Hi,

So before having a neck dissection (after treatment is finished) is there any other test or biopsy that can or should be done to see if nodes are negative or not?

Hi Lisa,

They didn't tell me of any. My wife works for the Chief of Staff at a VA and got a lot of advice from him and the surrounding doc's. If they would have had any ??s, they would have piped in and she would have asked. The ND is daunting, but as far as I know, the only way to tell if the stuff is gone is the pathology report after the disetion. Even though I was hooked up to suction machines and in the hospital, the negative report was the best day of my life.

Steve

Thanks Steve,

What about Ultra Sound Guided FNA? Read a study that says it's 100% accurate. I know FNA's are not, but not sure about the ultra sound guide ones? Anyone know anything about it?

My husband had SCC base of tongue and possibly 1 lymph node involved when he was initially diagnosed in Sept '05. He was treated in Canada with radiation & chemo (Cisplatin (sp) & the docs said they were going to 'hit him hard' in terms of the treatment because of his age (57) & he was in very good physical shape. We sought a 2nd opinion at Johns Hopkins in Balitmore & they agreed with the Cdn docs treatment plan. After finishing treatment end Nov in Cda, we went to MD Anderson in Houston for a checkup end of Jan. One lymph node was still a bit bigger, altho blood flow through the node was good (apparently the flow would not have been good if it were cancersous). Because he was still healing,the radiologist said to come back to get it re-checked in 6 months. We did so in July & lymph node was slightly bigger. According to CT scan, surgeon said he thought it was scar tissue, but agreed we could opt for an ultra sound guided needle aspiration, followed by a biopsy. He made it clear he didn't think it was necessary. We insisted anyway & Radiologist then used ultarsound to determine that node was no longer bigger, blood flow was good & therefore this was not the way a cancerous node acts, according to her. (She only treats head & neck cancer patients).She would therefore not do the needle biopsy. She added that even if she had a 2 to 5% doubt, she would have done it. We were very relieved & this kind of experience & followup is why we are spending alot of $$ to go to MD Anderson for check-ups. We are gettting very little follow-up care in Cda due to our over taxed, under resourced health care system. Do not hesitate to have a neddle biopsy. Do not necessarily listen only to your surgeon's/ENT's opinion either. Be aggressive. I'm not aware of any other way of checking the lymph nodes. Hope this helps.

Thanks, Survivor Canada, for reminding everyone of the importance of follow-up, and second opinions, and being aggressive. I am sorry you have to travel, but you have chosen a first rate institution.

Best wishes to you both for a long, long, and happy future.

dear Lisab.I want to apologize for the hostility you encountered at your other posting,it was a perfectly valid question.it appears that some members and administrators in remission for a year or more, have forgotten the panic of being hit with such devastating news.everything i've read leads me to believe the neck dissection should be done before radiation,it certainly didn't strengthen your fathers jawbone.i am looking at a n.d. and my surgeon requires a second biopsy,even though you can feel the cancer with your hand,something i don't understand.keep up the good work.

Thanks lyle.4 for your comment and support. It sure is a scary thing to go thru. Is your surgeon doing a biopsy before your nd? and how?

SurvivorCanada, I'm a bit confused on what you are saying. Did your husband not have the ultra sound FNA? They check the nodes blood flow by way of ultrasound? and was this done in the US at MD Anderson?

My Dad's surgeon said he'll do whatever we want, and agreed to another CT; booked for end of Sept; but he doesn't feel FNA is very accurate. I'm still thinking we might ask for one.

Your patience and time is appreciated.

Hello LisaB. Sorry I was unclear. He did not end up having the final needle aspiration biopsy because when the Dr. went to actually do it the next day, the ultrasound showed that the lymph node had completely gone back to normal in size & whatever else they are looking for via the ultrasound. In fact they had trouble figuring out exactly which lymph node had been suspicious 6 months earlier. I see that your dad only finished treatment in June, so he is likely still healing & perhaps? it is too early for an ultrasound guided FNA. By the way, at MD Anderson in Houston they do 100s of them per day we were told & the Dr. that does them only treats head & neck cancer. To repeat, even if the surgeon/ENT doesn't think it is necessary, he could ask for one further down the road. My husband had the first ultra sound of all the lymph nodes in the affected area (& other areas in the neck I guess?) 2 months after finishing his treatment.

Hi again SurvivorCanada,

He had another CT (just about 4 months post treatment). It says no changes (we were hoping the nodes would have shrunk more) however the report reads 'no progression'.

You say your husband had his follow up at 6 months. It makes sense as the body is healing from all the treatment. Is this what they recommend? Everyone seems to have different post treatment scan times. So confusing.

We meet with the surgeon next week to discuss the CT results. Think we'll ask for an ultrasound; FNA too.

Thanks for the info; feel free to email at [email protected] if that's easier.

Lisa