Head and Neck surgeon or plastic surgeon

Hello @anonymous624 I can't give you medical advice here but a head and neck oncology surgeon would be my choice. Since you are on Libtayo, I would assume your cancer has been classified HPV 16+. It is however curious to me that cancer on your forehead metastasized and morphed(?) into Squamous Cell cancer, which is typically an internal skin cancer such as the lining of the mouth, sinus, throat, etc.
Anyway, make sure your surgeon has a lot of experience with not only head and neck but cancer surgery primarily. Either way, it won't be a fun ride at the fair. Courage.

Thanks for replying! No, it is not HPV. We think that it traveled via lymphatic spread. Since it was an aggressive squamous, I had 25 radiation treatments to my forehead just to make sure there were no cancer cells missed by the Mohs surgery.

Hello @anonymous624. I also have metastatic SCC from skin origin, though mine was in my ear. Skin origin are never HPV associated per my Mayo Oncologist. My initial surgery included a temporal bone resection and select neck dissection with superficial parotid removal. My facial nerve was involved in the tumor so it was transected and the affected portion removed and reattached. The facial paralysis was total on that side as the nerve grew back together, then there is a fun thing called synkinesis where new nerves control different parts of the face. For example trying to smile on the affected side might raise your eyebrow a bit also.
It is a challenge but better than cancer.
But hopefully the Libtayo will shrink your tumor so no worries about facial nerve damage. Libtayo totally cleared my last kidney metastasis and I understand that it works better on skin origin SCC than mucous membrane origin inside the oral cavity. I had two surgeons at Mayo Clinic Rochester and both were ENT specialists, and the one who did the neck was also a plastic surgeon. Cancer surgeries of the head and neck is pretty much all he does. I would choose an oncological surgeon over plastics unless he/she specialized in cancer surgeries. You want a surgeon who does this type of surgery regularly, not occasionally. That is the benefit of a large referral center or cancer center where the doctors are quite specialized. Are you dealing with local doctors or do you have a referral center close by?

I am a patient at Moffitt Cancer Center in Tampa, FL. I have had 3 infusions of Libtayo. My fourth will be later in September and then scans in early Oct.
Depending on the results, I will have surgery or continue first with more Libtayo. Since I still have pain where the tumor is and it looks to be the same size, I don’t think it has shrunk yet. It takes longer for some people to respond,
I don’t want surgery too soon, due to possible facial paralysis.
Were you given any instructions from Mayo when you started Libtayo as to dos and don’ts during treatments? The only thing Moffitt told me was stop any supplements. I am curious what other cancer centers that prescribe Libtayo tell their patients. I want to do everything possible to allow this immunotherapy to work!

I am in Orlando and was treated at Mayo in Jax last year. I had both tonsils removed, a partial glossectomy and about 90 lymph nodes in the neck removed. You can probably reach out to them via their portal and ask. The ENT team there is accommodating.