Neck dissection decision

Capybara said:

The surgeon said I could opt to have a full neck dissection on one side or go out of area for a scan and monitor the lymph nodes.

Hi. I presume this is sentinel node biopsy? If it is and it delays your surgery by only a short time that’s what I would go for but that’s a personal opinion 

Hi Capybara

I did not have the same cancer as you as I had jaw cancer, however I had a neck dissection as part of my treatment. In fact I have had 2 neck dissections over time. One was part of my jaw surgery and then a few years later one on the other side of my neck as a stand alone op as a precaution. For me both of the neck dissections have caused me very little trouble other than a change in sensation and a slight feeling of tightness where the scars are. The recovery from them was quick and I have been left with a thin scar that is hardly noticeable. I know others have had different experiences. My team highly recommended the neck dissections so I followed their advice. Just wanted to let you know that my particular  experience wasn't too bad. I was left temporarily with a reduced range of movement in my shoulder and arm on that side but this resolved quite quickly for me. Others have said it has lasted longer and they needed physio so it can be variable.

Ask all the questions you need answered before going ahead though.

Best wishes on making the decision that is right for you. Trust the advice that your medical team give you as they have a huge amount of experience.

Lyn

Good evening Capybara, sometimes offering you choices can make our decisions harder, im very much like Lyn with similar operations including neck dissections, mine healed up ok and i do not have any side effects from it just the tightness of the skin to begin. With me, they had to remove quite a few lymph nodes (I can't remember how many now) as they looked suspect. My last operation was in 2010 so times have moved on with better treatment and operations. Sometimes they dont know what they will find until they start/during the operation so its hard to tell what needs to be done. If your consultant is confident they can get by with doing a neck dissection it might be worth considering it just means they will have to keep a closer look out with the lymph nodes, i would advise not to have any radiotherapy afterward just in case more surgery is needed further down the line, maybe you could bring these points up with your team. All we can do is offer advice from our own experiences. Good luck with your meeting on Wednesday. Take care.

                                                                         Chris x

Hi Chris

Could you clarify what you mean about not having radiotherapy afterwards in case further surgery is required.

I had radiotherapy after my first op and neck dissection but not until a couple of months after my surgery so that everything was completely healed. Also had radiotherapy after my second op but this was a year after my second neck dissection.

I understand about keeping radiotherapy in reserve if required later but it was highly recommended by my team so must have been thought necessary so the choice for me was fairly obvious.

Lyn

Hi Capybara I was treated for base of tongue cancer that spread to both sides of  my neck lymph nodes and had chemo and radio which was fine  for a year or so . Then someone drove into the back of my van and I rang my cancer nurse who arranged to see consultant . Had a neck dissection and they removed 33 lymph nodes 2 were cancerous.  Maybe the crash saved me who knows  . I personally would go with their advice . All the Best Regards Minmax

Hi Capybara I had tongue cancer with surgery in December 2023.

i had a sentinel node biopsy which is much less invasive than a full neck dissection. The scan is used to identify the lymph nodes the tumour is draining into and only those few are removed. The surgeon who treated me said one of the benefits of this scan is there may be lymph nodes requiring removed on both sides of the neck. Once they are sent for examination only about 20% of people require further surgery on their neck so quite good odds.

I agree with Dani that if it is only a short delay it might be worth it but only you and your team can weigh up the risks and benefits to you.

Wishing you good luck for your surgery and a speedy recovery.

Hi Cabybara, it's so difficult when we're given choices like this when newly diagnosed and in that shocking early stages of learning all about our cancers but just to throw a bit of balance into the mix that hopefully you might find helpful and not negative. I've a different cancer aswell but 8 months ago I had a major bilateral neck dissection and chest dissection for thyroid and lymph node removal but I'll be honest, I've found the recovery quite hard. Even now I'm still finding my neck and shoulders really painful, stiff and tight and am now accepting they probably always will be to some degree. (The scar itself no problem at all and you can hardly see it now). But that said there was no options for me, I completely trusted my consultant who did the surgery and he was absolutely brilliant and I believe that's all we can do really.

It's such a personal decision and do take into account in all you read that there are even many different types of neck dissections in what they have to remove but given your situation and after my own experience, I would echo what Dani said (although I've no medical training like she does) as long as it doesn't delay your treatment too long. All that said as you can see, lots of others have replied and not had too many problems with their neck dissections. Hope that's helpful :)

k9crazy said:

I've found the recovery quite hard.

We can't give medical advice and mine is never in that capacity. I just recall other people's experience. We have another forum member (In the same hospital as the OP) who is very unhappy that she went ahead with the surgery. I just think that if you can take the one or two nodes that are draining the cancer rather than masses of neck tissue it must be better if it is a viable option

I have just had tongue surgery, no flap as the area was small enough.

The surgeon wanted to do a sentinel neck biopsy, however it would have meant a 3-4 week delay, so he opted to not wait. He has mentioned the possibility of a neck dissection, but wanted to decide based on the histology results after the surgery.

I've not yet heard anything about the results.

Good evening Lyn, i think its because my radio and chemo were wasted after my first operation as it did not stop the cancer and came back twice more this caused issues when i had skin grafts during my second and third operations because the radiotherapy damaged the skin tissues. I think it was just a normal procedure to have the full works after a cancer operation. Back in 2008 i did not know anything about head and neck cancer or what damage the treatment could cause i just wanted them to get rid of the cancer. Nowadays i think we have a better understanding of the treatment and procedures on offer. I was 48 at the time and had a young family, mortgage, etc so you go into panic mode. I have never regretted having it done and will always be grateful to my consultant and his team. Hope it makes some kind of sense , all the best.

                                                              Chris x