Radical neck dissection

Hi Bev. It depends on what the primary is doing. Some cancers do have a tendency to spread to quite a few lymph nodes. Sometimes cancer can be found in nodes that didn't show up on any scans. Some of the spread is too small to be seen even on PET/CT. The only alternative is to irradiate a large area of neck which actually is riskier than surgery in some cases. I don't think a neck dissection is that risky. He will need some physio afterwards  but he should be OK.

I don't imagine his team would be advocating an unnecessary procedure.

Is your son's cancer HPV positive?

Hi Bev.  I, along with quite a few on here have had one. 

There seem to be a number of definitions of a radical neck dissection but the one I use seems to be in common NHS use - that is the removal of all the lymph nodes from jaw to collar bone.  I guess depending on how invasive a cancer it other parts of the neck would be removed at the same time.

In my case we were chasing the cancer as the primary was unknown at the time.  I had tonsils taken as well.  I am grateful for my surgeon convincing me to have my first (of 2) dissections as it was that which actually detected the cancer.  Previous needle biopsies were clear.  I think it was intuition that made him push.  Maybe the same with your son's surgeon.

In the end, as a precaution, I had all the lymph nodes removed on the right of my neck - and aside from the original one, none showed cancer.  I did not move onto radio or chemo.

All surgery carries a risk.  That said, I have not suffered any significant life changing effects from the surgery.  By the time I was 18 months post surgery I suddenly realised that some of the limited movement I originally had was back thanks to good physio.  There are others on here who have maybe suffered more, but generally with time it is OK.

Physical recovery was within about 14 days and relatively pain free - or at least I did not notice the pain as they took my tonsils at the same time.  That does hurt!  At 16 days I got on an aircraft to the USA and a week later was swimming with manatees on the Florida Gulf coast.

Outwardly the scars from both dissections are almost invisible.  The residual effects I have are lack of feeling in my chest wall and the strangeness of scratching my neck and feeling that scratch at the top of my ear!  I also have a lack of saliva due to the surgery.  That is probably not as bad as with radio, but being surgical there is no chance of it returning.  Keeping hydrated solves that problem.

There is a lot more detail I and others could go into if it would help you and your son gain assurance as to the reality of a neck dissection, but I hope my story has partially put your mind at rest.

I can't comment on the reasoning behind going for the "radical" option but just from my experience; my consultant told me it was the "easy" bit ahead if RT/chemo and he was right. Mine was down as a right sided "partial" but once they got a look inside they saw more worrying stuff so decided on a "modified radical". My right side jugular was "sacrificed" along with my accessory nerve but it really wasn't difficult to recover from, I was in hospital for five days in all.

Feels like a big deal for us but it's routine for the surgeons so try not to worry.

Hi beesuit.no his cancer isn't HPV positive. And like you say Ihis team wouldn't do an unnecessary procedure. I think I'm just frighten for him. Thankyou for reassuring me.

Hi Peter it's so reassuring to read your timeline of recovery. I do believe the surgeon is doing it as a precaution and he as said he Hope's he wont have to go on for further surgery by doing this.iso pleased your doing so well after such major surgery my son will also have a speedy recovery. Thankyou for your sharing your story.

Forgive me mikeo I thought I was replying individually to each person. How long if you dont mind me asking was your recovery.for such a major operation that's great you was out of hospital in 5 days. They've told my son 4 days in high dependency and possibly 2 wks in hospital overall but hopefully he might get out sooner. Did you have a tracheostomy.

Thankyou to all of you for commenting.

I didn't have a tracheostomy, no; if your son's having one that would probably explain the high dependency/two week stay. I had six weeks "recovery" time between the op and my radio/chemo starting but in fact the recovery time was much less.

Hi Bev 

i had a neck dissection, temp tracheostomy, maxillectomy and reconstruction of palate/maxilla from arm flap. 

I had 1 1/2 days HDU and total if 11 days in hospital over Christmas. Tracheostomy stayed in 6 days, all healing well and still recovering. I was told I’d be in 2 weeks too . 

elaine

Bev what else are they planning on doing to him whilst he is in surgery?

Hello all so for late reply. Hi Peter hes having tumor removed from inside his cheek,neck dissection, skin graft from arm to cheek connecting blood vessels and a temporary tracheostomy. So similar to elaine who commented above. Its sounds such alot in one go fortunately he seems to be taking it all in his stride. It's me and his wife that sick with worry