What is radical neck disection and why do some head & neck cancer patients have to have it and others don't? Thanks!

MAUR, Well for me it was the removal of my right jaw bone from my cheek to just the other side of my chin. My lymph nodes on both sides, the jug vein, most of the nerves, tho they try to say as many as the can, the floor of my mouth, all my bottom teeth, my tonsils and 75% of my tongue. I am sure I have left something out but this gives you an idea. That is radical. Some people don't have to have this procedure because of where their particular cancer is located.Or how big the tumor is. It just depends on how far they have to operate to get it all, clear margins. I hope I have helped you in some way. I am sure Doc will come on and explain it a lot better, Always Vicki Lynn

See this article on Radical Neck Dissection from the health encyclopedia made possible by the Dr. Joseph F. Smith Trust Fund.

More from Head and Neck Tumors

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Treatment of the neck

Either irradiation alone or radical neck dissection will control metastatic squamous cell cancer to a single small neck node more than 90% of the time if there is no extracapsular tumor spread. Hence, radiation treatment may easily provide prophylactic treatment of the neck if control of the primary tumor is undertaken with irradiation. Traditionally, if the tumor in the neck was N2 or greater, or if there was tumor beyond the confines of a node, radical neck dissection and irradiation were combined for optimal control of the neck tumor. More recently, evidence suggests that N2-N3 disease that has a complete clinical and radiologic response to induction chemoradiotherapy may not require a complete neck dissection. This concept continues to evolve.

Types of dissection

There are several approaches to the surgical treatment of the neck nodes in patients with head and neck cancer. The two main types of neck dissection are comprehensive and selective dissection.

Comprehensive neck dissection entails complete removal of all lymphatic tissue from the neck (levels I-V). A radical neck dissection includes comprehensive node dissection with removal of the sternocleidomastoid muscle, jugular vein, and spinal accessory nerve. Modified radical neck dissection was developed to diminish the morbidity of the classic operation. The most important structure to preserve is the spinal accessory nerve.

Selective neck dissection consists of the removal of lymph node groups at highest risk of containing metastases from a primary cancer. In such procedures, the lymph nodes removed correspond to the most significant drainage basins of specific head and neck tumor sites. These are staging operations usually performed in patients with a clinically N0 neck cancer. If metastases are identified, further treatment to the neck will be required. A selective neck dissection should not be employed as the sole treatment of clinically palpable disease.

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Hope that helps.

Vicki&Dr Vinod,

Thank you both so much for your reply! Vicki, y ou have been through so much. You must be such a strong person! Why did you need the radical neck dissection though? Did you have radiation too? I am still trying to understand all this.My friend finished his radiation on July 14. He is just starting to swallow water. He is getting frustrated and really wants to eat! izza: He is really bummed about his weight also.Any sugg.for weight gain other than the boost and ensure he is already using?Thanks again!Maur

Hello Maur., I had to have the neck dissection because the """C""" that was on the floor of my mouth had now spread into the jaw. They had to remove the jaw bone and replace it with a bone from m leg. They also removed 75 percent of my tongue. I cannot and have not tried to swallow anything by mouth since I was in rehab. I am terrified to even try. I almost choked to death that day. But I know that I am going to have to start trying to agian. As far as weight gain, I have gained all the weight back, plus some. However I also take in 5 novasorce a day. They are like ensure but have more calories to it. I have a feeding tube for nutrition. Maybe you need to drink more than you are of them to make sure that you are getting enough calories. I ish you well with it. You are in my thoughts and my prayers, Always Vicki Lynn

Vicki,

Thank you for your reply. My friend is doing the ensure and boost plus now but is hoping to be able to swallow soon for extra calories. izza: How long after treatment do the doctors leave in the peg tube? Rod is anxious for some normalcy in his life. He has never really been sick in his life and this cancer thing devasted him as you all know. He is also a very nervous person and has not been doing well emotionally since being diagnsed in April. I am hoping this will make him a stronger person.He went back to work part time and I think mentally it makes him feel better, I am afraid he will over do it though. He called yesterday and said when he woke up the left side of his mustache fell out! Is this normal for 4 weeks after radiation? He had both sides of his neck treated but the tumor was on the left tonsil. Alos is there a time frame for when someone should be able to swallow again? Thanks everyone and God bless! Maur