Page 21

Neck Disection:

      Although  not specifically mentioned before, the possibility of further preventive surgery was now put forward by the team oncologist. There was a possibility that malignant cells from the original tumour had spread to nearby lymph nodes in my neck, which is apparently not uncommon with this type of cancer. Radiotherapy is known to be less effective in this area, even though the scan evidence suggested that, in my case, it appeared to have done its job.

     The proposed surgery (Modified Radical Neck Disection) would remove lymph tissue from the neck area adjacent to the tumour site and thus prevent a recurrence of the cancer from this source. This seemed to be a good idea to me so, I had a discussion with one of the surgical team to find out more detail about the surgery and its possible after effects. Since the neck area is anatomically very complex, any surgery is time consuming and demanding. The added complication of previous radiotherapy makes the surgeon's task even more difficult, particularly in terms of the degree of nerve damage. I was warned about possible shoulder and lower lip mobility problems from a short, and long, term aspect.

     These side effects seemed manageable to me and not severe enough to outweigh the peace of mind which the surgery would bring. In hindsight I was naive and didn't obtain sufficient information about the procedure or its possible consequences to make a balanced decision. I was certainly mentally unprepared for the trauma associated with the surgery when it happened.