Thank you, Brian,

My husband fits the pattern you describe. His tumor size was considered small mass with relatively large node size. According to Dana-Farber Cancer Institute, this put him borderline for treatment with induction chemo. That was 6 years ago.

Brian, could your explanation be the reason my primary pathology was in situ but still metastasized to cervical lymph nodes?

I remember the ENT telling me that the only way he found Kevin's tumor was by, under anesthesia, putting his fingers down Kevin's throat and palpating his base of tongue area. He found that it was concave shaped. He then cut by feel since he couldn't see it. Three years ago now....

Uptown. Exactly these things are really small in some people but the tonsil and the lymph tissues on the base of the tongue and later l tongue boarders are part of the immune system/lymph system; and even a cancer small enough to be considered in situ is mature enough to cast off daughter cells - right into the lymph drainage passageways and down to the nodes, which are of course another step in the immune system components. They are designed to trap all kinds of detritus and cancer cells qualify.

Luckily SCC seems to stay in the regional nodes for some time, because if it did not, those drain further into the nodes in the upper body, which are close to vital organs. That is how mets that become terminal move in addition to the circulatory system.

This has turned into a very information discussion. Brian, thank you for your very knowledgeable input!

In light of the equal opportunity layer of blame theme this post has turned into, let's not forget that not all pathologists are created equal.

I found out the hard way! I had surgery #1 at a small local hospital and my biopsy slides were reviewed by the pathologist on staff. I was given the all clear. Well I found out months later that he "misread" my biopsy slides, and in one of them there was actually cancer at the margins.

This lead to months of doctor appointments (2nd & 3rd opinions), multiple scans and tests, and many sleepless nights. The recommended opinions started with more surgery and RT, to the final 2 options - RT alone or "watchful waiting". Surgery was ruled out by the doctors I consulted at this time.

I ruled out the "watchful waiting" option - just felt I needed to do something! So off to get fitted for my radiation mask and started the 7 weeks of RT. Looking back now and being now a more knowledgeable patient thanks in part to OCF, I'm not so sure I made the right choice.

Sorry to hear stories about serious mistakes such as yours. You always have to keep your antennae polished and your sniffer super clean to know how things seem to be going.

All the people involved with your health care are just that - people, human beings. We all strive to be 100% professional while on the clock but human nature has a way of affecting our daily performance, no way around it.

It is so vital to not only trust your doctors but also keep aware if you pick up on any off-kilter judgements or reasoning.

But this is nearly impossible when trying to simply digest all the chaos while undergoing diagnosis and treatment.

Hope all readers take notice and be on constant alert and not be shy getting other reviews if at all concerned.