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Thursday, April 24, 2014
Head and Neck Cancer
I have had a lump on my neck for almost 15 years. Never bothersome at all. Last checkup my doctor said it looked bigger and I went to an ENT for evaluation. He did biopsy, gave me prednisone and an antibiotic. The lump got smaller followed by some liquidy substance that came out my ear. I felt better and can hardly feel lump at all now. The ENT said biopsy report was "almost" sure it was cancer and he wants to do surgery. Do cancer lumps just shrink and almost totally go away with prednisone? I`m leary about having surgery. Thank you for your opinion.
Any physician should be concerned about any lump in the neck that persists for more than 2 weeks.....obviously the longer the mass is there lessens the possibility of a malignancy but does not rule it out. You do not provide us with all the details of your situation. However your physician seems to have approached the situation in a very logical manner.
It is not uncommon to see a reduction in size of a mass with steroids. Some cancers like lymphomas can shrink with steroids. Any tumor with an inflammatory component can also see a reduction in size with steroids. With all of this in mind your physician cannot ignore the information provided by the needle biopsy. You may want to have it reviewed by another pathologist, but if it is suspicious....it is suspicious and more needs to be done. More tissue needs to be obtained to get a diagnosis.
Removal of the mass is definitely reasonable. It will provide a diagnosis, and probably will solve the problem whatever the diagnosis. Discuss all of this with your physician, and remember that any lump in the neck is not normal. A firm diagnosis should be obtained.
Pierre Lavertu, MD, FRCS(C), FACS
Professor of Otolaryngology-Head and Neck Surgery
School of Medicine
Case Western Reserve University