I feel the need to weigh in:
My husband was diagnosed with stage III, T2N1M0 tonsillar cancer, with involvement of the floor of mouth, on August 14, 2002. He is a general superintendent with a large construction firm, and is known for his mouth!
He was understandably very concerned about his future, if his voice was affected.
After much consideration, he decided to have RAD and chemo, with no surgery.
I'm glad to say that he is cancer free.
Please.....consider, along with all options, the affect the treatment will have on you in the long run. There are many treatments available, and some "feel" right to the patient.
Love you,
Mandi

Thanks to everyone for all of this deeply appreciated feedback. Although chemo was not recommended to be added to the RT by the board (case conference) in my case, I will now discuss this possibility tomorrow. I'm strongly inclined now to request RT+Chemo. I will also ask to have the tumor tested for HPV. Here goes. Again, much, much thanks for this invaluable help.

Paul,

I can only tell you from my experience that my doctors did not recommend surgery for tongue base cancer. I did have a partial glossectomy for a left lateral tumor, with no radiation/chemo. Four months later, a new tumor on my tongue base appeared. I went thru 33 radiation + chemo. I am still recovering from the effects of that treatment. I am able to speak, and able to eat, so I am thankful for that.

Good Luck in your decision! I know it's not easy!
Joyce

Radiologist re-iterated today that chemo not recommended for me due to N-0 and tumor size and location (1.5-2.0cm, left side base of tongue, right on the crest of the oral tongue). However, he added that the salivary gland relocation surgery in a week will allow further evaluation of primary tumor and nodes, so, chemo addition can be revisited then. Currently, the plan is RT alone. What worries me most is the Jan18->Sept25th delay between onset of noticable symptoms and eventual diagnosis--staging is not an exact science. It is for those reasons that adding chemo seemed prudent to me, despite the huge risks of chemo ("it will greatly exacerbate the RT side effects, and has numerous serious morbidity risks including nerve damage, including high end hearing loss, 1% mortality, and so on"). But I agreed today to RT alone with chance to reconsider that before Nov 27th start of RT.

Paul,

I assume the chemo you refer to above is Cisplatin? I had Cisplatin and other than the HF hearing loss which one source says is permanent and my CO says lets wait and see and the nausea, I didn't experience any other side effects. I was told by my CO that Cisplatin would enhance the Rad's ability to kill the cancer by 30% so I opted to do it and would make the same decission today knowing what I went through for the 30%.

Since Paul is Stage II (as best as anyone can tell as of now), adding chemo would probably not lower his odds of recurrence as much as for someone who was Stage IV. At least this is how my medical oncologist explained it to me (I am a Stage II who had chemo with rad but it was optional). However, even for Stage II it could decrease chances of recurrence by 5-8 % according to my MO (using the, apparently commonly used, rule of thumb that it decreases chances for later stages by somewhere between 10 and 16% and as a Stage II you have half the chance of recurrence as those in later stages, so the % decrease should also be halved).

The hearing loss and neuropathy are genuine concerns for cisplatin but be aware that the 1% mortality is probably less than that if you go into treatment young and in reasonably good health otherwise.

I was told by the MO who recommended I have chemo, who was at one of the top CCCs in the country, that it is protocol to give chemo to Stage IIs in Europe but not in the States. He preferred the European model and recommended it, espeically to someone like me who was young and in good health otherwise. I trusted his recommendation and don't have any regrets about having it though there's no question it made the whole treatment much harder.

Nelie

The way it was explained to me was; while you are young and good health the idea is to throw the everything at it the 1st time for cure. Nothing is fool proof with this disease, so the best bet is to go with what you are comfortable with and pray for the best.

I would like to show all of the above information to my radiologist and H&N specialist on Friday. Would this be OK with each contributer? Thank goodness for this support group. I think in my case (age and otherwise good health) adjunctive chemo might be worth the slight increase in safety margin. Its a tough call, obviously. Having input from those in my situation and those who have had RT+chemo is so, so helpful, and generous of you. Thank you all. For the benefit of others, I'll update this thread with what treatment is chosen and why (Friday meeting this week is to sign informed consent forms for the treatment plan, I presume).