Question About New Neck Lymph Node After Radiation/Chemo in 9/2023

Hi Russ and All,

Only because I tend to be a little more pragmatic and intuitive instead of initially panicking, here I am again. My husband was diagnosed with Stage 1 base of tongue cancer (HPV+) in July 2023 (so a little over a year ago). He had 7 weeks of radiation to his left base of tongue and left 2 affected lymph nodes (but also received a bit lesser radiation to the right side of his neck, even though scans showed no metasteses to that side (so they radiated both sides). He also had 7 weekly doses of Cisplatin during that time, all of which he tolerated fairly well (other than losing about 30 pounds and has probably regained 15-20). He is actually at a much healthier weight now for his diabetes. Treatment was 9/6 to 10/27/23 (7 weeks as I said).

Anyways, today he had a routine dental visit (his second since his post-treatment PET in February 2024). Note also that his PET 2/24 showed NED, and he also had a camera/scope in late May 2024 by one of his tumor board doctors that also showed NED. The hygienist at the dentist today saw a swollen lymph node on the opposite side of his neck from the original tumor (so on his right side). She was concerned enough (about the size she thought) that he should get it checked by his cancer doctor(s). Unlike the first left side swollen lymph node which he noticed himself (which brought us to his cancer journey), he did not see, notice or feel this right sided one.

Tomorrow we are going for labs and seeing the Physician Assistant to his Oncologist for a check-up about this. I talked to his Oncologist nurse this afternoon and she made things happen. We also very much like and trust this PA.

So here's a question. Russ I've seen you write these TONS of times. Never assume you have cancer until they say it's cancer (or a recurrence). The question: Can 7 weeks of daily radiation to your head/neck cause reactive lymph nodes like this to swell going forward in your life?

I tend to think it's a possibility as I said, they radiated both sides of his head/neck last year, and saw nothing when his tumor board doctor scoped him in late May. He also saw his Radiologist in mid-August (he sees 3 of his tumor board doctors who will rotate the first year post-treatment every 3 months). Radiologist did not scope him in August, but his PA and he both did the whole speculum into his mouth/throat and again saw nothing. But of course we did not know anything about this "swollen lymph node" until the hygienist mentioned it today.

I personally have reactive lymph nodes (even had my left side one biopsied in 2019 and it was benign) so anytime I have the slightest virus it swells right up. Although my husband has not (thankfully) been sick like that.

Other than this, he is doing very well. Slight dry mouth (particularly at night), but not bad. Taste is maybe at 70% (but some things are still coming back more lately, particularly he loves tomotoes, spices anything he can season). Nothing tastes bad anymore, although he said sweets sometimes he can taste the first couple of bites like normal and then the taste goes away.

He has regained his strength and back to work 3 days/week (he's 68 so he does not need to work but loves it).

Anyways, would like to know your thoughts (or anyone else with this experience).

Swoosh13