Good morning. I am new to this board. I will introduce myself here since I have questions for all of you.

I am a 33 year old female. This summer I was diagnose with Squamous cell carcinoma on my face. I had it removed. In the meantime I had a few lymph nodes in my neck become enlarged. Nothing huge, just palpable. I went to an oncologist just to be on the safe side. (my husband is a 4 year testicular cancer survivor due to early detection, so we thought why not. Let's get it checked out). The oncologist ordered a pet scan and a ct scan. The pet scan was clear and the ct showed a few enlarged cervical lymph nodes. The doctor wanted to follow up in 4 months with repeat scans.

I had my second round of scans last week. The pet scan lit up on my right tonsil. The doctor said this could be due to inflammation but the radiologist said it needed clinical follow up. The lymph nodes were still visible on ct but remain unchanged. The doctor scheduled me with an ent. I had that appointment on Monday.

The ent said my tonsils appear normal by the naked eye. They right is larger than the left. He said we could watch it very closely with continued pet scans or we could take the tonsils out. He said the only way to know for sure is to remove them and if he were the patient and a pet scan lit up he would get them removed. He said his level of concern is low but there has been an epidemic in the last few years of oral cancer in my age group.

So here are my questions... I feel so conflicted. Is it really anything to worry about? Are my tonsils just swollen for some reason? I don't have chronic throat problems of any sort. Everyone I have spoken with has me terrified of this tonsillectomy. I feel it's the thing to do but hate to go through it all for just an enlarged tonsil. Has anyone been diagnosed with a similar story? Thank you for your time and I appreciate all of your input! I just need peace of mind and I think they only way I'll get it is with a tonsillectomy.

The only symptoms I've had other than the ones mentioned above are EXTREME fatigue and night sweats 2-3 times a week. Not sure it is related but thought it would be worth mentioning.

Welcome Wildcat. It could be anything. Did they suggest a fine needle aspirational biopsy, FNAB, under ultrasound guidance, for the enlarged lymph node? This is a non invasive, easy, accurate procedure done in 10-15 minutes in an office, hospital, usually by a pathologist, which can detect cancer and other histology, HPV.

Good luck

Thank you for your reply They have never mentioned a biopsy. The nodes are small but you can definitely feel them. I would say 3 are pea sized and one maybe the width of my fingertip. Originally the oncologist said he would order a biopsy if they grew. I guess since they aren't growing they aren't big enough to biopsy? They did however, start out rubbery and moveable and are now hard and fixed. the doctors don't seems overly concerned which is a good signs I suppose but does not help my worrying! Are they not concerned because its nothing to be concerned about or are they possibly missing something?

If they are going to do a tonsillectomy, which will be biopsied, and is invasive, there must be some concern, otherwise, why do an unnecessary surgery, which can have complications in adults. The FNAB is an alternative to the direct biopsy, and tonsil cancer, especially HPV, metastases quickly to lymph nodes, and usually shows there if they are involved. Cancerous lymph nodes can be moveable, especially when small, they harden when they attach to structures. It's more the shape, diameter thickness that some doctors can tell by. Good luck.

Hello Wildcat - welcome to the family. Whether you have cancer or not, you asked for help, that makes you a member of a large and very supportive family. You will get answers to your questions here.

I suppose my case is similar. Go to the Introduce Yourself forum and start reading the Old B-52 Bombardier thread, rather than me repeating everything again here. Others with similarities to you will be found there also.

You will get lots more responses if you too start off with an Introduce Yourself thread. I will PM Christine after this response and ask her to move your thread to there. It's the way the forum works and will get you much better and more answers. Then later, if/when you begin treatment you can start a new thread in Currently in Treatment.

Thank you so much for taking the time to reply. I will check out your thread!!

What kind of doctor isnt concerned about your lymph nodes? An oncologist? You should be seeing an ENT who treats oral cancer patients. Some ENTs primarily place tubes in childrens ears, thats not the type you need to see. Sounds to me like your current ENT is opting for a tonsilectomy instead of first doing a biopsy. I would suggest checking with another ENT who treats oral cancer patients. It may be nothing more than an infection or who knows what else. Better to have a biopsy to know whats going on than to keep getting scans or having an unnecessary surgery. A second opinion never hurts.

Good luck!

Both actually. The oncologist says they aren't growing and aren't reactive on pet scan. The ent didn't even really address the nodes. Just said maybe after removing the tonsils they would shrink back to normal. The oncogist said I just have some sort of chronic lymph something (word meaning chronic enlargement I believe). Part of me thinks well, they are doctors, they know what they are doing. Then part of me thinks maybe they aren't used to this type of presentation or maybe my age has thrown them off etc. thank you for your reply. I will try to get a second opinion.

In the future you may want to take a notepad and pen with you to write down the names of things you might not remember from you doctor visits. Our group is very good at understanding most every thing about this disease and can comment intelligently on it "even though we are not doctors, and can't give medical advice".

Sometimes I too want to say, yes they are doctors, they know what they are doing. BUT (a big but) doctors are people too, and busy people at that. If you don't push them you will often not get the answers to your individual questions. This forum has taught me to push and push hard to get all my questions answered in a manner that satisfies me. It's all part of being your own patient advocate.

You're doing great, keep on doin.

Tony

Hi wildcat sorry you have to be part of our family, my surgeon did a biopsy of my tonsils to test for scc after my neck dissection showed cancer in the lymph node, this was done fairly easily, oncologist asked for it before rad treatment started to make sure they were infected. I did not get a tonsillectomy even though they new they were involved as the rads remove the cancer, mine was HPV positive good luck with your journey....ken