u/ViviBene

Update: thanks for all the advice and support. We decided to seek out additional opinions and were able to get into MD Anderson next week and Mayo at the end of the month, both in Phoenix. We canceled the surgeries with the ENT. We both feel better about about this plan. Thank you all again!!

We met with my husband's surgeon today. He was diagnosed with HPV+ SCC at the base of the tongue. The surgeon wants to proceed with a neck dissection and then removal of the tumor. Based on palpation, he thinks there is one malignant lymph node. The surgeon said no PET scan is necessary before surgery. He works independently and is not sending my husband's case to a tumor board. Does this sound normal?

The surgeries are tentatively scheduled in 10 days for the neck dissection and 14 days later for the excision. While I appreciate moving quickly, I feel like we aren't getting all the information we need to make informed choices. The surgeon would not say how confident he was on whether clean margins could be obtained and that if they weren't, chemo and radiation would be required. He was not a fan of the de-escalation trials. We're trying to find somewhere to get a second opinion in the next 9 days, but I'm wondering if we should hit the brakes on the first surgery. Any thoughts or advice are much appreciated !

My husband was diagnosed with HPV+ SCC of the base of the tongue, at least stage one per pathology of the lingual tonsil, but not formally staged yet. We have an appointment with the surgeon tomorrow. He has a neck dissection and tumor excision tentatively scheduled in July. We just got the diagnosis a couple weeks ago, so we're in the early stages of trying to navigate choices and information.

Knowing what you all know now, what questions would you recommend asking the doctor?

My husband was just diagnosed with HPV+ SCC. He underwent a biopsy of a lingual tonsil a couple months ago that was originally read as negative, but underwent a tonsillectomy last week and the pathology came back with a finding of SCC. We just got the results today, so we're a little shell shocked. I'm trying to navigate treatment options and figure out how to pick out an oncology practice or facility. We're in Phoenix, so Mayo and MD Anderson at Banner are both here. Any advice or recommendations would be much appreciated!! Thank you!

I have insurance that falls under the Aetna Choice POS II network, which requires pre-certification of a procedure. Unbeknownst to me, my doctor's office called the wrong Aetna pre-certifcation phone number (despite having copied my insurance card with the correct number) and were (erroneously) informed that pre-certification was not required. I had the procedure, and the claim was subsequently denied for failure to obtain pre-certification. We were able to confirm the doctor's office did not call the right Aetna by the reference number the doctor's office provided. The doctor's office sought reconsideration of the denial, and Aetna again denied the claim for failure to get pre-certification and also stated that I could not be balance billed for the procedure because the doctor is an in-network provider who failed to follow the pre-certification requirements. Nevertheless, I am being billed as a cash-pay patient. The doctor's office uses an outside billing company who says they cannot do anything and I'm not able to get anyone from the doctor's office to get back to me. Any advice on how to proceed? It doesn't seem I should be liable for the doctor's staff's error.