Good morning @newtonguecancer. Oh gosh, I’m so sorry. The news that there’s now lymph involvement in your tongue cancer journey has to be so disheartening for you after all you’ve gone through so far. I’m sure you’re feeling discouraged and frightened having to face more surgery and worried that this even more invasive than previously thought.
Right now you have a decision to make whether or not to have the questionable lymph nodes removed or to have radiation treatments, is that right? Or is it too late for radiation? I’m a little confused as to why you’re switching back and forth between medical facilities to have your treatments. You had 3 out of 4 institutions recommending radiation for the perineural involvement. Did you opt not to do that? Did you go ahead with the surgery at JH to take off some remaining high grade dysplasia? Is there a reason you didn’t continue with the recommendations of John Hopkins?
If MSK removes the nodes will they also followup with radiation? You mentioned there was indication of perineural involvement. That means cancer cells have invaded the tissue around the nerves near the original cancer lesion. Even though there is was no indication in the tissue around the surgical site or lymph involvement at the time of the surgery, this can be a source of possible metastases. It would be beneficial to have the lymph nodes biopsied to see if the cancer has spread and removed as needed. But there may also be a need for other treatments as a followup because the lymph nodes are not the source of the cancer cells. (They’re the collection point). It seems that JH, University of Rochester and Bassett all were leaning towards a more preemptive approach. Did you discuss the swollen nodes with your doctor at JH?