Head & Neck Cancer Archive Questions

Below are Dr. Strome’s answers to Head & Neck Cancer questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 15 of 17.

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Q : 1 10/08/2009	My sister, 24, was diagnosed with papillary carcinoma of the thyroid with local lymph node metastasis 6 years ago. She underwent hemithyroidectomy of the left lobe of thyroid. She has been on daily thyroxine replacement since then and is doing well. Now her USG neck test revealed swelling in the left side with enlarged lymph nodes. Could this be a recurrence of the papillary carcinoma? What should the next step be in the treatment process? This should be evaluated by needle biopsy and if the result is positive I would recommend resection of the remaining thyroid tissue as well as the nodes. She would then likely be a candidate for radioactive iodine and thyroid suppression. This should be discussed with her surgeon and endocrinology team.
Q : 2 07/13/2009	I have a lump on my thyroid which was found 2 years ago, but was dismissed as a goiter. Then it measured at 23mm/40mm and now it measures at 37mm/20mm, has microcalcifications and increased blood supply. I am having it removed so it can be determined whether or not the growth is benign or malignant. Is there a great chance that it is malignant? Since your growth has microcalcifications and high blood flow, it is very important to have it surgically removed so that an accurate diagnosis can be made.
Q : 3 06/17/2009	My husband had a total thyroidectomy for papillary carcinoma of the thyroid. The surgeon says both vocal cord nerves were identified and preserved, but that the right side had been stretched. My husband is now 3 weeks post-op and has no movement of the right vocal cord and minimal movement of the left. Is there any chance that one or both will not improve? Yes, there is still a chance that both will improve. That said, I would suggest getting a test called a Laryngeal EMG to see if there is any activity that may show signs of recovery.
Q : 4 05/07/2009	My Father has cancer of larynx. He had radiotherapy, but then had to have a total laryngectomy a month ago. After the operation, they said he had complications that resulted in a fistula. It is getting better, but his doctors still say that he needs reconstructive surgery to able to eat through his mouth again. Is this the appropriate treatment? A fistula is a connection between the swallowing tube and the skin. Sometimes fistulas do heal without surgical correction, but they often do require further surgery to be completely corrected.
Q : 5 02/03/2009	I am a 36 year old female and I was recently told that I have a 1.6 enlarged paraesophageal lymph node at the thoracic inlet. I also have chronic fatigue, rapid weight loss and I am unable to fight off colds or infections even with antibiotics. I am scheduled to see a thoracic surgeon, but what could cause this besides lymphoma? Unfortunately, it is very difficult to make this type of suggestion without taking a detailed medical history, performing an exam and reviewing your imaging studies. You should definitely see a thoracic surgeon. A biopsy may be the best way to determine what has caused the node to become enlarged.
Q : 6 12/07/2008	I am an adult male, age 77, and have been diagnosed with adenoid cystic carcinoma of the trachea. Does your department handle this disease? It depends where in the trachea it is. If it is high, then our Head and Neck Oncology multidisciplinary team would handle. If it is low, then generally our thoracic surgeon, Dr. Richard Battafarano, and his team would handle. Please feel free to contact me if you would like to discuss this further, at 1-800-888-8823.
Q : 7 04/07/2008	I had undergone partial laryngectomy for the recurrence of cancer on my right vocal cord after radiation (33 sittings), 3 years back. Now I get pain in the neck below the right hand side ear, and other discomforts while eating food and drinking liquids. My ENT doctor who performed the surgery says that there are no lymph nodes in my neck, so not to worry and take paracetomol tabs whenever pain occurs. From your experience, what type of problems are noticed after 3 years and beyond in patients who had undergone partial laryngectomy? I would get an imaging study of your neck, likely a PET scan.
Q : 8 03/25/2008	I have heard that certain high-risk HPVs have contributed to oral cancers. Due to chronic throat problems, I have been to the ENT doctor's office a few times. I noticed the doctor did not wear gloves; he just folded the gauzes back and forth and then held the tip of my tongue... Is it the standard method? Also, if the doctor happens to have some HPV on his hand, would I be at risk of getting the virus in my mouth? Gloves should be worn. I would ask your physician to wear them.
Q : 9 07/24/2007	Would you recommend an elective modified neck dissection for a 44-yr-old male patient recently diagnosed with well differentiated squamous cell carcinoma of the tongue, with no evidence of lymph node involvement? The patient has no risk factors, non-smoker, does not drink, and the lesion started as a leukoplakia (on the initial biopsy), and over one year, became painful, ulcerated, and was diagnosed as an abscess. Pathology was positive for Squamous cell carcinoma. This depends on several factors including the size of the lesion, evidence of blood vessel and or lymphatic invasion and the depth of invasion. I usually also get a PET scan but a negative scan will not influence my decision to do a neck dissection if the other fcators noted above are concerning.
Q : 10 12/18/2006	My aunt has a benign tumor in her pituitary gland. She is constantly in pain with head aches and sometimes experiences vertigo. She waited 8 months to see a specialist, who looked at her file and said there is nothing he could do for her. She does not want to have to take pain medication all of her life. Is there anything else we can do? Often these are operable tumors. She needs to see an endocrinologist and a neurosurgeon. They should be able to provide the best advice on next steps. Best of luck!
Q : 11 12/17/2006	I had papillary thyroid cancer 5 years ago and had a total thyroidectomy with a dose of radioactive iodine (the larger dose with the hospital stay). What are the "odds" of it returning? The cancer was contained in my thyroid. Do you think the blood globulin test for recurrance is accurate? In general, papillary thyroid cancer has an excellent prognosis. I would consult your endocrinologist regarding prognosis.
Q : 12 12/07/2006	My mom was just operated on for thyroid carcinoma. The doctor says it was incapsulated, that this is good, and that he will treat her with radioactive iodine. Is this good? What should we expect? Radioactive iodine is often used in conjuction with surgery for the treatment of papillary throid cancer. I would speak with your physicians regarding side effects etc.
Q : 13 12/01/2006	I have been diagnosed with a CBT measuring 4.5 x 4cm on the left side of the neck. I am a 49-year-old male in good health. How many CBT removals do you and your staff routinely perform? I am assuming you mean a carotid body tumor. Generally, we do these as a team in concert with a neurovascular surgeon. Please feel free to give me a call if you would like to discuss. We can then set up a visit.
Q : 14 11/20/2006	My husband completed 39 IMRT and 7 weekly chemo sessions, 4 weeks ago for his right tonsil and one node. On the first checkup with the ENT doctor, she wanted to perform a neck dissection without a CT. We didn't want to do this if it was not necessary, so she had him get a CT to see how it looked. Everything on the CT came back good, except for 2 calcified lymph nodes. She told him he definitely needs the dissection, and it had to be done within 6 weeks of ending radiation. We want to know if this is appropriate, or if he should get a second opinion, and do we have more than the 6 weeks post-radiation to do this. This is a controversial issue right now and there is not a straightforward answer. Rather, it depends on your initial nodal size, the results of post-treatment pet/ct, the overall treatment strategy which was used, i.e. did they radiate the neck at full dose or were they planning a neck dissection, and the findings on the current CT. I am happy to review your case but it would require a visit to Maryland and a complete review of everything that has been done. Alternatively, you could seek a second opinion closer to home.
Q : 15 11/10/2006	My husband had chemo and radiation for squamous cell carcinoma for the linguil tonsil area and removal of one lymph node in neck that was affected. He had to have all 8 molars removed due to damage and received Hyperbaric treatment prior to dental. He has been in remission 4 years but suffers from chronic dry mouth. His chest x-rays are clear and shows no signs of cancer to date. He also suffers from not being able to keep warm when the temperature goes into the 60's or below. Is there any thing that he can do to help the dry mouth & coldness? The dry mouth is a very difficult problem to treat. Regarding the coldness, please ask your doctors to check his levels of thyroid hormone. Some folks have decreased thyroid function after this treatment and this is known to cause coldness.

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