The Upcoming Surgery: a Description

(Dr. Chuma gave me a brief overview of this a couple of weeks ago and I've been filling in the "why's" and "how's" -- from him and other sources -- ever since. Here's what I know now.)

The operation, which is known as a "Modified Radical Neck Dissection," has three primary goals:

• remove tissue that may contain cancerous squamous cells like those found in the original lymph node surgery. Then do a biopsy on this tissue to determine whether or not cancerous cells are present. In other words, how far has the cancer spread?
• remove two small hard, swollen and highly suspect lymph nodes located just under and behind my chin that we've found since the first surgery. (Were they there at the time of the first surgery? Don't know. They are tucked up very close to the chin bone itself and easily could have been missed. I believe they've gotten bigger since they were first noticed...)
• take samples of tissue from places where this type of tumor typically starts, including the base of the tongue, tonsil remnants, sinuses, larynx, and a few others. Then do a biopsy on these samples to try and locate the tumor itself. With luck, biopsy on one and only one of these samples will come back positive.

Most likely tissue for cancerous squamous cells would be, of course, the remaining lymph nodes on the left side of my neck. So a bunch of them will be removed for biopsy. In order to do this, the sternocleidomastoid (or "SCM") muscle on the left side of my neck will also be removed, since the muscle and its surrounding fascia contain lymph nodes that are often invaded by cancerous cells. This is a fairly large muscle, but I've been told by several people who ought to know that you can get away without it with no loss of mobility or strength. Yay!!

The jugular vein on the left side will also be removed. But this also seems to be okay, since you don't have just two jugular veins, but you actually have four: two superficial ones and two which are deeper in the neck. One of each on each side of your neck. (Did you know that?) So it's the shallow one on the left side that needs to go. Double yay!!

I've become far more comfortable with this than I ever thought possible. As I'll explain in the next posting.