Emily,
If I am understanding you correctly, you are trying to decide if your Mom should seek treatment locally at DUKE, or elsewhere.

DUKE is ranked 9th in the nation for cancer treatment and it is a NCI designated CCC. Duke is an elite top tier facility.
http://health.usnews.com/best-hospitals/rankings/cancer

Nevertheless, a second opinion elsewhere (such a (#1)MD Anderson, (#2)MSKCC, (#3)Johns Hopkins) is always a good idea particularly since your Mom is dealing with a recurrence.


Don
TXN2bM0 Stage IVa SCC-Occult Primary
FNA 6/6/08-SCC in node<2cm
PET/CT 6/19/08-SCC in 2nd node<1cm
HiRes CT 6/21/08
Exploratory,Tonsillectomy(benign),Right SND 6/23/08
PEG 7/3/08-11/6/08
35 TomoTherapy 7/16/08-9/04/08 No Chemo
Clear PET/CT 11/15/08, 5/15/09, 5/28/10, 7/8/11