I represent the other side as Moffitt recommended concurrent chemo/rad first and surgery after, IF NEEDED. It wasn't needed so I avoided surgery all together.

I was told the ND protocol is determined by the tumor board after considering staging, guidelines, and extenuating circumstances.

In my situation the chemo was replaced with SND surgery "first" because I have impaired kidney function. Also standard IMRT was replaced with TomoTherapy.

My ENT has mentioned complications that can arise from ND surgery when the nodes are near or attached to critical nerves, arteries, etc.. and that using chemo "first" (or concurrently) can often mitigate having to deal with these issues.

I also remember reading an article that mention the possibility of accidentally spreading microscopic cancer during ND surgery.

I would think if a ND was still necessary post RT that the nodes would be must smaller and less invasive so that it should be easier to get good clear margins.

Very true about the post RT ND. T's tumors were shrunk by tx and RT...the ND followed to remove dead tissue(tumors) and any "left over" SCC. There is always a risk of mets with surgery but, you have to outweigh the +++ vs. the ---. Because the tx is still working after tx, they proceed carefully. If you are at a CCC, you are doing good.

Here�s my story on the post-treatment swollen lymph node(s). I had radiation burns that showed up after the treatment ended and it was painful to touch and get a real good feel at first, so I waited a week or so before I felt around again. It was smaller than when I originally found it, but it was still there, which worried me some. After checking it several times a day for awhile, and thinking it wasn�t getting smaller, I decided to check it less often, usually every three or four days. That way I would be able to notice if there was a size difference.

This worked because I did notice it was a bit smaller every time I checked it. Drs. had told me the radiation continues to work for several weeks and that the irradiated tissue takes a while to be passed out of the system. I remember how it kept getting smaller to the point that if had not known it to be there I would not have found it. Eventually, about four or five weeks out, I couldn�t find it. Drs. said this was great. CT scan was clean at 60 days post treatment.

Like Davidpa, I did not have surgery. Feeling pretty good now. I did just notice a little L'Hermitte's sign, but that should go away with time. Haven't seen a whole lot about that on here. Maybe i should start a thread!


This worked because I did notice it was a bit smaller every time I checked it. Drs. had told me the radiation continues to work and that the irradiated tissue takes a while to be passed out of the system. I remember how it kept getting smaller to the point that if had not known it to be there I would not have found it. Eventually, about four or five weeks out, I couldn�t find it. Drs. said this was great. CT scan was clean at 60 days post treatment.

Like Davidpa, I did not have surgery.

Thanks Ray.

Good post Ray, I still have a lump after all of tjhis time, but heck with it for now, maybe tjhis antibiotic will shrink it.

Hi Boston,

I'm just catching up on this thread. Have you talked to the doctor yet?

I have a small residual lump from a large, swollen lymph node. I'm 2 months post-Tx (7 weeks radiation, 70 doses incl IMRT, plus chemo). On a follow-up visit this past week, my RO palpated my lump. It didn't faze him in the least. "Good progress," he said. I will see my onc in about a week and of course will ask her opinion too. But the bottom line is, while concern and vigilance are absolutely warranted, you might want to reserve judgment before you start worrying in overdrive. Get a consensus from the professionals first.

Boston,

If you feel it! Then it is worth checking it out!! It will make you feel so much better!!

Take care.. Diane