Mar 22, 2013 - 8:58 am
Hi, everyone. I have received two different treatment recommendations for my
Tx, N2c, M0 metastatic squamous cell carcinoma with unknown primary. Do any of you have advice on the pros and cons of the two options? Here they are:
1. Mayo Clinic is recommending doing a single robotic surgery to remove affected lymph nodes on both sides of my neck, do biopsies of tongue, tonsils and throat, and try to locate the primary source of cancer and remove the cancerous tissue. After the surgery, they are recommending radiation only. This is different from the standard treatment according to the Comprehensive Cancer Center Network guidelines,but they are recommending the lymph node removal because they have the robotic surgery equipment that makes the surgery less invasive and with shorter recovery times. I don't know why they are recommending only radiation and no chemo. I have asked about this.
2. The Humphrey Cancer Center is following the CCCN guidelines and recommending not removing the lymph nodes, but doing a tonsillectomy and biopsies to try to identify the primary source of cancer and then do a combination of chemotherapy and radiation treatment. After this, I would get another PET scan and if there is still cancer in my lymph nodes or other site, they would do surgery to remove the cancerous tissue.
To make this more complicated, I learned that a friend of mine had the same diagnosis as me a few years ago (metastatic SCC with unknown primary site) and she had surgery to remove the lymph nodes and do the biopsies but they did not find the primary site. What is unusual is that she did not receive any radiation or chemotherapy treatment afterwards. She is cancer free after more than one year.
Maybe I need a third opinion!!??