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rmowery8699
rmowery8699 Member Posts: 4
edited May 2011 in Head and Neck Cancer #1
Husband 53 yrs. Although my husband underwent a tonsillectomy on 11/24/11 for cancer he wasn't "officially" diagnosed with SCC of the tonsil until 12/1/11. He is staged at T2 N2 MO Stage IVA. He finished a radical chemo/rad treatment 3/28/11 & just had a new PET Scan done. The scan showed an all clear for for the tonsil area but still has a mass in his lymph node. Size is 3.2x4.5x3.0 with an suv of 4.7. SUV is now about half what it was prior to treatment. He will be going to James Cancer Center monday for evaluation for a modified radical neck dissection. I have tried to read up on this but I guess I need it in laymen's term. I would appreciate any help I can get. Also, we're both a bit concerned that the chemo/rad. was done prior to any surgery. We have been told that this is a no no as it would make healing much more difficult after surgery.

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  • tnsilcncer
    tnsilcncer Member Posts: 64
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    Neck dissection
    Well, I can't offer advice because I'm not far enough out to tell you what to expect, only let you know that I'll pray for you guys. I finished 33 radiations and 2 chemos on February 18th and go for a selective right neck dissection on May 17th. I will post on here how it turns out and what I experienced so maybe that will help? Anyway, hugs and prayers!

    Karen
  • MarineE5
    MarineE5 Member Posts: 1,031 Member
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    Surgery after treatments
    rmowery,

    I'll try to answer your questions and I am sure others will follow when they check in.

    First, yes to the surgery after treatments. The healing does take longer. I was told that it could take twice as long after the radiation only because the DNA in the tissues radiated react differently now. I had my surgery first because of that. But each case is different. Your cancer Team may have thought it best to radiate first to reduce the size of the mass as you have indicated, it is now half the size it was before treatment.

    Second, I had a Radical neck disection which involved the removal of many lymphnodes and the SCM muscle. The Modified, may not require the removal of any muscles and will work in your husband's favor as far as neck movement in the future. The side effects of any neck disection may vary and in most cases can be taken care of with some Physical therapy and gentle massages for the movement of the lymphnode system to move the fluids that may build up around the face and neck afterwards. This does not happen to each patient, just making mention of it for you in case it does happen and you can be aware of it.

    Shout out your questions and there are plenty of knowledgable people here to help answer them.

    My Best to Both of You and Everyone Here
  • rmowery8699
    rmowery8699 Member Posts: 4
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    Neck dissection
    Well, I can't offer advice because I'm not far enough out to tell you what to expect, only let you know that I'll pray for you guys. I finished 33 radiations and 2 chemos on February 18th and go for a selective right neck dissection on May 17th. I will post on here how it turns out and what I experienced so maybe that will help? Anyway, hugs and prayers!

    Karen

    Neck Dissection
    Karen, Just want to thank you for replying. I wish the very best for you & will keep you in my prayers.
    Rose
  • rmowery8699
    rmowery8699 Member Posts: 4
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    MarineE5 said:

    Surgery after treatments
    rmowery,

    I'll try to answer your questions and I am sure others will follow when they check in.

    First, yes to the surgery after treatments. The healing does take longer. I was told that it could take twice as long after the radiation only because the DNA in the tissues radiated react differently now. I had my surgery first because of that. But each case is different. Your cancer Team may have thought it best to radiate first to reduce the size of the mass as you have indicated, it is now half the size it was before treatment.

    Second, I had a Radical neck disection which involved the removal of many lymphnodes and the SCM muscle. The Modified, may not require the removal of any muscles and will work in your husband's favor as far as neck movement in the future. The side effects of any neck disection may vary and in most cases can be taken care of with some Physical therapy and gentle massages for the movement of the lymphnode system to move the fluids that may build up around the face and neck afterwards. This does not happen to each patient, just making mention of it for you in case it does happen and you can be aware of it.

    Shout out your questions and there are plenty of knowledgable people here to help answer them.

    My Best to Both of You and Everyone Here

    Surgery After Treatments
    Thank you so much for your reply. I so appreciate the information.
    The report showed that the suv level had decreased from 7.8 to 4.7. Isn't that just the activity level of the cancer opposed to being the size of the mass?
  • MarineE5
    MarineE5 Member Posts: 1,031 Member
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    Surgery After Treatments
    Thank you so much for your reply. I so appreciate the information.
    The report showed that the suv level had decreased from 7.8 to 4.7. Isn't that just the activity level of the cancer opposed to being the size of the mass?

    You are correct
    rmowery,

    You are correct, the ( SUV) is now nearly half, the activity of the Mass that is of concern. I will edit my reply.

    I wrote>>>>Your cancer Team may have thought it best to radiate first to reduce the size of the mass as you have indicated, it is now half the size it was before treatment. <<<<

    My other reply won't let me edit the sentence to read ( reduce the SUV in the mass ). I need to proof read better before I hit the post button : )
  • Goalie
    Goalie Member Posts: 184
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    Surgery After Treatments
    Thank you so much for your reply. I so appreciate the information.
    The report showed that the suv level had decreased from 7.8 to 4.7. Isn't that just the activity level of the cancer opposed to being the size of the mass?

    Yes, after treatments
    They did my neck dissection after the rads and chemo. This is often the case that they want to kill just as much as possible and, as others said, shrink as much as possible, before going in. In my case they waited two months from the end of treatment before surgery to give the skin a chance to heal and also to do the needed scans before surgery. You have to stop glowing before they can scan you. Don't worry about this aspect of it.

    Nearly three months post-dissection I am lucky to have nearly total healing there and near-total movement of the head and neck. I just played a hockey game last night, in fact. I admit that I am very lucky and somewhere on the top end for recovery. Your mileage may vary, alas.

    Doug
  • D Lewis
    D Lewis Member Posts: 1,581 Member
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    Stanford
    My Doctor at Stanford, Chief of the Head/Neck Surgical Oncology Department, told me that my treatment would be chemo/rads first, and "salvage surgery" afterwards and only if anything remained to be surgically removed. In my case, chemo/rads took care of everything. I'm one year out, and so far, no masses left, and no hot spots left. So, I'm thinking it is not so unusual to be prescribed the chemo and rads prior to any surgery. It's probably based on the preference of the individual doctor.

    Deb
  • hawk711
    hawk711 Member Posts: 566
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    D Lewis said:

    Stanford
    My Doctor at Stanford, Chief of the Head/Neck Surgical Oncology Department, told me that my treatment would be chemo/rads first, and "salvage surgery" afterwards and only if anything remained to be surgically removed. In my case, chemo/rads took care of everything. I'm one year out, and so far, no masses left, and no hot spots left. So, I'm thinking it is not so unusual to be prescribed the chemo and rads prior to any surgery. It's probably based on the preference of the individual doctor.

    Deb

    Same as DLewis
    I am exactly like Deb, Rads and chemo for base of tongue, with 2 lymph nodes on left side of neck. I was to have "clean up" surgery if necessary also, but it was not necessary. I had a sizeable "hot" spot 3 months after treatment, but it had shrunk quite a bit. Now at 13 months after treatment I am clear on the PET scan and am considered to be "NED". Keep the faith as the rads and chemo can do a lot of healing by themselves so the need for surgery is negated. Best of luck to you. Keep the faith.
    Steve
  • KareGiver
    KareGiver Member Posts: 301 Member
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    hawk711 said:

    Same as DLewis
    I am exactly like Deb, Rads and chemo for base of tongue, with 2 lymph nodes on left side of neck. I was to have "clean up" surgery if necessary also, but it was not necessary. I had a sizeable "hot" spot 3 months after treatment, but it had shrunk quite a bit. Now at 13 months after treatment I am clear on the PET scan and am considered to be "NED". Keep the faith as the rads and chemo can do a lot of healing by themselves so the need for surgery is negated. Best of luck to you. Keep the faith.
    Steve

    Ditto
    My husband, tonsil cancer (even though they had been removed as a child), is halfway through treatment, 3 chemo/38 rads. At the beginning, they said surgery could not be ruled out. Tumor on side of neck is definitely smaller. Sounds like this treatment plan is pretty common (we're in the Chicago area). Positive thoughts coming your way...
  • KDDavis
    KDDavis Member Posts: 34
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    Neck dissection
    Well, I can't offer advice because I'm not far enough out to tell you what to expect, only let you know that I'll pray for you guys. I finished 33 radiations and 2 chemos on February 18th and go for a selective right neck dissection on May 17th. I will post on here how it turns out and what I experienced so maybe that will help? Anyway, hugs and prayers!

    Karen

    May 17th
    Karen, my family and will keep you in our prayers for tomorrow!
  • Jamie_Ann
    Jamie_Ann Member Posts: 35
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    Neck dissection
    Well, I can't offer advice because I'm not far enough out to tell you what to expect, only let you know that I'll pray for you guys. I finished 33 radiations and 2 chemos on February 18th and go for a selective right neck dissection on May 17th. I will post on here how it turns out and what I experienced so maybe that will help? Anyway, hugs and prayers!

    Karen

    Prayers for tomorrow.

    Prayers for tomorrow.