Thanks David for the concern about the primary, and reason I asked where the involved lymph was. Stacy, there is other info from the node like it being poorly, or moderately differentiated, non keratizing,etc, and noted it was SCC, which most H&N cancers are, and helpful for treatment. I didn't see it was HPV related until David mentioned it, but saw on subsequent threads it was. David is right that HPV positive has a ponderence to be Tonsil or BOT primary. Usually the first nodal path for orolpharyngeal cancer for neck metatses is in level II, and in oral cancer level I, but there can be skip Metasteses. This effects where high doses of radiation should be directed, and assume that was decided being he is in treatment already. Too bad they didn't find the primary, and didn't see if other work up tests were done to find the primary like a MRI, CT, PET, chest imaging, and if the node was in certain levels, a largynoscope with a direct biopsy for concerned areas, and possible tonsillectomy. Was a neck dissection done or was just the one involved node, removed, If there were two or more lymph involment there should be chemo along with radiation, and then if the is still nodal activity, a neck dissection will probably follow, if not already done, but think they went for radiation first, instead of a neck dissection first.

Like mentioned, HPV positive or not, this still is a deadly disease. HPV positive shows it responds better to treatment, has better outcome, both maybe up to 20 percent, but that doesn't add up to a 100 percent cure rate when the 5 year overall survival rate for late stage H&N cancer, which your has is less than 50 percent. It's more like 38 percent for oropharyngeal, and a little higher for oral cancer in the 40 range, and goes even further down based on other factors based on number of nodal involvement, distant metastases The sign of lymph node Metastases is a a strong indicator of prognosis, usually poor. The first shot at this is the best shot, when over 40 percent have a recurrence before the 2nd year. I'm in my 5th. The advise here from Christine, David, Cheryl, and others said are on target to get your husband motivated to kill this cancer once and for all.

Good luck, and take care.