Thanks for the feedback. Some answers:
-she is being treated at a CCC - Dana Farber in Boston.

-We are waiting results for HPV. The doctors tell us that the results will not change their treatment recommendations.

-The team (after the tumor board review) has given us the two options and say that the end result will be the same. This gives me great comfort that we cannot make a wrong decision. It's up to us to make the choice. Needless to say, the surgeon is pro surgery, and the chemo onc. prefers the non-surgical option!

-The options:
-surgical option: surgery+chemo+rad
-non-surgical: chemo+rad, with a 33% chance of need surgery post-treatment.

Of course, we feel a lot of pressure to make a decision very soon. If she goes the non-surgical route, then we have the rad dry run on Thursday and chemo the following Monday.

I know every case is different, but for what it's worth, my husband was a chemo, then chemo/radiation patient, with surgery left on the table as a possibilty, if needed. He's one of the lucky ones, the chemo/rad's worked very well (2 clear scans, knock on wood). It's our understanding that what really works to kill this cancer is not the chemo (only shrinks), but the radiation.

Have the explained the risks to you of going both ways? My husband had the same 2 options, although from 2 different institutions, and the chances of survival were the same either way. My thoughts are if you're at a really good CCC, let them try to get it with the chemo/rad, then use surgery as a salvage treatment, hopefully avoiding the further insult of surgery.

Hi little bird, the difference that HPV and non HPV status makes is this. HPV cancers respond well to rads and chemo, and non HPV cancers are often best dealt with by using surgery, then rads and chemo - just because non HPV cancers can be more aggressive.

Take care.

I actually found that the surgery was a piece of cake compared to the rads and chemo, but mine was negative for HPV.

I was also HPV negative. The reason why they gave me the rad option was that the tumor was entirely removed with clear margins in the tongue and all of the nodes removed through the neck dissection came back negative for cancer.

My surgeon never anticipated that rads would not be necessary as my PET was positive on both sides of my neck for lymph node involvement (turns out a false positive).

At the end of the day, your mom will have to weigh the pros and cons of each option, but I feel very fortunate to not have had to go through radiation.

Good luck!

Ditto what Tina said... surgery is a much easier recovery than rads and chemo, and the long lasting effects of rads and chemo are way more difficult than the tightness, and arm weakness from surgery. Both of which will change over time with therapy. Take care.

I really doubt it will be HPV+ and if that's the case I would treat this as aggressively as possible.

Ditto.... If it's not HPV... surgery then rads and chemo is best.

Hi LB

I personally hate it when doctors who are supposed to be experts give you options like this - as if you have any chance of making an informed decision. I have no problem with the doctors stating the options provided they THEN tell you what they, the experts think.

My suggestion is if your mother doesn't have a very strong preference and you are all unsure, that you ask the doctor what he would recommend if it was his mother sitting in the chair.