Hi, I am writing from New Delhi, India.

Papa has been diagnosed with stage 2 oral tongue cancer. CT scan indicates POSSIBLE involvement of the lymph nodes and a MRI and PET scan are being done.

My question: is it normal for the surgeon to remove all or part of the lymph nodes as a precaution?

Does anyone have any statistical info on recurrence?

FInally what is your opinion on how lymph nodes should be handled if no involvement is present? One ENT we saw said to remove ALL the lymph nodes regardless as a precaution, while another said he does a "selective clearance" followed by detailed pathology.
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Whether it's normal or not for the surgeon to remove all or part of the lymph nodes really depends on the doctors and on what they see in the scans and other tests before surgery. I got the whole package when I had surgery--hemiglossectomy, resection, trach, and modified neck dissection--because that's what my doctor does. I was glad to have the dissection as it meant that the pathologist would be able to test all the tissue at the same time without requiring me to undergo further surgeries. I had 50 lymph nodes removed, all of which were clean.
julia, thanks. do you have any info about what the post op side effects and complications of neck dissection are? also I see you are in MI. my husband and i live in auburn hills (but are presently in new delhi to treat papa).

tasha
tasha,

I had a left neck disection and had 39 nodes removed... of which one had cancer. I understand the the fact that one is out of the original area also indicates a different staging. Any matastisis takes it to Stage three. It also determines where the radiologist need to focus the beams and determines future treatment. (so I'm told)

that's my two cents....

best wishes in New Dehli,

bob (pembo)
thanks...I haven't yet found out what happens when nodes are left and/or untreated. where would cancer spread to next? have you heard of the amas test and what's your oinion?
Natasha,

Honey, honey, honey. Slow down! You're all over the internet asking the same questions over and over and always ready with the next one before digesting the responses to the last.

You've either been given or have taken on (or both) a huge undertaking and appear to disregard what the medical professionals in New Delhi are telling you. Judging by your reports of Papa's tests, he is not in an advanced stage of oral cancer and should respond well to conventional treatment (disclaimer: IANAD - I am not a doctor). Am sure you're spending lots of time googling and may be overwhelmed by the information you've been given.

Your question about AMAS? Check this out from quackwatch.org:

Stay Away From Biomiracle Testing

It may be hard for we 'Mercans to comprehend, but there are many countries with medical expertise that surpass, equal or at least approach ours; India is one of those countries, particularly the medical facilities and doctors that you've been referred to.

You sound like a wonderful person and a spectacular daughter-in-law, but you can't get definitive answers from anonymous schlubs like me - we can give you the anecdotes but you're asking for stats - rely on the professionals for those answers. They're right there in front of you.

Best of luck to you and your family. Chill.

Mimi
Hi mimi,

I am in a big hurry in selecting the right cancer center, and yes I am panicing, as we need to choose our team and surgeon ASAP. I usually post the same questions on two different sites because I didn't get any responses to them initially. But you are right and I will calm down:-) Contrary to your opinions about medical in India, there is very poor data analysis in India, and virtually no support groups and also very few multidisciplinary cancer specialty teams. That said, surgery itslef is fantastic, waiting periods are often nil, doctors are highly accessible, but preventive care and availability of many western drugs and supplies is excrutiatingly expensive or impossible to obtain.

I do not trust any doctor without having a good reason, and the title doesn't even remotely impress me. I was blessed to find Ananth with the help of some of you, and he has been instrumental in guiding us towards the right hospitals around new delhi.

Without the schlubs here, I'd be lost. For example, one schlub was lovely enough to send me a link to the NCCN head and neck guidelines, upon which a huge amount of my questions will be based in coming days.

But you are right, I will calm down some. Thanks:-)

BY the way thanks a bunch for info about AMAS testing.
quote:
stage 2 oral tongue cancer. CT scan indicates POSSIBLE involvement of the lymph nodes and a MRI and PET scan are being done

Hello tasha

If the cancer is limited to the tongue and surgery will cause only limited morbidity, it is generally preferred as radiotherapy can be held in reserve. If lymph nodes are involved, a neck dissection is done and most are removed. Then, depending on the histology of the nodes, a decision on radiotherapy is made. If unsure about lymph node involvement a selective dissection for sentinel node biopsy is done. If they are sure that there is no lymph node involvement, as in an early case, no neck dissection is done. The CT, PET and MRI scans will help with making those decisions.

You could find statstics for Odds of a Recurrence recurrence but as every case is different, you shouldn't focus your energies on worrying about that.

Hope that helps.

Best wishes
Vinod Coffee

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