I've been reading several posts and see a lot of references to dissections. I've also read the definitions of the procedures. I am wondering when typically one of the procedures is performed. She is now in 3rd week of chemo and starts radiation next week. I don't think a dissection has come up in the treatment plans. Just curious about this aspect.

hi, i'm a cancer survivor, not a medical professional, but here is my take on this:

The neck dissections are a surgical procedure along the lymph system,done to assess whether the cancer has spread through the neck lymph system and/or to remove the cancerous node(s).

your signature says your sister has "N1" meaning 1 positive node. I am guessing that the medical team found this through some sort of imaging such as MRI. My non-medical guess is that because she is undergoing 2 types of cancer treatment - chemotherapy & radiation, they are not going the surgical route (at least not at this point).

It is a reasonable and good question to ask her medical team. I found it amazingly helpful to have my husband with me at all of my appointments, it is great to have someone to help listen and ask questions and to remember the answers! I don't know if anyone is going with her to her appoinments but it is very helpful. Also, I brought a composition notebook to each appointment & would write down info, it also helps to write down questions.
I hope this helps some, and good luck on her treatment!
michelle

Hi Sarah,

The doctors didn't mention anything about ND before or during my Dad's treatment at all.

It was after treatment on the 1st month follow-up (before scans) that they mentioned it and then on the 2nd month follow-up (with CT and MRI scan results) the rad dr suggeted we see the surgeon to discuss ND. Scans showed tongue tumour is gone and nodes shurnk 50%. He had a PET afterwards and it's negative.

Seems no set way of doing things; some dr's do ND's regardless of scans as a precaution and some do them if scans show any areas of concern.

Lisa

Hi Sarah,

Lisa is so correct, my cancer was a tumor on the maxilla (upper front jaw), which had metastasized to the bone. I had surgery immediately and did not know what they meant when they said they would "look at the lymph nodes" it did mean dissection in my case, even though the nodes were clear.

Sarah, I had 2 positive left nodes with SCC and a base of tongue primary. I got 5 cancer doc opinions ranging from a Radial Neck Dissection with chemo and rad to just concurrent chemo and rad with no node surgery. That came from Moffitt Cancer Institute. I opted for their treatment. I am only 5 weeks out but the nodes are normal and as they told me I can always have the surgery but they don't forsee that. Get other opinions.

Thank you all- I will pass this on and I am going to attend a consultation with my sis at Dana Farber on the 10th - so will ask all of this at that time. I only wish she had been more assertive in getting this 2nd opinion sooner (prior to her beginning her treatments), however what's done is done and I will be with her on the 10th-we;ll take it from there- funny I feel like the "big sister" now!

Hey Little "Big Sis", It is great that you will be there to listen and support. That is such an important part of this process for the person going through it. Be as available as you can for her. Amy

Acvtually, a number of the top CCCs are no longer routinely doing neck dissections because some recent studies have found a modest improvement (wih ND) in local control -- about 5-10% -- but no long-term survival advantage. And a significant increase in morbidity (bad side effects). Many doctors do not like the idea of long, unnecessary surgeries and the newer treatments are so effective that our ENT said most of the NDs he does show no cancer. For this reason at Hopkins it is not promoted by the MOs and ROs, and even the surgeons are cautious -- they do a lot of testing. Even if there are suspicious areas (with a fused PET/CT) they will order an MRI and maybe some other things before doing any surgery.
At Sloan-Kettering , where we went for a second opinion, we were quite bluntly told "we don't do them"

You may wish to google for some of the recent studies on effectiveness or need for post-treatment neck dissection. The current thinking seems to be moving towards doing it only in selected cases.

Gail

What would be considered selected cases?

Thanks

Sarah here is a study, might be interesting to you.

http://www.jco.org/cgi/content/abstract/24/9/1421

Postradiotherapy Neck Dissection for Lymph Node