Bi-Lateral Neck Dissection

My 74 y/o mother was dxd w/base of tongue cancer in April 2007. She went through 35 radiation txts and 3 chemo (Taxil/Carboplantin). She is a month out from the last rad txt. Now her ENT has scheduled her for bi-lateral neck dissection to remove affected lymph nodes and the left jugular vein.  We know the surgery will be 6 hrs and she will be in the hospital 4-5 days but we don't know anything else about recovery from this surgery. Can anyone help me out with this?  How long is recovery? Will she require constant care at home?  We also know there may be after affects be it temporary or permanent.  Any information anyone has will be greatly appreciated.  Her surgery is scheduled for Aug 30th, 2007.

Mine wasn't the same, but let me tell you what I know.  I had a right side modified neck dissection 8/4. He only removed (15) lymph nodes, no other structures. It was a 2 hour surgery. I styed only 1 night in the hospital. It was virtually a painfree surgery and recovery. By 8/7 I was pretty much back to normal routine-just resting more. Of course, I am 54-that'll make a difference. My ENT was wonderful. Lucky me-all nodes were negative for malignancy! I had had 4 malignant ones we  knew of before-1 was excized and the others apparently destroyed by the 35 IMRT rad.in Mar and Apr. I had an unknown primary tumor in the head and neck area. Best of luck and my prayers are with your mother!  Gayle

 

On 8/15/2007 gayleann wrote:

Mine wasn't the same, but let me tell you what I know.  I had a right side modified neck dissection 8/4. He only removed (15) lymph nodes, no other structures. It was a 2 hour surgery. I styed only 1 night in the hospital. It was virtually a painfree surgery and recovery. By 8/7 I was pretty much back to normal routine-just resting more. Of course, I am 54-that'll make a difference. My ENT was wonderful. Lucky me-all nodes were negative for malignancy! I had had 4 malignant ones we  knew of before-1 was excized and the others apparently destroyed by the 35 IMRT rad.in Mar and Apr. I had an unknown primary tumor in the head and neck area. Best of luck and my prayers are with your mother!  Gayle

 

Gayle,

Thanks so much for your input. We met w/her ENT again since I wrote the original message and he answered a lot of our ?s/concerns. She will also be having a modified neck dissection so I am hoping her recovery will be smooth.  Good luck to you as well. 

I think my worst issue was due to throat damage from the radiation, (normal), my throat was swollen after surgery, and still is. Harder to swallow than before. Hurt my eating; and I wasn't eating too well anyhow. Did anyone mention that? How did she do wIth eating thru the radiation? Do they have an idea of what they'll find in there? Or is it just a precaution? Gayle

Hi there, I just wanted to share my dad's experience with you. He had a couple months of induction chemo with Taxol, Carboplatin, and Erbitux (he was diagnosed a stage III, treated like a stage IV) then he had combo chemo/radiation for 37 weeks--- well, he didn't finish through with the chemo because of a heart attack, and then on July 10, he had a billateral dissection. The doc told him he didn't know if he was going to have to do any kind of reconstructive surgery until he got in there. It was feared that he was going to have to take part of his tounge. He said it could be anywhere between a couple hours and twenty hours in surgery. Well---it was a 71/2 hour surgery---good outcome! He had around 60 lymph nodes removed and I think the doc "cleaned" up the area. He was accepting visitors THAT NIGHT and was out a few days later. He was able to take pretty good care of himself, and was eating the following morning (slowly, but surley)! He does have some shoulder numbness and swelling left in his neck. His saliva glands are still fried from the radiation, but he's happy as can be! This is DEFINATELY doable! He told me the pain from his back surgery was much worse. He was pretty tender (especially a few days after), but he is recovering, and sounds a lot better. Hope this helps. Let me know if you or anyone else has any questions. ~Aimee

 

On 8/16/2007 gayleann wrote:

I think my worst issue was due to throat damage from the radiation, (normal), my throat was swollen after surgery, and still is. Harder to swallow than before. Hurt my eating; and I wasn't eating too well anyhow. Did anyone mention that? How did she do wIth eating thru the radiation? Do they have an idea of what they'll find in there? Or is it just a precaution? Gayle

Gayle,

Thanks for this info. My mom already has a peg tube that she had prior to radiation. The pain and soreness in her throat is her biggest issue since radiation ended. She has only been able to swallow pills w/water through her mouth, everything else goes through the tube!. This dissection is an "insurance policy". ENT will remove 15 to 16 lymph nodes and possibly the right jugular depending on what he finds when he gets in there. He doesn't anticipate finding any further cancer and we are praying that is the case. Drs. feel because it was a small tumor and hard to find (base of tougue) that it was destroyed by the chemo/radiation.  Sx is Monday, so I will let you know after that. Thank you again.   

 

On 8/16/2007 Glitterrgirl wrote:

Hi there, I just wanted to share my dad's experience with you. He had a couple months of induction chemo with Taxol, Carboplatin, and Erbitux (he was diagnosed a stage III, treated like a stage IV) then he had combo chemo/radiation for 37 weeks--- well, he didn't finish through with the chemo because of a heart attack, and then on July 10, he had a billateral dissection. The doc told him he didn't know if he was going to have to do any kind of reconstructive surgery until he got in there. It was feared that he was going to have to take part of his tounge. He said it could be anywhere between a couple hours and twenty hours in surgery. Well---it was a 71/2 hour surgery---good outcome! He had around 60 lymph nodes removed and I think the doc "cleaned" up the area. He was accepting visitors THAT NIGHT and was out a few days later. He was able to take pretty good care of himself, and was eating the following morning (slowly, but surley)! He does have some shoulder numbness and swelling left in his neck. His saliva glands are still fried from the radiation, but he's happy as can be! This is DEFINATELY doable! He told me the pain from his back surgery was much worse. He was pretty tender (especially a few days after), but he is recovering, and sounds a lot better. Hope this helps. Let me know if you or anyone else has any questions. ~Aimee

Aimee,

Thank you so much for you info.  How old is your dad?  Sounds like he is doing really well after the neck dissection. He had basically the same txt as my mom except they didn't use the Erbitux although it was discussed if they didn't get good results from chemo/rad therapy. That combo has worked and her ENT doesn't anticipate finding any cancer when he operates on Monday. He said he will remove about 15 to 16 lymph nodes (Don't know if that is total or for each side) and possibly the right jugular vein. She has a really good attitude going in to this and she is a real fighter. I anticipate everything going well.  Thank you again. 

Well, it is not a simple deal. I had same may 05, 9hr surgery, over 100 lymph nodes & thyroid, 4 days ICU, 20 in hospital. Ear to ear, and vertical ea side, 7" scars. Trach and stomach tube. Recovery was slow, out 8 mos from work, then another 3 a year later. Lymphedema was significant, make sure you ask about that. At that age, mobility will be additionally difficult. I am 46. Make sure you have someone doing this that does many. The AMJS says experienced is 2 a month, I say not. My surgeon has done thousands, 20 a month or so. This is so connected to the skill of the surgeon. I went to the Surgical Institute, Zeg Lieberman / John O'Brien at Baylor in Dallas. I was in excellent hands and it still has changed my life forever. The quality of life for Moms depends on the surgeon, make no mistake. I am sure you have heard what could go wrong, so if I had it all to do over, I would want to know EXACTLY, what are you gonna do. where are you gonna cut, what are you gonna do, stiches , staples...trach, tube...The cut is going to cost the same, so get the best. My ENT wanted to do it, in the end, a head and neck surgeon...not a head and neck specialist. You want a professional cutter, that's all they do. You are buying experience not just knowlege, they must have both. These guys are from MD Anderson and Sloan, they have their own head and neck research center as big as the cancer center. I am telling you because no one told me, most of us are suffering and hard to access. All you can find is procedure type. Recovery is directly related to trauma, the more you know how to navigate all the delicate things...nerves, muscles etc...the better the recovery. These guys are not good because they are special, they are good because they have made the mistakes, listened to the patients, and know how to read the road. I complained and they said, wow, you are lucky to be alive, count your blessings, took me two years to get it. There will be wound drains, 4-8, try not to leave the hospital with them in, they are high maintenence. Pain meds are a given, if she has a history of ETOH or drug abuse, caution. She will have to go to PT, learn to use the muscles in her neck and arms differently and build strength. The pool is ideal. She will have a myriad of healing pain from numbness to shooting, electriacl like pulses. She will tire very easily. Too much to write, feel free to contact. She will be fine, you will get through this, I will pray for you. You, must do what you can. The Dr's won't care if you bail, get a cutter. jeff 

On 8/14/2007 Lmblitz wrote:

My 74 y/o mother was dxd w/base of tongue cancer in April 2007. She went through 35 radiation txts and 3 chemo (Taxil/Carboplantin). She is a month out from the last rad txt. Now her ENT has scheduled her for bi-lateral neck dissection to remove affected lymph nodes and the left jugular vein.  We know the surgery will be 6 hrs and she will be in the hospital 4-5 days but we don't know anything else about recovery from this surgery. Can anyone help me out with this?  How long is recovery? Will she require constant care at home?  We also know there may be after affects be it temporary or permanent.  Any information anyone has will be greatly appreciated.  Her surgery is scheduled for Aug 30th, 2007.

 

 

On 8/17/2007 Redstring wrote:

Well, it is not a simple deal. I had same may 05, 9hr surgery, over 100 lymph nodes & thyroid, 4 days ICU, 20 in hospital. Ear to ear, and vertical ea side, 7" scars. Trach and stomach tube. Recovery was slow, out 8 mos from work, then another 3 a year later. Lymphedema was significant, make sure you ask about that. At that age, mobility will be additionally difficult. I am 46. Make sure you have someone doing this that does many. The AMJS says experienced is 2 a month, I say not. My surgeon has done thousands, 20 a month or so. This is so connected to the skill of the surgeon. I went to the Surgical Institute, Zeg Lieberman / John O'Brien at Baylor in Dallas. I was in excellent hands and it still has changed my life forever. The quality of life for Moms depends on the surgeon, make no mistake. I am sure you have heard what could go wrong, so if I had it all to do over, I would want to know EXACTLY, what are you gonna do. where are you gonna cut, what are you gonna do, stiches , staples...trach, tube...The cut is going to cost the same, so get the best. My ENT wanted to do it, in the end, a head and neck surgeon...not a head and neck specialist. You want a professional cutter, that's all they do. You are buying experience not just knowlege, they must have both. These guys are from MD Anderson and Sloan, they have their own head and neck research center as big as the cancer center. I am telling you because no one told me, most of us are suffering and hard to access. All you can find is procedure type. Recovery is directly related to trauma, the more you know how to navigate all the delicate things...nerves, muscles etc...the better the recovery. These guys are not good because they are special, they are good because they have made the mistakes, listened to the patients, and know how to read the road. I complained and they said, wow, you are lucky to be alive, count your blessings, took me two years to get it. There will be wound drains, 4-8, try not to leave the hospital with them in, they are high maintenence. Pain meds are a given, if she has a history of ETOH or drug abuse, caution. She will have to go to PT, learn to use the muscles in her neck and arms differently and build strength. The pool is ideal. She will have a myriad of healing pain from numbness to shooting, electriacl like pulses. She will tire very easily. Too much to write, feel free to contact. She will be fine, you will get through this, I will pray for you. You, must do what you can. The Dr's won't care if you bail, get a cutter. jeff 

On 8/14/2007 Lmblitz wrote:

My 74 y/o mother was dxd w/base of tongue cancer in April 2007. She went through 35 radiation txts and 3 chemo (Taxil/Carboplantin). She is a month out from the last rad txt. Now her ENT has scheduled her for bi-lateral neck dissection to remove affected lymph nodes and the left jugular vein.  We know the surgery will be 6 hrs and she will be in the hospital 4-5 days but we don't know anything else about recovery from this surgery. Can anyone help me out with this?  How long is recovery? Will she require constant care at home?  We also know there may be after affects be it temporary or permanent.  Any information anyone has will be greatly appreciated.  Her surgery is scheduled for Aug 30th, 2007.

 

 

I had had a PEG tube throughout radiation, too-but it was removed about 3 wks prior to the neck dissection because I was doing so well. I had it over 4 mos-good for her she can still have it and use it. My pathology showed the ENT removed 15 nodes and tissue and YAH-all clear for malignancy. For me, also, it was an extra precaution, and now we know the radiation DID get it all in the neck. I am healing very well and couldn't ask for a better recovery. Keep us posted! Gayle