Zeynepuygun
I am not sure if the treatment protocols and IG-IMRT systems in Istanbul are up to the standards found in major CCC in the States.

I feel knowledge is power but unfortunately, as individuals we will never have enough of it.

Since my doctors don't totally agree, it comes to a team consensus that might at times be the lowest common denominator - therefore I respect them but I try to rigorously question them.

Surgery is curative if the cancer can be excised. Unfortunately with extra-capsular spread the cancer is beyond the confinement of the lymph node and that is not good, but it doesn't mean that surgery alone won't be curative.

This treatment failure is so soon after your Mom's primary treatment that you should ask if this lymph node received any radiation and if so, how much. If possible, post surgical focal radiation (re-radiation) of the tumor bed should be discussed.

Does this treatment center have highly precise IG-IMRT focal radiation/re-radiation expertise and systems (such as Cyberknife and Tomo). I notice how Centers often promote the expertise and technology they have and somewhat discount what they don't, so if you have even a little doubt, research and second opinions can be critical.

Clear surgical margin in cases involving extra-capsular spread and perineural invasion can be misleading due to a much higher probability of undetectable micro-mets to or beyond the tumor bed.