He has the possibility to get past this with the surgeries and chemo, including the reconstruction of his mandible etc. at the time of the removal of the tumor mass. Stage 4 patients do make it, though their odds are tougher than cancers caught earlier. There is little doubt that lifestyle choices made caused this cancer to return, and you have heard plenty of that from previous posters. When you rhetorically ask

Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.