickel. It was my decision I went with what he suggested.

My incision is in a crease (wrinkle) in my neck from the bottom of my ear to the middle of my throat, it can't be seen. When I tell people I had a ND they ask where, can't see it.

I'm glad I had it done.

As far as radical I don't know anything about it.

Take care,
Connie

Hi there ditto to what everyone said. I had a neck dissection, and am glad I did. My dr. Told me up front even if I didn't have cancer in my nodes, he was taking 40 regardless, and he did. Thankfully it was planned becaus between biopsy and surgery one did pop up. If I could have I would have asked for one on both sides.

Thanks for the info. I meet with my team late next week. I am just gathering information. Radical should not have been in the description, just neck dissection.

I am not sure what they are going to recommend. I have two concerns what are the negative effects of no lymph nodes in neck? And what happens to the shedded cells of the primary if no lymph nodes are there to deal with them?

Very confused. Still learning.

Hockeydad,

I was told my doc #3, an ENT, that I needed a radical and rad and chemo and he gave me a 60% of surviving 5 years; Doc #4 said only partial ND and chemo and rad and he gave me a 70%; next seen was Moffitt, a CCC, whose TEAM said NO SURGERY NECESSARY but recommended chemo and rad and they gave me a 90% 5 year survival chance. I chose the EXPERTS and I had no surgery and I'm still kicking.

My advice is to not let anyone cut on you without multiple agreeing opinions.

Very good question I think. I think they inserted a zipper in my neck or should have. It's been opened and checked 4 times since the 1st one. Now if they could pass on some tips for an easier way to shave the neck. Feels like a canal where they cut so much.

David, you will still be kicking and giving advice when you are 101. You do good work for us.

Hockeydad

Radical is one type of ND. The main OCF website spells out the various types of neck dissections.
OCF types of ND
It's short so print it out and take it with you to the doctors. It is a big deal what type you get, similar to breast mastectomies. At a minimum you want the surgeons to avoid cutting the shoulder and neck muscles, they can be moved albeit with trauma.

My CCC, Georgetown has a very nice explanation on its web page including more specifics on "how" and "why". It is an indepth answer to your post so I won't repeat it.
As DavidCPA implied, there are major downsides to losing the lymphatic system's defenses that need to be balanced against the risks as Kelly noted.
GT: Neck Dissection
Even though it's longer, I'd still print this one out also just to reread.
Keep the Faith
Charm