AK... PaulB can give you the info you need. The dr. is doing what he feels is right within his knowledge base. Your mother and brother need to now look outside this and move on to someone who can do more for him. I would take Paul B's advice. He's been in the same situation. Make arrangements to get all of his medical records and have them sent to whomever he suggests. Your brother is very young. He has this going for him in terms of being able to handle more treatment. If your mother has to take him out of state for treatment then I would suggest she do this. In this case there are two options... proceed with clinical trials.. (which have a limited scope in terms of cure) or seek a different surgeon/ENT/onclogist who can offer you more than just a trial. It does sound as though his cancer is resistant, so surgery in the hands of a skilled surgeon with what paul suggested... Intraoperative rads (specified area/smaller radius less damage) and proton therapy is your best and most viable option. People tend to hold on to hope that a trial will work, and for some it does. But when there are other options in practice (proton therapy. Intraoperative rads.) then Trials should be used either in conjunction with them (if possible - some trials don't allow this) or they should be a last case scenario.

Hugs.

Best of luck.