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 is metastasis and why is it dangerous?

When will the doctor usually order a bone marrow study? 

Usually bone marrow studies are ordered if some abnormality shows up in the complete blood count or peripheral smear. It is a routine test for suspicion of leukemia or to check if cancer has spread to the bone marrow. The presence of abnormal blood cells is frequently an early sign of tumor cell invasion of the bone marrow.
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What is a metastatic workup? 

A metastatic workup is done to see if cancer has spread to other parts of the body. It usually consists of bone and liver scans; sometimes brain and lung scans are added.

Why would the doctor order a bone scan if my cancer is in the breast? 

This is a relatively routine check, so don't let it frighten you. It is done because the bone is a common place for breast cancer to spread.

What does the doctor determine from the liver scan test? 

Although they are not truly diagnostic, these tests are valuable in alerting the doctor to the presence of liver involvement. The intravenous injection of radioactive material helps to accurately outline liver size, shape, and position and to detect the presence of abnormalities that alter the structure of the liver.

What specific tests does the doctor do to find out whether or not the cancer has metastasized? 

For the most common sites to which cancer spreads, the general diagnostic techniques and treatment are as follows:

Lung: 

This is the most common site for cancer of other organs to spread. X-rays, tomograms, bronchial brushings, scans, fiberoptic bronchoscopy, and biopsies are used in diagnosing lung metastases; chemotherapy and sometimes surgery are used for treatment.

Bone: 

Metastases to the bone from cancers which start in other organs are more common than is primary bone cancer. Diagnosis is done by x-ray, bone scans, and gallium scans. Radiation, chemotherapy, and hormonal therapy are used for treatment.

Liver: 

Metastases to the liver from cancers which begin in other organs are more common than is liver cancer itself. Ultrasound and liver scans are used to diagnose it. Radiation and chemotherapy can be used for treatment, depending upon the primary site of the cancer.

Brain: 

Brain metastases are detected by physical examination and then usually confirmed by brain or CT scan. The treatment is usually radiotherapy or corticosteroids.

Am I wise in not wanting to know the extent of my disease? 

It is certainly your privilege to specifically tell your doctor not to inform you if your diagnosis is bad. However, knowledge of what is happening to you really is more valuable than not knowing.

Should I ask my doctor to explain my case to me? 

The fact is that the better you understand what is happening to you and what the alternatives are, the more likely you are to help in making the right decisions about your own care. The doctor has both a right and a duty to give the patient reasonable knowledge about his condition.

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