Hi everyone,
Back with another question! Mary has about 10 more radiation treatments to go, and unfortunately the docs think that she will probably need a neck dissection about 2 months after the radiation is finished because there is still a mass in her neck. She has handled the radiation very well so far, not eating any solids but managing with the PEG, and some mild mucositis-but compared to others she has done pretty well.

I have read a lot on this site from people who have had a neck dissection first, followed by chemo and radiation. Have many people had it done in this order, with surgery at the end? Mary is wondering if it will take longer to heal, as the tissue has already been damaged from the radiation? Also, will this surgery delay her ability to eat-she would like the PEG out as soon as possible.
Any thoughts or comments would be helpful. Thank goodness for this site, I don't know where else I could find such great help!

Liz

Liz, Bob's ND to remove a remaining mass was 3 months after he finished radiation. He had no problems healing and it did not affect his eating. It went very well.
Linda

Liz,

I had my neck dissection about 2 months following Tx and actually had the PEG removed prior to that, about 5 to 6 weeks after my final radiation day. My neck was done later as my ENT wasn't satisfied that the nodes had shrunk as much as she had hoped for. She removed 11 nodes with all being negative.

Bill D.

Liz, as you know, Buzz had modified radical neck disection,then eight weeks later began IMRT & chemo. I assumed that this procedure was standard. Early on in my research, I became extremely concerned due to the diverse treatment plans I was seeing. However, I could never get a straight answer from Buzz' surgeon as to why he performs surgery first.
Another forum member went to the same doctor, got the same recommendation, but chose to go to another hospital, where no surgery was done, only chemo & radiation. Last I heard, he was doing well.
Personally, it is my belief that Buzz would have never survived surgery following IMRT/chemo due to the insuing weakness, weight loss and severe depression, among other complications.
EVERYONE is different, and I think it comes down to fully trusting your doctors.
Bottom line with Buzz, he was in much better position, physically and emotionally to have surgery first.
GOOD LUCK TO YOU!

Lois & Buzz in NC

Liz,

I had 5 different Tx protocols from 5 different cancer docs before settling on Moffitt. Three of the 5 wanted ND before anything else, one didn't mention anything but surgery and Moffitt said no ND before chemo/rad but they would decide after chemo/rad if I needed a ND. They told me my nodes we small and the rad should kill the cancer and there was no need to do the surgery first as it would just postpone the killing Tx.

There has also been some research indicating that different Tx protocols MAY apply to HPV+ SCC including foregoing ND in some cases. I did not see that Mary was tested for HPV but reading her signature it seems more likely than not to be the cause.

Right, it does seem that her SCC would be HPV related, however when they tested her tumor they were "80% sure" that it was not related to HPV. Is that research available through a link here? I would be interested in seeing that.
Of course, as I said to Mary, she has come this far- if the surgery is needed it is needed. The docs said they will repeat CT Scan and PET Scan and if there is ANY question of what they are looking at then it comes out!

I had the neck dissection the same day they took part of my tongue. Never had rad or chemo . Now that OC has come back on both sides of my tongue, I sure wonder why I never had Rad& Chemo before this reoccurence. NOw it's implant time and lose the teeth time. I wonder if this could have been prevented.

Jim,
I read your posts on here all the time, and I am so sorry that you have to go through this again- really there is nothing to say. I guess you always wonder with this- did I do enough? should I have done Chemo longer? Should I have the surgery before or after the radiation? On and on it goes.... I guess we just have to trust in the doctors we have chosen and have faith that we have done all we can. In my case it is providing all the support I can, and the most factual answers I can.
And I keep all here in my thoughts and prayers, because no person should have to go through this once, never mind a reoccurance!
Liz