JB,

There's a lot here so I'll answer as many questions as I can with the information you've provided, I'll share my personal opinions and thoughts however please know I'm not a medical professional so take that as it is.

A mandiblectomy is a very big surgery and yes it can be performed after chemo. Unlike most OC patients I had rads/chemo first to try and shrink my tumors in order to make surgery a possibility due to the shear size of them. I responded well to treatment and then had my surgery performed at one of the top programs in the states (UWMC ranked 12th in ENT at the time by US News). Between the neck dissection and mandiblectomy I spent 17 hours on the table. Understand, a mandiblectomy is an advanced procedure, especially if the tumor is large or in a bad spot and not every surgeon will be able to do it.

A patients overall health going into that surgery is one of the determining factors on if they will perform it...I'm assuming they believed that your mom wouldn't be healthy enough to survive the procedure. There are a lot of questions I have though as to her care anyway as to me it doesn't make sense.

Chemo generally isn't used as a stand alone tx with OC, it's normally used in conjunction with rads to enhance the effectiveness of RT. Where Cheryl is right, it's a poison but it only attacks fast growing cells in the body. Standard of care with advanced stages of OC is surgery then rads + chemo, deviations are generally made for tricky cases and are done by tumor boards where several medical professionals are given a chance to study and weigh in on the best treatment protocols.

As far as the Cytogen machine goes, I've never heard of it nor could I find it in a quick search. My personal opinion would be to get your mom stateside and try and find a surgeon as really surgery or rads or the combo of both are the only proven ways to beat this disease.

Best of luck

Eric