Hi, I have a general question that puzzles me. Why do some H&N cancers spread to the nodes and some don't? I've noticed on the forum that even people with T3&T4 tumors will not have node involvement, while smaller primaries T1-T2 will have node involvement. Richard's is a small primary T1 about a 1/2 inch in size, but 1 node about an inch from the primary is involved. Does location matter or is this simply one more unanswered question about cancer? Thanks for any thoughts on the subject. Geri

My guess would be genetics and probably some other factors that we don't know anything about yet. I'm waiting for some magical answer to pop out of the sky to explain why I got cancer, but I think I'm going to be waiting for a while! My positive node was on the same side of my neck as my tongue cancer, so maybe location does have something to do with it.

The answer may lie in the 'differentiation' description of the tumor, with poorly differentiated being more likely to have spread elsewhere regardless of tumor size (Size being the prime basis for T1/T2).

Another thing to consider is that just because a large node contains the cancer by a biopsy doesn't mean that smaller ones in someone else might also already have the cells growing but just go undetected. I haven't talked to anyone that knows why some Primaries shed and others don't and even if they shed the cells the nodes are supposed to filter them out and I haven't met anyone who could tell me why some nodes allow the cancer cells to multiply and others do their job and dispose of them. Most just say our genetic makeup which is the educated way of saying I haven't the foggiest.

Hi,
Thanks everyone for the replies. Richard's primary was moderately differentiated and the node keeps shrinking. We see the RO today and I'll have many questions for her. The MO indicated the radiation will keep working after treatments end and seemed to think the node would return to normal size. The RO wants it gone NOW and that's why she switched Richard to 2 infusions of Erbitux for the last 7 radiation treatments. Has anyone ever heard of only 2 infusions of Erbitux after 2 infusions of Cisplatin during the treatment period?

Richard's 1st Erbitux was Tuesday. It was the loading dose. He had flu-like symptoms, but is back to normal today. His 2nd infusion will be next Mon. with 3 more rads to go. This time next week, he will be done with treatments and we will wait and see if all this has worked. I'll post when I get more info after today's RO appointment. Talk to you all later...Geri