Chemo radiation to lymph nodes vs neck dissection

Hygienist97

Hello, it’s been a while since I last posted . The first time was for treatment advice for my husband back in December 2017 and many members offered very useful information at that time. My husbands 13 week post treatment PET scan is approaching and the scanxiety I see discussed on the boards here is setting in. His treatment was removal of tonsils tumor on right only no clear margins and 1-2 lymph nodes involved No neck dissection just chemo radiation recommended for the lymph nodes both sides of neck. My concern at this point is wether or not the rate of NED is best achieved with or without neck dissection or are the % the same! Any input would be appreciated.

CivilMatt

go eat some popcorn

Hygienist97,

I only had one lymph node removed from my neck. It was entangled with my jugular vein and my ENT did a jugular vein dissection along with removal of the ulcer from my tongue. I believe he trimmed to clear margins.  I did not have any other lymph nodes remove (no 75 node neck dissection) and neither my ENT, my rad onc. or my chemo onc. suggested we remove more lymph nodes. If they had suggested more removed I would have said yes without (too much, maybe a little) hesitation. While I have learned a lot about H&N cancer I have not taken the time to find out WHY, sometimes they go for broke and others they simply do not see the need? I believe I received what treatment I needed, and as of today, I am 6 years, 2 months and 11 days post.  That is very good for a former stage IVa, SCC, BOT, 1 lymph node, HPV+ (surgery, rads, Erbitux).  

 

I do try to eat well, take my meds on time, get all the vitamins I need and hopefully I will be ok.

 

I did not know much about the Erbitux I agreed to take, but wondered if it was the best choice when compared to the very successful results the H&N patients receive from the Platinum based chemo (the gold standard).  I asked my chemo onc why she choose the Erbitux over the Platnum based chemo and (I believe she said) she had good results with a cancer presentation like mine and he did not want me to go through the often terrible time with the side effects we see on here daily from Platinum based chemo.

 

You are asking for % and I normally do not do % the variables can be many.  A NED without a neck dissection is still a NED.  Do not let the past treatment decision ruin what should be a joyous step forward in the H&N member’s post cancer timeline.  IF, things go south, then I will apologize to you and you can spit on my picture (BUT I wish you would not).  After all, what are you going  to do now?  Have you heard of Botox Parties, Butt Implant Parties or other crazy things that people do (even when the percentages (%) are not in their favor?   Well, I don’t want to read about “local H&N member, Hygienist97 receives neck dissection without guarantee of NED’s forever”.

 

Take care. How is everything else going with him.

Matt

DarcyS

No percent but...

My husband had chemo and radiation to treat ssc of the piriform sinus stage 4 T1N2bM0 over 5 yesrs ago.  At the University of Chicago we were told surgery would be plan b if the chemo and radiation were not successful.  They  said this protocol would also help preserve swallowing function, speaking and was as effective without doing surgery as well.  5+ years later and doing great.  Scanxiety is something I remember well.  Second guessing the treatment decisions was also part of my thought processes.  I also liked to know the numbers, but they were not encouraging for his diagnosis. They are only numbers.  Every person is different.  Wishing you good health and great results!

donfoo

no formulas

The fact is every incidence of cancer presents unique circumstances and variables. Each case is reviewed by experienced medical professionals and the best recommendations are offered. There are many other factors than the type of treatment it is just speculation if just chemo, chemo and rads, or surgery and etc. etc. is the determining factor. Remember, the doctors know best and build a treatment plan using all available tools and procedures. Please rest assured your options are good. That said, you can seek a second opinion from another team if that makes you more comfortable. good luck. don

dalaitom

donfoo said:

no formulas

The fact is every incidence of cancer presents unique circumstances and variables. Each case is reviewed by experienced medical professionals and the best recommendations are offered. There are many other factors than the type of treatment it is just speculation if just chemo, chemo and rads, or surgery and etc. etc. is the determining factor. Remember, the doctors know best and build a treatment plan using all available tools and procedures. Please rest assured your options are good. That said, you can seek a second opinion from another team if that makes you more comfortable. good luck. don

I agree with getting a second

I agree with getting a second opinion. I felt I was in very good hands with my first set of doctors and then got second opinions from the new doctors that are part of the clinical trial I'm in. A couple of major differences. I was first told I would need radiation to both sides of my neck and after chemo/rads I would need a modified radical neck dissection. New doctors said I only need radiation to one side and no need for neck dissection. Good luck with whatever you choose.

OKCnative

My first doc wanted to cut

My first doc wanted to cut first - neck dissection and then robotic surgery on the base of my tongue.

I didn't agree and sought a second opinion from a cancer center as opposed to an individual doctor.

The cancer center agreed with me and felt radiation and chemo first was the best course of action.

So glad I sought the second opinion. I'm now 6-months post treatment, all signs of cancer are gone and I never went under the knife.

wbcgaruss

Glad to see your Comment OKCNative

I see my ENT today at 3 and I have a recurrence of cancer.

Originally throat cancer now have a spot under left side if tongue.

Had a PET scan clear everywhere else.

He is going to remove cancer with a partial glossectomy and frozen insections.

I will run this by him in the discussion to see what he thinks.

Maybe I could get by with radiation and chemo.

Thats what I had the first time no operations.

But since I was previously radiated it may cause a problem. 

I will be discussing all options with him.

I absolutely trust my ENT is a nice guy and open to ideas and discussion and takes his patients to heart.

PCB Joe

wbcgaruss said:

Glad to see your Comment OKCNative

I see my ENT today at 3 and I have a recurrence of cancer.

Originally throat cancer now have a spot under left side if tongue.

Had a PET scan clear everywhere else.

He is going to remove cancer with a partial glossectomy and frozen insections.

I will run this by him in the discussion to see what he thinks.

Maybe I could get by with radiation and chemo.

Thats what I had the first time no operations.

But since I was previously radiated it may cause a problem. 

I will be discussing all options with him.

I absolutely trust my ENT is a nice guy and open to ideas and discussion and takes his patients to heart.

A friend had his first

A friend had his first recurrence about a year ago. He was given erbitux and additional 29 rads. About a month ago, he had jaw surgery for osteonecrosis. My ENT and Med Onc at Levine Cancer Institute said if I had a recurrence, they would give me chemo and possibly surgery if necessary, but NO rads.