Diane, thanks for your input. A cancer care team evaluated my case and recommended RT without surgery, and without chemo, in light of two considerations, 1) no "clinically significant" evidence (CT results and palpitation) of nodal involvement, and 2) my job as a teacher. MRI is ordered but not done yet. Likelihood of microscopic N1 is 15-20%, hence RT is also recommended for nodes bilaterally. They make their recommendation, then your H&N specialist explains each possible option in detail, the attending risks and likely benefits. Final choice is not placed on the patient's shoulders without clear recommendation. Instead, they communicate which options are preferred and why, e.g., which will have what side effects and the likely prognoses of each. For example, in my case, definitive RT (RT alone) was recommended over surgical excision of primary/flap reconstruction + bilateral node excision (and whatever post-surgical treatment is recommended, e.g., RT yes or no)--but the latter was said to have about the expected effectiveness for longterm disease control. They told me to evaluate and indicate my own preferences with respect to morbidities between RT and partial glossectomy/reconstruction. The cancer team have their own considered view of these issues. They debated whether post-surgical swallowing and speech issues was a slightly greater concern in my case, due to my job (I'm a teacher) than RT's xerostomia, dental issues, and bone necrosis. So, no, they are not allowing me to formally "decide" in the sense they will do anything I think best for me. Instead they are giving me as much informed consent as possible, and MAY accept different treatment preferences I may have based on all these matters in my case. If anyone is aware of similar decision circumstances (equally good/equally bad) and what the final considerations were, and what the morbidity outcomes were in those cases, obviously I would greatly love to hear about them before Tuesday. I'm leaning in the direction of definitive RT because the cancer team recommend that option in my case, and the Clinical Guidelines for base of tongue SCC, T1-2/N0-1/M0, do so as well.