Hi everyone.

I have a question with regard to the usual course of treatment post chemo/radiation therapy. My husband Doug completed his treatment in mid June. His stage IV base of tongue cancer had invaded lymph nodes in the neck bilaterally. He went for follow up in July with his otolaryngologist who will be doing another laryngoscopy and biopsy August 17th. During his follow up appointment with his radiation doctor, he was told that a PET/CT would be done after his laryngoscopy and biopsy. I know that radiation changes the feel of tissues in the neck (he had conventional radiation as his cancer was quite advanced and they felt that this would be more of an agressive course of treatment). However, he has a small egg sized lump that remains on his left neck. The radiation doctor said that this could be dead tissue. My question is, what is usually done? Do you have to wait for another biopsy inside the mouth for additional scans and for plans for neck dissection if indicated? I know there is a window period for post radiation neck dissection and he will be two months post radiation at this time. Any information would be greatly appreciated as I know many of you have gone through this and you all have my admiration as wonderful people and survivors of this disease. Thanks!
Sincerely,
Virginia
wife to Doug (Base of tongue cancer T4N2cM0)

Virginia, I had the neck dissection done about a month and a half to two months after radiation and chemo. My neck still had sort of a swollen lump, which is why my surgeon/ENT pretty much insisted that I needed the neck dissection.

When they finally did the surgery, they told me that all the cancer cells in the lymph nodes were dead ones from radiation. This was pretty reassuring. I certainly hope after all I endured that all the cancer cells were dead.

I had a CT scan done somewhere in this time period. I don't know if any of the areas lit up or not, but none of my doctors showed any concern. There's another CT scan due for me coming up in September they tell me, and perhaps.... fingers crossed... it will be clear.

In my case, because my neck nodes were still sort of puffed out there, they decided to go ahead with the neck dissection and do a look see. Although I was still too pooped to really take all this in as good news, it definitely was better than the alternative of live cancer cells found.

Best of luck to you.

Jen

Lobby for MRI's -you don't need any more radiation and they display soft tissue issues better anyway.

Thanks guys for all the info. Doug and I really appreciate it. MRIs are better than CT/PETs?
He is being treated at the University of Michigan which is supposed to be a great facility but I think sometimes it is best to talk to those who have already walked in my husband's shoes so we can all be as informed as possible.
If MRI is better, I will be sure to ask. I was just concerned because they don't want to do anything until after the laryngoscopy and biopsy in August which will be about 2mos post radiation