Although I had a known primary at the base of the tongue, I too had Stage IV diagnosis, and had chemo, radiation and bilateral neck dissection. Doctors explained that the only way to have a realistic chance at a cure was to be aggressive, and that was all I needed to hear.

Head & Neck cancers are, as a rule, sensitive to radiation, which is one of the reasons radiation is a primary treatment modality. Most chemotherapy serves to make the cancer even more vulnerable to radiation.

I think the jury is out as to whether radiation itself causes more cancer. In my case, I'm pretty sure it was responsible for a skin cancer that popped up in the center of the radiation field on my upper chest. However, the point is that the skin cancer was easily removed and should cause no further problems. Might I get more in the future? Could something else crop up? Its possible, though certainly not probable. On the flip side, if I had only had the neck dissection and chemo, it was highly probable that I would die from the SCC in relatively short order. Choice was pretty clear from where I sat.

I realize choice may not seem as clear with an unknown primary, and each person has to make their own choice. I would personally do anything they offered to provide a reasonable chance at a cure.