Hi I was positive for HPV 16 cancer that was in my tongue it was considered stage 1. They removed the primary tumor and then additional area on side of tongue that had moderate to severe dysplasia. The biopsy report from the initial cancer sugery revealed positive for hpv 16 and no spread to blood or lymph but some perineural involvement. I saw drs at Sloan Kettering, John’s Hopkins, and the University of Rochester. Of all of them only the one at Sloan Kettering recommended to take the lymph nodes out right at the same time of tongue surgery. Now today I went in for an appointment and he determined that I had a swollen lymph node that was concerning. Now I don’t know what to do next? Should I go to Sloan Kettering for neck dissection since it appears his idea was right and he does a lot of neck dissections ? I called today and they could get me in next Friday and ideas would be appreciated, it’s just crazy how it was undetectable in pet scan and even from the biopsy but there is a chance it could have still spread to my lymph nodes. Should neck dissection be automatic for people with oral cancer ? What should I do next ?