John,

In some cases I believe the "normal" test protocol dosen't exist. It sometime falls into the category of "gut instinct". Unfortunately there is no protocol that is 100% predictable. The recommendations fall into percentages towards or against a certain outcome.

What everyone here is saying is you should be well advised (which you may already be) and explore every advantage when dealing with this cancer. Second tries are much less succcesful with this SCC. On the other hand radiation is a beast to go through.

You are in a difficult position because of the options you still have. If I were you I would seek several more opinions from the best professionals you can find. NOT because your doctor is wrong, but because YOU need to make the right decision. Right now I think you need more information to make that decision.

take care

Mark, 21 Year survivor, SCC right tonsil, 3 nodes positive, one with extra-capsular spread. I never asked what stage (would have scared me anyway) Right side tonsillectomy, radical neck dissection right side, maximum radiation to both sides, no chemo, no PEG, age 40 when diagnosed.