A young doctor might not have the clinical experience with serious disease states to have the professional decorum that we see in most docs. As a stage four patient with bilateral node involvement, my doctors at MD Anderson knew that it had been around for too long. (i.e the opportunity for metastasis out of the local region was a possibility.) That said, mine had not left my neck, and everything was still local. But IF bilateral is his case, they will likely have an aggressive approach to any treatments, involving several types of treatment/approaches/modalities.

That he could, without scans, tell you how it spread from point A to point B and C, was not a big leap. There are known pathways of spread of squamous cell carcinoma from the tongue, to the nodes in the floor of the mouth to the various chains of nodes in the neck etc. This wasn't a Tarot card trick by him, but it is fairly predictable.

As to the comment about one shot to get it, this is largely a function of stage of progression at time of discovery/diagnosis. Obviously more advanced diseases (of all types) require a "throw the kitchen sink at it" kind of approach, vs. early stage finds, which more conservative measures might be an adequate approach, since options and time are on your side.

Don't be surprised by the rapid replies, even in the middle of the night... there are OCF posters in Australia who are just getting up now, and likely to chime in before you wake up in the morning.