What is a radical neck dissection? when is it done?

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What is a radical neck dissection? The surgeon removes a block of tissue from the collarbone to the jaw and from the front to the back of the neck. The large muscle on the side of the neck that is used for rotating, flexing or extending the neck is also taken out, along with the major vein on the side of the neck. Sometimes, a less drastic operation, called a supraomohyoid neck dissection is done. This takes out only the lymph nodes, the tissue surrounding the nodes and a muscle at the front of the neck. Another technique, called a functional neck dissection, saves the muscles of the neck, taking out only the lymph nodes and tissues surrounding them.
What kind of incision is made with a radical neck dissection? The incision depends upon what the surgery is for. It can run from below the ear to the collarbone. Everything in the front of the neck on one side or on both sides may be removed. This may include the lymph nodes, blood vessels, nerves, and the salivary gland under the jawbone.

What helps with nausea and vomiting from chemotherapy?

What can be done to help control my nausea and vomiting from chemotherapy?

Drugs called antiemetic agents are used to help lessen nausea and vomiting. They are usually given before the chemotherapy treatment begins. Nausea and vomiting vary from person to person and also depend upon the chemotherapy agent being given. Among the drugs that may be prescribed to help combat nausea and vomiting are Compazine, Thorazine, Phenergan, Torecan, Trilafon, Inapsine, Haldol, Decadron, and Metoclopramide. Most are given orally, intramuscularly, or rectally.

Can I take drugs at different times of the day to help control nausea and vomiting? 

It depends upon the drug. Some must be taken or given at specific times or else they will not be effective. However, most nausea and vomiting seem to occur 2 to 4 hours after the treatment and last less than 24 hours. For some drugs, and some people, getting the drug early in the morning (along with antinausea medicine), then taking the antinausea medicine again 4 hours later and eating a light meal, allows them to eat a large meal at dinnertime, free of symptoms. Others say that taking their treatment late in the day along with antinausea medicine and a sleeping pill seems to work. These people say they can sleep through the night and feel only slightly nauseous in the morning. Talk with your doctor or nurse to see if there is any way to experiment with the times you take your antinausea medicine, depending upon the drugs you are being given.

Do nausea and vomiting usually occur at specific times? 

Generally there seem to be three different kinds of nausea and vomiting experienced by cancer patients on chemotherapy:

• Nausea and vomiting which start a few hours after treatment and last a short time (this is the most common)

• Violent nausea and vomiting which is of 12 to 24 hours' duration

• A feeling of nausea which seems to be always with you (with this symptom you must force yourself to eat)

Is it true that marijuana can reduce nausea and vomiting? 

The active chemical compound of marijuana, called THC tetrahydrocannabinol has been reported by researchers to be helpful in controlling nausea and vomiting in some cancer patients. The researchers feel that the drugs used in chemotherapy often cause the patient to feel nauseous by triggering a response in the brain rather than a response in the stomach. Marijuana, they theorize, acts on the brain to block or at least suppress the response. Over the past 10 years, the National Cancer Institute has tested THC on 20,000 patients.

Is the THC tablet available to cancer patients? 

Yes, it is now available in prescription form under the trade name Marinol (dronabinol) and is manufactured by Unimed, Inc.

Does the THC tablet have any side effects? 

Since THC is a mood-altering drug, some cancer patients on chemotherapy reported problems in tolerating the moodaltering effects, even when THC was helpful in curbing nausea and vomiting. Particularly in some older patients, problems were severe enough to require hospitalization for psychiatric care. Side effects of THC include anxiety, hallucinations, disorientation and dizziness. Many doctors feel that other drugs available are effective for nausea and vomiting without exposure to mood-altering problems. THC is probably most useful for those patients who have had a history of pot smoking and are accustomed to the drug's mood-altering effects.

Chemotherapy: What can I do for nausea or vomiting?


Has hypnosis been used to curb nausea and vomiting? 

Some people are plagued with nausea and vomiting before the chemotherapy treatment begins. For some, just a glimpse of the highway leading to the hospital or the smell of the clinic will trigger an attack. Several centers are using mindcontrol techniques to help ease the anxiety that brings on this anticipatory nausea. Among the mind control techniques under study are relaxation, biofeedback, and self hypnosis, which patients can do before leaving home. Some centers are using classical music and pictures of pleasant scenes to help patients. Most are having some success with mind control techniques in giving their patients relief from the anxiety that can trigger attacks of anticipatory nausea and vomiting.

Sometimes the nausea takes away my appetite. Other times, even when I am not nauseated, I don't feel like eating. Is there something I can do? 

It is important for you to eat well especially a diet high in protein during your treatment period. Your appetite may be poor, but you need to make sure you are eating a balanced high protein diet in order to maintain your strength, to prevent body tissues from breaking down, and to rebuild the normal tissues that have been affected by the drugs. 

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