neck lump

Hello, my 43 year old son discovered a lump on the right side of his neck. A trip to the Dr put him on antibiotics for 2 weeks. After 2 weeks the lump was still there. He was then sent to a specialist who did a biopsy and took cat scans. The cat scans showed nothing else anywhere in his body but the lump biopsy came back positive for cancer cells. He was then sent for a pet scan at the Vancouver cancer clinic. The pet scan was inconclusive but they said maybe from his right tonsil or tonque on the right side. He was operated on and they removed the right tonsil and did a biopsy on the tongue, both came back negative. The following week they removed the lump from his neck and sent it away for testing. The test came back and he was told it was Squamous Carcinoma. At this time he was told the survival rate for this type of cancer was about 40%. He his now going through the procedures to get him ready for chemo and radiation treatment to start on April 7. He was obviously upset by this result. I visited the local Cancer Foundation office in my home town and was told that there has been many success stories with this type of cancer and there is many factors that play a role in its success. Having never dealt with this type of illness before Im worried we are missing something else that should be done. My son lives 500 miles away so its not like I can go with him for every Drs visit although I did meet him in Vancouver for the Pet Scan and will travel there when he starts treatment. Any further information you can give me will be greatly appreciated !!

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Comments

  • phrannie51
    phrannie51 Member Posts: 4,716
    Hi and welcome to this forum....

    You have stumbled on the best group on the internet.  The folks here are very supportive, kind, and informed.  It sounds to me like he has SCC (squamous cell carcinoma) with no known primary.....there are many here who have had the same thing, and with good results.  I swear some of these Drs. either get their information from the internet, or maybe looking for a hero award when things turn out great??  The survival rate of Head and Neck cancer is far higher than 40%.....my ENT told me 80%. 

    Because he has no known primary, they will radiate a greater range of tissue, but he'll have the normal number of treatments (anywhere from probably 30 to 35 days)....and maybe chemo, also.  Did they say anything about chemo? 

    Most of us were Stage III or IV when we finally got past the antibiotics and on to the specialists.....and we're still here to talk about it. 

    Are you in Vancouver, Wa. or Vacouver BC?  If you're in the states, then a second opinion might be the way to go....I don't know if you can do that in Canada....but if so,  then a second opinion is what I'd be looking at.....if for nothing else, a Dr. who is a tad bit more optimistic.....

    p

  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    Welcome....

    As Phrannie said, survival rates are much higher than you were told... If that's their story, I think I'd head for a different facilty.

    I was STGIII SCC Right tonsil, and a lymphnode on the same side HPV+..., started out exactly as your son.

    Tonsils removed, sixteen weeks of four types of chemo, seven of which were concurrent weekly with 35 daily rads sessions...

    Oh, and that was January 2009.....

    All clean and clear since..

    It's a rough treatment, but very doable.

    John

     

  • concerned parent
    concerned parent Member Posts: 9

    Hi and welcome to this forum....

    You have stumbled on the best group on the internet.  The folks here are very supportive, kind, and informed.  It sounds to me like he has SCC (squamous cell carcinoma) with no known primary.....there are many here who have had the same thing, and with good results.  I swear some of these Drs. either get their information from the internet, or maybe looking for a hero award when things turn out great??  The survival rate of Head and Neck cancer is far higher than 40%.....my ENT told me 80%. 

    Because he has no known primary, they will radiate a greater range of tissue, but he'll have the normal number of treatments (anywhere from probably 30 to 35 days)....and maybe chemo, also.  Did they say anything about chemo? 

    Most of us were Stage III or IV when we finally got past the antibiotics and on to the specialists.....and we're still here to talk about it. 

    Are you in Vancouver, Wa. or Vacouver BC?  If you're in the states, then a second opinion might be the way to go....I don't know if you can do that in Canada....but if so,  then a second opinion is what I'd be looking at.....if for nothing else, a Dr. who is a tad bit more optimistic.....

    p

    Neck Lump

    Thank you so much for your reply. The Dr who told him this was not the regular Specialist he had that removed the toncil and did the biopsy work and removed the lump. Hopefully he returns soon as he was by far more optimistic. We are In British Columbia,Canada so the Vancouver Cancer Clinic is the best we have. Alot has happened in the last 2 months and they have really been acting quite quickly on it. My son is 43, married with a 6 year old daughter. Hopefully the chemo and the radiation will solve whatever problem remains. The pet scan didnt show any real primary sourse so I dont know wheather to believe there isnt one or they just cannot find it.

  • concerned parent
    concerned parent Member Posts: 9
    Skiffin16 said:

    Welcome....

    As Phrannie said, survival rates are much higher than you were told... If that's their story, I think I'd head for a different facilty.

    I was STGIII SCC Right tonsil, and a lymphnode on the same side HPV+..., started out exactly as your son.

    Tonsils removed, sixteen weeks of four types of chemo, seven of which were concurrent weekly with 35 daily rads sessions...

    Oh, and that was January 2009.....

    All clean and clear since..

    It's a rough treatment, but very doable.

    John

     

    neck lump

    Thanks for your reply. I must admit i couldnt understand them saying 40% when the pet scan found nothing other than maybe the toncil or tonque. The lump had been taken out already so it really threw us for a loop.

  • donfoo
    donfoo Member Posts: 1,771 Member
    welcome

    Sorry for the cancer in your son. He's lucky to have you to care so much about him and be able to be near during treatment. Surgery followed by chemo/radiation is a common treatment plan. I did not see any reference to HPV status in your note. There is quite a difference in survival rates between HPV positive and negative cases. Either way, you should not focus on prognosis and only treatment for now. Do your best to attend to the side effects and ensure as much comfort as possible.

    Remember the three things to watch over. Hydration - plenty of water every day. Nutrition - get calories in anyway you can. Pain management - get whatever narcos you need to kill the pain. Do these well and you will get through as smoothly as possible.

    Good luck, Don

  • CivilMatt
    CivilMatt Member Posts: 4,722 Member
    concerned

    C.P.,

    Welcome to the H&N forum, I am sorry for your son’s situation.

    I was stage IVa, scc, bot, hpv+ and I have been doing well for 2 years (in 5 days).  Maybe the 40% was for finding a parking space, it sure isn’t a realistic survival number.

    Your son’s treatment will be similar to what many of us received.  It can be difficult, but we all made it through.  There are many tips, tricks  and meds to help him get through in one piece.   Read the SuperThread (top of page) for gobs of information.

    It is a confusing and scary time, but you will work through it and in a few months the treatment will be over and you can work on healing.

    Matt

  • wmc
    wmc Member Posts: 1,804
    Concerned parent........

    Sorry you need to be here, but welcome.

    I do beleave the rate is very much higher. I was Stage 3 SCC [Squamous Cell Carcinoma] T3; N0; M0 and had no RAD or chemo, only surgery and did a lot of research plus my Doctors said survival is very high. I beleave over 80%.  Very sory for both you and your son and family. I had a lump that you could see in my neck that was just a lymph gland doing it's job and it did not have cancer. They did find my tumor and removed it. It is scarry and the unknown is tought but your son can beat this as so many have done.

    wmc

  • fisrpotpe
    fisrpotpe Member Posts: 1,349 Member
    Challenged

    sorry you have had to join and contact the site. as said before the best place to get advise, wisdom and support. 

    couple questions i would ask

    - did they find the primary?

    - is it HVP positive?

    - was it in a lymp node?

    if they know the primary, this will help in the maping process for using radiation. it also reduces the field that the radiation has to be used. 

    from what i know and understand being hvp positive raises the percentage of long term survivorship

    being in lymp node might increase the risk of being in more in the head and neck area. 

    from the day anyone is told they have cancer, is the day they become a survivor. 

    a huge help in the fight against cancer is to maintain a Positive Mental Attitude that he will kick cancers butt. 

    share with all friends and family to always be positive when around your son. 

    john 

     

  • cureitall66
    cureitall66 Member Posts: 913
    Welcome....

    Welcome.  You have come to the right forum for support and information.  There are plenty of us here that have been around a long time...some for a few years, and some that are either entering or coming out of treatment.

    I was a caregiver to my loved one who was diagnosed SCC Stage IV BOT (base of tongue), HPV16+, 2 lymphnodes.  His treatment consisted of 35 rads, 7 chemo.  He was dx Aug 2012, started tx early Oct 2012 and ended at very end of Nov 2012, had PET scan Feb 2013 with NED (no evidence of disease).  No surgery. It was tough, but doable. We are looking forward to celebrating our 2 yr NED in November!

    I would suggest getting a second opinion if there are any doubts.  I know there are a few on here that had an unknown primary and have done well with treatment. I would also suggest you ask them to test for HPV as there are many here that had that as the leading cause...especially if he is a non-smoker, and non-drinker. If you think your son could use some mental support, I would also suggest he comes here.  It may make him feel much better knowing he's not alone with this.  Having support before, during, and after tx are important as this is a tough thing to soak up.

    Not sure if anyone mentioned the "Superthread" at the top of all the posts, but it has several topics that may help during the process.  Look forward to your posts and helping you through this process.

    God Bless,

    ~C

    ...oh, our treatment facility U of M told us 90% cure rate for the type of cancer (HPV+)

  • ratface
    ratface Member Posts: 1,337 Member
    it's an individual disease

    I'm sorry to hear of your son's illness. We can generalize a little but the more information you have the better. Ask him for the staging information. It's a standard grading system which can be interpreted by following some flow charts. Post it here and we can help you.  You then have a starting point for him.  From here they formulate a treatment plan. The size of the lump will come into play. I think Phrannie hit the nail on the head, "Unkown primary" and it's "Loco Regional" and a small primary because they can't find anything. Chemo and radiation and even a neck disection are all treatment possibilities. Don't fear any of them! The 40% number is just wrong, The books say 50% but that information is all outdated. This treatment has been evolving by leaps and bounds. I'm simply amazed by what they can do.  From what you have told us so far he is certainly treatable if not curable. I admire your parenting! Welcome to the Board.

  • hwt
    hwt Member Posts: 2,328 Member

    Welcome....

    Welcome.  You have come to the right forum for support and information.  There are plenty of us here that have been around a long time...some for a few years, and some that are either entering or coming out of treatment.

    I was a caregiver to my loved one who was diagnosed SCC Stage IV BOT (base of tongue), HPV16+, 2 lymphnodes.  His treatment consisted of 35 rads, 7 chemo.  He was dx Aug 2012, started tx early Oct 2012 and ended at very end of Nov 2012, had PET scan Feb 2013 with NED (no evidence of disease).  No surgery. It was tough, but doable. We are looking forward to celebrating our 2 yr NED in November!

    I would suggest getting a second opinion if there are any doubts.  I know there are a few on here that had an unknown primary and have done well with treatment. I would also suggest you ask them to test for HPV as there are many here that had that as the leading cause...especially if he is a non-smoker, and non-drinker. If you think your son could use some mental support, I would also suggest he comes here.  It may make him feel much better knowing he's not alone with this.  Having support before, during, and after tx are important as this is a tough thing to soak up.

    Not sure if anyone mentioned the "Superthread" at the top of all the posts, but it has several topics that may help during the process.  Look forward to your posts and helping you through this process.

    God Bless,

    ~C

    ...oh, our treatment facility U of M told us 90% cure rate for the type of cancer (HPV+)

    Prayers

    Prayers that your son has an easy and successful journey. 

  • concerned parent
    concerned parent Member Posts: 9
    ratface said:

    it's an individual disease

    I'm sorry to hear of your son's illness. We can generalize a little but the more information you have the better. Ask him for the staging information. It's a standard grading system which can be interpreted by following some flow charts. Post it here and we can help you.  You then have a starting point for him.  From here they formulate a treatment plan. The size of the lump will come into play. I think Phrannie hit the nail on the head, "Unkown primary" and it's "Loco Regional" and a small primary because they can't find anything. Chemo and radiation and even a neck disection are all treatment possibilities. Don't fear any of them! The 40% number is just wrong, The books say 50% but that information is all outdated. This treatment has been evolving by leaps and bounds. I'm simply amazed by what they can do.  From what you have told us so far he is certainly treatable if not curable. I admire your parenting! Welcome to the Board.

    neck lump

    Hi..can someone explain to me what HPV+ means. Im finding that goggle is kind of confusing me what that means. It sounds like its important in the testing procedure so I want to make sure we have this covered. Thanks.

  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member

    neck lump

    Hi..can someone explain to me what HPV+ means. Im finding that goggle is kind of confusing me what that means. It sounds like its important in the testing procedure so I want to make sure we have this covered. Thanks.

    HPV

    HPV, the human papillomavirus.

    HPV has come into play a lot over the last several year concerning H&N Cancer... You more than likely have heard of it mostly concerning cervical cancer in young girls and Gardisil Injections for possible prevention.

     

    While treatment is the same whether you are or are not HPV+ derived cancer. The thought is that HPV derived cancer in H&N tends to respond a little better and have a little better out come long term.

     

    But with everyone being different, there are ton's of variables that come into play...

    John

  • Guzzle
    Guzzle Member Posts: 710
    Skiffin16 said:

    HPV

    HPV, the human papillomavirus.

    HPV has come into play a lot over the last several year concerning H&N Cancer... You more than likely have heard of it mostly concerning cervical cancer in young girls and Gardisil Injections for possible prevention.

     

    While treatment is the same whether you are or are not HPV+ derived cancer. The thought is that HPV derived cancer in H&N tends to respond a little better and have a little better out come long term.

     

    But with everyone being different, there are ton's of variables that come into play...

    John

    SCC

    Hi Everyone. I am new to this and from Liverpool England. This site is an inspiration. I have seen another guy from Liverpool and an amazing person who has survived SCC for 20 years in various posts. I am 47 and had a long smoking history although quit. I am going i Monday for a removal of what is eith a Branchial Cleft Cyst or Submadibular cancer. Given my age etc the odds are that I have cancer.  I surived teritoma of the testicle 25 years ago. I was training for the marathon in May to support a local cancer hospital. If any of you amazing people have had either a neck dissection and/or radiotherapy I would be really greatful if you could tell me how long it takes to get active again and also the debilitating impact on the shoulder. I know this will vary from person to person but any insight would be great.

     

    All the Best and Thanks

  • debbiejeanne
    debbiejeanne Member Posts: 3,102 Member
    Guzzle said:

    SCC

    Hi Everyone. I am new to this and from Liverpool England. This site is an inspiration. I have seen another guy from Liverpool and an amazing person who has survived SCC for 20 years in various posts. I am 47 and had a long smoking history although quit. I am going i Monday for a removal of what is eith a Branchial Cleft Cyst or Submadibular cancer. Given my age etc the odds are that I have cancer.  I surived teritoma of the testicle 25 years ago. I was training for the marathon in May to support a local cancer hospital. If any of you amazing people have had either a neck dissection and/or radiotherapy I would be really greatful if you could tell me how long it takes to get active again and also the debilitating impact on the shoulder. I know this will vary from person to person but any insight would be great.

     

    All the Best and Thanks

    guzzle, i recommend that you

    guzzle, i recommend that you copy and paste your post into a new post so it can receive the proper attention and get the replies.  i had rad tx first and they were rough but i came thru them alright.  it took so time for me to be able to eat and my neck was burned pretty bad but aqua4 helped tremendously with the burn.  2 years later i had a neck dissection for recurrence and i had a much harder time recovering from that.  i developed a fistula which took forever to heal and in fact required another surgery.  hopefully, you will not have any complications.  it took me about a month to recover from the neck dissection well enuf to go home from hospital.  i truly don't know why it took me so long as my memory of the surgery doesn't exist.  many here have had neck dissections without any complications and healed just fine.  i'm sure they will chime in for you.  to start a new post, go to top of topics page.  you'll see "start a new topic".  click that and create your post.  good luck.

    dj

  • PJ47
    PJ47 Member Posts: 376

    neck lump

    Hi..can someone explain to me what HPV+ means. Im finding that goggle is kind of confusing me what that means. It sounds like its important in the testing procedure so I want to make sure we have this covered. Thanks.

    Hi concerned parent

    The teaching hospitals and cancer centers in the USA test tissue samples (tongue, tonsil, lymph node) for HPV virus and that will give him a better idea of his prognosis.  Encourage him to ask his surgeon about the test as it may have been done.  If he does not smoke or drink alcohol heavily it most likely is caused by the HPV virus and if so it usually responds well to treatment.  He is also young and obviously has you in his corner and that is a plus!  Best of luck for you both,

    PJ

  • concerned parent
    concerned parent Member Posts: 9
    PJ47 said:

    Hi concerned parent

    The teaching hospitals and cancer centers in the USA test tissue samples (tongue, tonsil, lymph node) for HPV virus and that will give him a better idea of his prognosis.  Encourage him to ask his surgeon about the test as it may have been done.  If he does not smoke or drink alcohol heavily it most likely is caused by the HPV virus and if so it usually responds well to treatment.  He is also young and obviously has you in his corner and that is a plus!  Best of luck for you both,

    PJ

    neck lump

    Hi all, thank you's all so much for the information you's have given me. I have passed all this information onto my Son and Daughter-in- Law. He is sceduled now for 3 visits at the Cancer Clinic for mask fitting etc and treatment starts April 7th. When asked if he was tested for HPV he said they did alot of tests but didnt know if they did that one. They will be following up with this tomorrow to ensure its been done. For them just knowing that the percentage for survival is probably way off base has helped them alot.  Again, thank you's all so much !!!!!

  • concerned parent
    concerned parent Member Posts: 9

    neck lump

    Hi all, thank you's all so much for the information you's have given me. I have passed all this information onto my Son and Daughter-in- Law. He is sceduled now for 3 visits at the Cancer Clinic for mask fitting etc and treatment starts April 7th. When asked if he was tested for HPV he said they did alot of tests but didnt know if they did that one. They will be following up with this tomorrow to ensure its been done. For them just knowing that the percentage for survival is probably way off base has helped them alot.  Again, thank you's all so much !!!!!

    neck lump

    Hi all, its true there has been many advances in the treatment for cancer. Unfortunately there are still Doctors out there who could use some skills in dealing with people who are trying to stay positive in dealing with the cancer and treatment. Ive been told over and over that maintaining a positive attitude is so important in dealing with this yet there are Doctors that start their discussions with the words " unfortunately ". Hopefully some of them learn they have alot to do with how their patients deal with the cancer and the treatment.

  • Guzzle
    Guzzle Member Posts: 710

    neck lump

    Hi all, its true there has been many advances in the treatment for cancer. Unfortunately there are still Doctors out there who could use some skills in dealing with people who are trying to stay positive in dealing with the cancer and treatment. Ive been told over and over that maintaining a positive attitude is so important in dealing with this yet there are Doctors that start their discussions with the words " unfortunately ". Hopefully some of them learn they have alot to do with how their patients deal with the cancer and the treatment.

    From Liverpool England

    Concerned parent. Good luck to your son. In in hospital recovering from my operation with a similair condition. They found a small primary on my tonsil and my surgeon suspects hpv although I await biopsy. I will start RT in about a month. I just wanted to say my surgeon was much more positive and hoped to get more than 5 years out of me. He is renowned in his field and we have the world famous Clatterbridge hospital here. I know this is a worry but me and your son are still here. Look to all these fine people who are also. All the luck in the world to him. I will be looking for tips from him via yourself on coping with RT!

  • concerned parent
    concerned parent Member Posts: 9
    Guzzle said:

    From Liverpool England

    Concerned parent. Good luck to your son. In in hospital recovering from my operation with a similair condition. They found a small primary on my tonsil and my surgeon suspects hpv although I await biopsy. I will start RT in about a month. I just wanted to say my surgeon was much more positive and hoped to get more than 5 years out of me. He is renowned in his field and we have the world famous Clatterbridge hospital here. I know this is a worry but me and your son are still here. Look to all these fine people who are also. All the luck in the world to him. I will be looking for tips from him via yourself on coping with RT!

    Treatment

    Hi All..sorry I havent been on here for awhile. My son has started treatment and I traveled up to where he lives for the last month. Hes had 19 radiation treatments so far and 1 chemo. They were supposed to do the second chemo last tues but his white blood cells were to low and hopefully they do the second one this week. Ive come home for a week to catch up on things and as soon as I know they are doing another round of chemo I will fly back up there again. Hes had alot of problems swollowing and he says that his mouth tastes like copper. Its a chore to try to get him to eat. Hes been living basically on chicken noodle soup and its been hard to find something he will drink. Ive tried milkshakes, smoothies, portein drinks etc but he gags on them. Has anyone got any other suggestion as to what to try? Im very impressed with the cancer clinic thats treating him and hopefully we can get through the next month and then get on with the recovery period. Wishing you all the best of luck !!!!