Partial Neck Dissection

Angb1026

A little back story, I was diagnosed with papillary micro-carcinoma in 2010. After I had the left lobe of my thyroid removed. Upon finding the bit of cancer I made the decision to go ahead and remove the right lobe as well. More cancer in the right side. Going on four years. At my last checkup my thyroglobulin levels were elevated. Radio-iodine scan revealed a"hot spot". MRI to get a better look.

2 weeks from today I am scheduled for a partial neck dissection, to remove the lymph nodes in my lower neck, both right and left sides. This is extreme for me. Has anybody else had this done? And what are some things I can expect?

thank you 

Baldy

Neck Disection

Almost exactly three years ago, I had a similar surgery to the one you're scheduled for in two weeks.  Mine was more extensive than the one you'll be having and I had everything done at once, total thyroidectomy and the neck disection.  My scar runs about ten inches from my lower left neck to just below my right ear, the surgeon called it an apron incision.  From what you're describing, it sounds like yours won't be nearly as extensive as mine was, maybe no more extensive than your previous two surgeries.  I think it likely your recovery will be much like what you already went through for your other two surgeries, maybe less since they won't have to go as deep as they did for the partial thyroidectomies.  You might lose some sense of feeling near the incision and you may have some itchiness occaissionally.  You may also experience some wierd nerve related things that will eventually go away, for some months after my surgery it felt like somebody was tugging on my right ear lobe every now and then.

Some background - I was diagnosed after they biopsied a lymph node in my right neck at the level of my adams apple and found papillary cancer cells.  I too have {or as I hope, had} the micro kind, the four foci ranging from .8mm to 2.6mm.  Of the fifty plus lymph nodes they removed {levels I through VI}, only one more had cancer cells and it was immeadiately adjacent to my thyroid.

Do they recommend RAI therapy for you?  If not, I'd be interested to know why.  They did for me, though it was a small dose.

Alan

Angb1026

Baldy said:

Neck Disection

Almost exactly three years ago, I had a similar surgery to the one you're scheduled for in two weeks.  Mine was more extensive than the one you'll be having and I had everything done at once, total thyroidectomy and the neck disection.  My scar runs about ten inches from my lower left neck to just below my right ear, the surgeon called it an apron incision.  From what you're describing, it sounds like yours won't be nearly as extensive as mine was, maybe no more extensive than your previous two surgeries.  I think it likely your recovery will be much like what you already went through for your other two surgeries, maybe less since they won't have to go as deep as they did for the partial thyroidectomies.  You might lose some sense of feeling near the incision and you may have some itchiness occaissionally.  You may also experience some wierd nerve related things that will eventually go away, for some months after my surgery it felt like somebody was tugging on my right ear lobe every now and then.

Some background - I was diagnosed after they biopsied a lymph node in my right neck at the level of my adams apple and found papillary cancer cells.  I too have {or as I hope, had} the micro kind, the four foci ranging from .8mm to 2.6mm.  Of the fifty plus lymph nodes they removed {levels I through VI}, only one more had cancer cells and it was immeadiately adjacent to my thyroid.

Do they recommend RAI therapy for you?  If not, I'd be interested to know why.  They did for me, though it was a small dose.

Alan

The oncologist is

The oncologist is recommending radio-iodine and possibly external radiation. 

Baldy

Angb1026 said:

The oncologist is

The oncologist is recommending radio-iodine and possibly external radiation. 

External Radiation

I'm surprised about the external radiation, the only posters on here who have mentioned that have had metastisis in places that were either inoperable or very difficult/risky operations {lung mets & thoracic lymph nodes come to mind}.  If it were me, I would be reluctant to go that route.  I think I would wait and see if the surgery and RAI were effective.

Where is the "hot spot"?  My surgeon told me that lymph node involvement is almost always on one side of the neck or the other, but not both.  Is it in the thyroid bed?  My pre-RAI/post-surgery scan showed a "hot spot" very close to the thyroid bed that was thought to be a thyroglossal duct remnant.  Whatever it was, it wasn't in the one year post RAI scan.

Alan

Angb1026

Baldy said:

External Radiation

I'm surprised about the external radiation, the only posters on here who have mentioned that have had metastisis in places that were either inoperable or very difficult/risky operations {lung mets & thoracic lymph nodes come to mind}.  If it were me, I would be reluctant to go that route.  I think I would wait and see if the surgery and RAI were effective.

Where is the "hot spot"?  My surgeon told me that lymph node involvement is almost always on one side of the neck or the other, but not both.  Is it in the thyroid bed?  My pre-RAI/post-surgery scan showed a "hot spot" very close to the thyroid bed that was thought to be a thyroglossal duct remnant.  Whatever it was, it wasn't in the one year post RAI scan.

Alan

lower right side if the

lower right side if the neck...

radio-iodine scan showed the lower right side of the neck. Then there was some confusion with the MRI showing something on the left. Surgeon looked it over and said the scan showed the hot spot on the right from behind. And the MRI picked it up from the front. we spent some time looking at the scan and the MRI to determine exactly where and what we were looking at. 

I am at a loss to what questions to ask. I took for granted that I was cured. Now feel like I am starting over. Learning new things. 

External radiation is a bit scary to me. My Mom just finished radiation and is burned pretty bad. And with radiation of the throat area I worry about saliva glands among other things. I will definitely be asking a lot of questions before I agree to that.

Baldy

Angb1026 said:

lower right side if the

lower right side if the neck...

radio-iodine scan showed the lower right side of the neck. Then there was some confusion with the MRI showing something on the left. Surgeon looked it over and said the scan showed the hot spot on the right from behind. And the MRI picked it up from the front. we spent some time looking at the scan and the MRI to determine exactly where and what we were looking at. 

I am at a loss to what questions to ask. I took for granted that I was cured. Now feel like I am starting over. Learning new things. 

External radiation is a bit scary to me. My Mom just finished radiation and is burned pretty bad. And with radiation of the throat area I worry about saliva glands among other things. I will definitely be asking a lot of questions before I agree to that.

Questions

All the ones you're asking here.  You might also want to find out how experienced your oncologist is with thyroid cancer and how experienced the surgeon is with the operation you'll be having.  I don't have an oncologist, instead I have an endocrinologist who specializes in thyroid cancer.  My surgeon is a head/neck specialist who has done hundreds of similar operations.