I just want to point out that David's case (which is similar to many peoples in terms of stage at diagnosis) is one where they knew already the cancer had advanced to the lymph nodes and thus that radiation would be done. So in that case, it makes sense to me they wouldn't see a need for doing a neck dissection before the radiation and chemo and would only recommend one afterwards if there was an indication that the rad and chemo hadn't cleaned everything up.

OTOH, in my case, and for many people who are Stage II, there is no indication, either from feeling the nodes or from a CT that the cancer has spread to the nodes BUT ****there is practically a one in three chance**** that it HAS but cannot be detected by any kind of non-invasive clinical observation (such as a CT or feeling the nodes) but WILL be found if a neck dissection is done. If you are one of those 30%, then what THAT means is your cancer is actually more advanced than it appears without a neck dissection and if you DON'T have a neck dissection you may end up being undertreated because of that.

So actually, ironically, from what I've seen here that often mean that people who appear to be stage II are more likely to get neck dissections before the decision about rad/chemo is made than people who have later stage cancers where rad/chemo is going to happen no matter what.

Nelie