OK base of tongue is USUALLY an HPV positive tumor. Late staging in these oral cancers has about the same long term survival at 6.5 years (That's as long as we've been tracking) as earlier stage tobacco cancers. This is both good and bad. Base of tongue responds well, but it's also a place that you don't want to mess with it surgically if possible, since the long term quality of life issues of messing with it are significant. You want to be particular diligent about the scan in the tonsil area. It is not uncommon for occult (not seeable) cancer to exist in the tonsils as well. Those you can surgically deal with no QOL issues. In actuality the lymph style tissue from the tonsils also runs across the base of the tongue, and there are actually in most people, small flame shaped flags of tissues on the edges of the base of the tongue (normal) that people mistake for some kind of growth that are really just lingual tonsils.

One thing that is becoming apparent to doctors now is the BOT cancers move very quickly to the cervical nodes of the neck because they are so close to the pathway of lymph tissue that leads down there. Hence very rapid move from intra-oral to cervical, which in tobacco, anterior of the tongue cancers, can take as much as a year in some people.

Unilateral nodes are better finds that bilateral. But as I said before bilateral is not the horrible thing that some say.... there are a bunch of us here that show good results in spite of it. Nevertheless, once in the nodes it is on the freeway that leads everywhere else. That's why I do not want you to wait for that 2 week away appointment, but call them and PUSH, CAJIOL, LIE, THREATEN, CRY, and any other tactic you can think of to get an earlier date. Even with an earlier date there is lots to do before treatments can begin. TIME> TIME> TIME.... unlike the stones song, is NOT on your side when it comes to any cancer (except prostate). Urgent does not mean come unglued and think the worst. Urgent does mean fight for what you need when you need it, and be your own advocate. No one cares about you as much as you do (OCF members excluded). Doctors included.

Tobacco is very hard to quit. Nicotine is as addictive as heroin. Fear is a great motivator. Having said that I saw patients go outside for a smoke while waiting for radiation treatments. Most were lying to their doctors and spouses. Take nothing for granted. Buy NRT's at the drug store if Dave is having any withdrawal issues.