lymph node testing for cancer

unitedsteel

I am going into the hospital at the end of the month for surgery.  My dr said the swollwn lymph node is either lymphoma or squamous.  Has anyone had this?  If squamous will take part of lymph node to find out what kind of cancer.  If no squamous found will take all lymph nodes on right side of neck.  Don't know what to expect after surgery.  Any advice would be appreciated.  Thanks

avisemi

Hi,
sorry you have to be here

Hi,

sorry you have to be here but glad you found us. I have received lots of support from a great group of folks here. Did you have a biopsy done? My husband had swollen lymph node (right neck). They did an aspiration needle biopsy which gave us the squamous cell diagnosis. He did not have surgery since the chemo did a nice job getting rid of the tumor in the neck. 

After biopsy came positive they did MRI, petscan and more to reach final diagnosis: nasopharyngeal squamous cell Carcinoma.

Where r u getting treated. If possible, go directly to a big cancer center.

it is scary and the road is not easy but you can do it!

Good luck! 

Bart T

LYMPH NODE REMOVAL

I had all the lymph nodes removed from one side of the neck during the same surgery as a hemiglossectomy. I’m almost three years out of surgery. If I recall 44 nodes were removed. The removal of the nodes was the lesser of the operations in terms of recovery and after-effects. There was a rather large incision (from about the ear to the chin along the middle of the neck), but it was placed in a crease in the skin. Now, the scar is barely noticeable unless you’re looking for it. Since I’m a guy who didn’t make a living posing for pictures, the scar didn’t bother me much.

Pain from the surgery cleared up within a few weeks, and I have just about full painless motion in the neck. I still do have a loss of sensation in the area of the incision, just enough that I switched to an electric razor. When doing dental work in the lower rear portion of my jaw, I can’t get numb with novicane, and I’m told that it was because the nerve channels in that area were disrupted. So the once that I needed work in that area, I had to go to a sedation dentist who did the work under general anesthesia. .

Many have problems with a condition which I believe is called lymphodema. It is swelling in the area of the neck due to fluid build-up because the lymph nodes have something to do with drainage. That problem is minimal for me, and when it starts to swell, I just massage the area a bit and I’m generally fine.

Bottom line at least for me was the neck dissection and lymph node removal was the least of my problems. I needed radiation after the surgery, and the radiation caused most of the problems I have today. Either way you slice or dice it, I’m still around to gripe about it, so that’s the real bottom line.

Frankly, I’d be a bit concerned about the uncertainty regarding your diagnosis and procedure. Nobody even talked to me about surgery until it was clear exactly what I had and what was going to be done. I suggest either you get a better understanding of what you have and what will be done, or find a doctor who can make a better or more clear diagnosis before surgery. 

I wish you the best. 

phrannie51

Welcome to our little...

home away from home (so to speak)....you have found the best forum on the internet for Head and Neck cancer.  My ENT did a needle biopsy in the swollen node, and it came back as SCC....however, he did tell me that should it come back inconclusive they would take the node, slice and dice it...to see if there was cancer in it.  Needle biopsies are famous for coming back inconclusive, and many people here have had the node removed rather than bothering with the needle.

You'll find many MANY people here who have had the neck dissection that your Dr. is talking about (where they take all the nodes)....and most if not all say that part of treatment was the easy part...quick to heal, and the scar seems to get lost in the neck....and is very hard to see after it's healed. 

For now, lets wait and see what you have....there's even a chance it's not either lymphoma OR SCC....one day at a time for now, ok?

p

CivilMatt

welcome

Unitedsteel,

That is a strong handle, welcome aboard.

A swollen lymph node was my harbinger of what was to come (surgery, rads & Erbitux).

For me, a jugular vein dissection and base of tongue surgery wasn’t bad and I healed quickly, the rads are a different story.

For you, as P51 said “it is not cancer until they say it is cancer” and I hope it is not!

Good luck,

Matt

wmc

Welcome and YES I have.

I had SCC [squamous cell carcinoma] is the type of cancer. Mine was just above my larynx which they removed and did a neck dissection on both sides to remove the lymph glands as a precaution. 48 on the left and 38 on the right. I was asleep so it wasn't that bad, but did take 8 hours of surgery. I hope you are going to a major Hospital that does this all the time. Going local for the biopsy is fine. From what I foung doing my resurch there are about 200 to 300 lymph glands in the neck so they don't really take all. They did section 2-5 on me and didn't do 1 which is under the chin. If they do one side they will cut you behind the ear and around to about the center of your neck. I had both and removed my larynx so mine was from ear to ear. You will have drain tubes in for several days. The side they do will be numb for some time, and may be forever. My left will always be numb but I got the feeling back on the right. Wow does it feel weard with headphones on, you can't feel them. SCC is very treatable. If they do radation and chemo it is a rough road you will begoing dowm. BUT many have been down that road before you and we will all be here to help get you through it. Were open 24/7.

I was back at work in 10 weeks and most of my job was talking. Just take one day at a time, and don't try to Google it, you can get so much wrong information if you don't know where to go. Your best bet is ask here as we all have gone through it or are going right now.

Bill

stayingpositive

United,
I also had the

United,

I also had the surgery you are discribing, my doctor Ear Nose and Throat doctor did the needle biopsy in his office and it came back inconclusive.

When my node kept swelling two weeks later they decided on the surgery to remove it, while in surgery, they removed and disected it, it came back positive with stage III metastatic malignant melanoma, they took 35 or 40 nodes. It took about 7 hours in surgery, I have a scar from the back of my ear to my adams apple.

I had 6 weeks of radiation and six months of in house chemo followed by six months of at home injections of interferon.

That was in feb of 2012...

I had a few problems with movement of my left arm (could not raise it above my shoulder while held straight to the side), i had nerve tinglings on my chest (felt like a sunburn), i had numbness on the left side of my face, neck and shoulder (some of that has gone away).

I went through physical therapy for the arm, took medications for the sunburn feeling and some of the numbness has gone away. I hear each case is different, but you will heal and get back to a normal life. LOL well, as normal as it can be....

Take it in stride, recovery is better if you stay positive......

unitedsteel

stayingpositive said:

United,
I also had the

United,

I also had the surgery you are discribing, my doctor Ear Nose and Throat doctor did the needle biopsy in his office and it came back inconclusive.

When my node kept swelling two weeks later they decided on the surgery to remove it, while in surgery, they removed and disected it, it came back positive with stage III metastatic malignant melanoma, they took 35 or 40 nodes. It took about 7 hours in surgery, I have a scar from the back of my ear to my adams apple.

I had 6 weeks of radiation and six months of in house chemo followed by six months of at home injections of interferon.

That was in feb of 2012...

I had a few problems with movement of my left arm (could not raise it above my shoulder while held straight to the side), i had nerve tinglings on my chest (felt like a sunburn), i had numbness on the left side of my face, neck and shoulder (some of that has gone away).

I went through physical therapy for the arm, took medications for the sunburn feeling and some of the numbness has gone away. I hear each case is different, but you will heal and get back to a normal life. LOL well, as normal as it can be....

Take it in stride, recovery is better if you stay positive......

Thanks to everyone, I am

Thanks to everyone, I am staying positive and this site has helped me greatly.

petroglyph

unitedsteel said:

Thanks to everyone, I am

Thanks to everyone, I am staying positive and this site has helped me greatly.

I concur with the others. It

I concur with the others. It ain't cancer until proven it is. And for me and others it's a mental exercise that anytime something tweeks or pulls or feels swollen etc. the brain wants to go "right there".

It's difficult for me that your dr. went right from a swollen lymph to suggesting surgery. If that is the case run, don't walk away from that doc, IMHO. Usually in a case like this they usually try a dose or two of anti-biotics to see if the swelling goes down. Tumors don't shrink like that.

Others have said and I concur wholeheartedly, get to a hospital that specializes in this. This is where each of us has to be the captain of our own ship. There is no one in this world who can care about your health better than you.

For sure you want a minimum of a fine needle biopsy with positive results before any kind of surgery. You need to have a sincere heart to heart discussion with your [would be] surgeon about where you are willing to go with this. There are different approaches as well. 

I was offered radiation or chemo, either or both to try and reduce the size of my necrotic lymph nodes and either follow it or not with other methods.

You need to fully understand if this is a metastatic tumor before getting anywhere near a surgeon. Know this if nothing else. If it is cancer, in this area it is probably SCC, or squamos cell carninoma. Although it is a dangerous disease, it is slow. You have time, you can not ignore it, but don't go into panic mode. YOU HAVE TIME. H&N SCC is also 85% curable, those are outstanding odds in your favor.

How long have your nodes been swollen? They should have done at least a ct and given you a size. That approach to me is barbaric. I too had the neck resection surgery, I am 13 months post op, and I saw my ent today. He said it looks great, although it does hurt some, nothing life altering as far as the scc goes. Get another opinion.

unitedsteel

petroglyph said:

I concur with the others. It

I concur with the others. It ain't cancer until proven it is. And for me and others it's a mental exercise that anytime something tweeks or pulls or feels swollen etc. the brain wants to go "right there".

It's difficult for me that your dr. went right from a swollen lymph to suggesting surgery. If that is the case run, don't walk away from that doc, IMHO. Usually in a case like this they usually try a dose or two of anti-biotics to see if the swelling goes down. Tumors don't shrink like that.

Others have said and I concur wholeheartedly, get to a hospital that specializes in this. This is where each of us has to be the captain of our own ship. There is no one in this world who can care about your health better than you.

For sure you want a minimum of a fine needle biopsy with positive results before any kind of surgery. You need to have a sincere heart to heart discussion with your [would be] surgeon about where you are willing to go with this. There are different approaches as well. 

I was offered radiation or chemo, either or both to try and reduce the size of my necrotic lymph nodes and either follow it or not with other methods.

You need to fully understand if this is a metastatic tumor before getting anywhere near a surgeon. Know this if nothing else. If it is cancer, in this area it is probably SCC, or squamos cell carninoma. Although it is a dangerous disease, it is slow. You have time, you can not ignore it, but don't go into panic mode. YOU HAVE TIME. H&N SCC is also 85% curable, those are outstanding odds in your favor.

How long have your nodes been swollen? They should have done at least a ct and given you a size. That approach to me is barbaric. I too had the neck resection surgery, I am 13 months post op, and I saw my ent today. He said it looks great, although it does hurt some, nothing life altering as far as the scc goes. Get another opinion.

The lymph node started in

The lymph node started in Sept. 2014, told Primary Doctor about and he said it came from TMJ not to worry.  I don't have TMJ.  Went to dentist first of 2015 for teeth cleaning and he felt it and said go to your primary dr immediately.  Went the same day, saw a nurse practioner, had blood work.  Blood work ok.  Went for ultrasound, showed a mass.  Have had needle aspiration, showed only lymph node cells.  Inconclusive tests.  The ENT said that since I am a smoker we need to have more tests in hospital.  Now he says squamous or lymphoma.  My ENT is also a oncologist.

wmc

unitedsteel said:

The lymph node started in

The lymph node started in Sept. 2014, told Primary Doctor about and he said it came from TMJ not to worry.  I don't have TMJ.  Went to dentist first of 2015 for teeth cleaning and he felt it and said go to your primary dr immediately.  Went the same day, saw a nurse practioner, had blood work.  Blood work ok.  Went for ultrasound, showed a mass.  Have had needle aspiration, showed only lymph node cells.  Inconclusive tests.  The ENT said that since I am a smoker we need to have more tests in hospital.  Now he says squamous or lymphoma.  My ENT is also a oncologist.

Enlarged lymph node......

Thought I should add this as it might help you understand, "It's not cancer until it is confirmed cancer by a doctor".

When I was about your age [a few years younger] and I did not smoke then, I had a lump in my groin area and it did not seem to go away. The dr said it was a lymph node and it just is not working right. They get infections out of your body and yours just stopped and got pluged and wont pass the fluid. Cancer was never talked about at any time, just mine needed to be removed, which they did. Mine just stopped working and got enlarged and stopped passing the fluid as it was suposed to do. I never had any more problems with it, they just removed it, nothing else was ever done. That was over 45 years ago. Yours might be the same. No good doctor will ever say it is Squamous or Lymphoma without a biopsy to confirm it.  I would get a second opinion. 

Bill

petroglyph

wmc said:

Enlarged lymph node......

Thought I should add this as it might help you understand, "It's not cancer until it is confirmed cancer by a doctor".

When I was about your age [a few years younger] and I did not smoke then, I had a lump in my groin area and it did not seem to go away. The dr said it was a lymph node and it just is not working right. They get infections out of your body and yours just stopped and got pluged and wont pass the fluid. Cancer was never talked about at any time, just mine needed to be removed, which they did. Mine just stopped working and got enlarged and stopped passing the fluid as it was suposed to do. I never had any more problems with it, they just removed it, nothing else was ever done. That was over 45 years ago. Yours might be the same. No good doctor will ever say it is Squamous or Lymphoma without a biopsy to confirm it.  I would get a second opinion. 

Bill

I concur completely with wmc.

I concur completely with wmc. Has anyone mentioned a PET scan? Do you have insurance that will pay for a PET if one is deemed appropriate for the evidence that makes your ENT suspect SCC?

You defininely want at least one 2nd opinion, which you are entitled to before even thinking about surgery.

I was a chain smoker for 47 years. They will continue testing you until they can prove to themselves that you are cancer free, long after you are tired of the procedures, especially since you are/were a smoker. I have since quit, something about my diagnosis helped me find my willpower to stop? 

You have had an enlarge lymph since 9/14, has it gotten any larger? Did the dentist see anything inside your mouth that would alarm them? It seemed odd to me, mine was being rushed I thought. I first presented with a sore throat, and it wouldn't leave for a year and again it seemed odd, after waiting a year for a diagnosis, the Dr's almost acted like they were going to put out a fire.

Of course the Dr's know best, but like I said before, you have time for another opinion, from the absolutely best source available to you. If you are within travelling distance of a premier facility, your ENT will help you get a second opine. You are not his first patient that has wanted another opinion. Mine got me "cuts in line" at the Mayo. These guys have all worked hand in hand before, they know the ropes, and they are aware that you are not. Stay the course, but from now on know, that you are the only person who can be your best health advocate. It can be a daunting chore, mine is, but time after time I have been so glad that I keep a copy of my files always. If you have the tech savvy you may want to consider uploading all your info and scans onto a thumb drive. It is hard to get another Dr. to do anything other than a quick scan of a radiologists report or synopsis. The will look at digital media, but I have found it hard to get them to look at paper files or discs of scans.

You will beat this regardless of what it is, but it is up to you. It is the week-end, you do not have a diagnosis, there is no good that can come from worry.

unitedsteel

petroglyph said:

I concur completely with wmc.

I concur completely with wmc. Has anyone mentioned a PET scan? Do you have insurance that will pay for a PET if one is deemed appropriate for the evidence that makes your ENT suspect SCC?

You defininely want at least one 2nd opinion, which you are entitled to before even thinking about surgery.

I was a chain smoker for 47 years. They will continue testing you until they can prove to themselves that you are cancer free, long after you are tired of the procedures, especially since you are/were a smoker. I have since quit, something about my diagnosis helped me find my willpower to stop? 

You have had an enlarge lymph since 9/14, has it gotten any larger? Did the dentist see anything inside your mouth that would alarm them? It seemed odd to me, mine was being rushed I thought. I first presented with a sore throat, and it wouldn't leave for a year and again it seemed odd, after waiting a year for a diagnosis, the Dr's almost acted like they were going to put out a fire.

Of course the Dr's know best, but like I said before, you have time for another opinion, from the absolutely best source available to you. If you are within travelling distance of a premier facility, your ENT will help you get a second opine. You are not his first patient that has wanted another opinion. Mine got me "cuts in line" at the Mayo. These guys have all worked hand in hand before, they know the ropes, and they are aware that you are not. Stay the course, but from now on know, that you are the only person who can be your best health advocate. It can be a daunting chore, mine is, but time after time I have been so glad that I keep a copy of my files always. If you have the tech savvy you may want to consider uploading all your info and scans onto a thumb drive. It is hard to get another Dr. to do anything other than a quick scan of a radiologists report or synopsis. The will look at digital media, but I have found it hard to get them to look at paper files or discs of scans.

You will beat this regardless of what it is, but it is up to you. It is the week-end, you do not have a diagnosis, there is no good that can come from worry.

Having CT scan tomorrow and

Having CT scan tomorrow and second opinion on Thursday.  Lymph node hasn't gotten any larger, its as hard as a rock.  Blood work shows WBC 12.5, from 9.5 in january 2015.  I greatly appreciate everyone for their input. The ENT said Pet scan after surgery.

petroglyph

unitedsteel said:

Having CT scan tomorrow and

Having CT scan tomorrow and second opinion on Thursday.  Lymph node hasn't gotten any larger, its as hard as a rock.  Blood work shows WBC 12.5, from 9.5 in january 2015.  I greatly appreciate everyone for their input. The ENT said Pet scan after surgery.

IMO, and that is all this is,

IMO, and that is all this is, and on the www to boot, but.

Breathe, I think it is the most important thing we can learn to do. In through the nose, out through the  mouth. I will stop for a minute and follow my own advice. OK, I'm back.

No matter what it will help your body, blood, spirit etc. to get a higher O2 saturation. Calm, you have time. These procedures are a real PITA, but by a very high margin, quite survivalble. You are on "the survivors" network btw.

The high WBC count shows your immune system is battling "something", we don't know what it is. Let's just say worst case scenario it is SCC. A necrotic lymph node isn't the cancer itself, it is a symptom of a cancer [it is also a symptom of a plugged lymph gland], if it is SCC, it more than likely originates somewhere else, and the dying cells from a tumor would be collecting in a lymph gland, causing swelling, because it couldn't excrete the amount of dead cells. That is what cancer is right, an uncontrollable cell growth?

Ok, back. SCC in the neck area H&N I believe comes from the base of tongue, BOT. A tumor is usually near the lymph that is swollen or excretes into that lymph node, so the origin of a swollen neck lymph usually comes from the BOT, and they usually do a biopsy of the BOT before suggesting surgery. In my case I had a CT, which indicated SCC, than I had biopsy's, than I had a an FNA, fine needlle biopsy, then a PET which came back indicating SCC, in two necrotic lymph nodes, then surgery, in that order. It was hard to pin down anyone who would state in writing that I definately had SCC. Around here it seemed no one, wanted to go on record either way, they were ambigous.

You are also in charge here, and can decide to take command of your health directives or you can turn control over to your ENT. I think most people take choice B. If I didn't have so much fear of medical procedures and I had blind faith in Dr's, I probably would have just shut up and listened and took the advice of the first ENT that I visited. I have taken control of my own ship and will live with my own choices, or at least that's my story.

I just hope that you thouroughly understand the procedures you have mentioned. The OP said remove part of a lymph, I think that was only a misstatement, the whole lymph comes out and it is biopsy'd. The OP goes on to say that all lymph's will be removed if the first one comes back cancer free? Yeah, they are ruthless to us smoker's. Pretty incredible the lengths they are willing to go to prove or disprove cancer.

Oh, I forgot, did you get sent to a dentist? They do that to first get the dentist's opinion. They see lots of tumors, and to assess and medically relevent [to surgery] dental needs. 

It does not seem that you have a diagnosis of SCC, like Mat said, it ain't cancer till they prove it is. Welcome, to our lives. Good luck, and keep thinking positive [breathe].

 

Skiffin16

Confused...

Why would your MD make you wait this long to determine cancer and put you through all of that anxiety...? 

I'd presume he could do an FNA or some other mode of biopsy and pretty much give you near immediate results..

My ENT saw me on a Friday, had me go for a CT and comeback on the same day, scoped me, and pretty much assured me that I had SCC Tonsils.. Set me up for surgery to temove the tonsils on the following Monday and determined at that time I was STGIII Tonsils, I also had a swollen lymphnode.

John

unitedsteel

phrannie51 said:

Welcome to our little...

home away from home (so to speak)....you have found the best forum on the internet for Head and Neck cancer.  My ENT did a needle biopsy in the swollen node, and it came back as SCC....however, he did tell me that should it come back inconclusive they would take the node, slice and dice it...to see if there was cancer in it.  Needle biopsies are famous for coming back inconclusive, and many people here have had the node removed rather than bothering with the needle.

You'll find many MANY people here who have had the neck dissection that your Dr. is talking about (where they take all the nodes)....and most if not all say that part of treatment was the easy part...quick to heal, and the scar seems to get lost in the neck....and is very hard to see after it's healed. 

For now, lets wait and see what you have....there's even a chance it's not either lymphoma OR SCC....one day at a time for now, ok?

p

After surgery

What were u able to eat after surgery?  I want to be prepared since I will be by myself after my surgery.  I thought of ensure or boost.  Thanks

debbiejeanne

welcome to the family

welcome to the family although, i'm sorry you may need to be here.  i had nodes removed on both sides of my neck.  no cancer found.  i can't remember the recovery, or if it was hard or easy as I had the neck disection the same time i had a total laryngectomy and was pretty much out of it.  i wish you the very best and i will definitely be praying that its not cancer.

God bless you,

dj

unitedsteel

debbiejeanne said:

welcome to the family

welcome to the family although, i'm sorry you may need to be here.  i had nodes removed on both sides of my neck.  no cancer found.  i can't remember the recovery, or if it was hard or easy as I had the neck disection the same time i had a total laryngectomy and was pretty much out of it.  i wish you the very best and i will definitely be praying that its not cancer.

God bless you,

dj

I had surgery on the 30th and

I had surgery on the 30th and was blessed with the news, "It's not cancer."  It was a warthin's tumor that was benign.  Thanks to everyone for your caring and support, I am so very thankful.

God Bless All of YOU!

 

petroglyph

unitedsteel said:

I had surgery on the 30th and

I had surgery on the 30th and was blessed with the news, "It's not cancer."  It was a warthin's tumor that was benign.  Thanks to everyone for your caring and support, I am so very thankful.

God Bless All of YOU!

 

Fantastic. Absolutely

Fantastic. Absolutely fanstastic. I hope everyone that doesn't have a positive diagnosis would see your story and read it. That is part of why cancer  scares us so much, the not knowing, dealing with waiting for results, etc.

Really glad for you and thanks for posting, I had wondered.