Hi don, I agree don't wait for your appointment see if you can get the area looked at now. To me the time between biopsy to spread tells me it's fairly aggressive, despite how you feel surgery sounds like the best option. Get rid of all of it, first then clear up anything microscopic. It beats the maybe of - did they get it all? And the opportunity for it to spread further plus operating on radiated skin is hard and it doesnt heal as quickly or as well in some instances. (cant remember if you were HPV + - if so there is a good chance you may have not needed the surgery as HPV+ cancer responds well to rads and chemo... - if not surgery was likely a good choice). Once your palate heals things will be better. Just keep it clean there are a few here who have had similar surgeries they can help give advice. Re your shoulder and arm - it takes a while - do some physio with it now it will help return function in the long run. Good luck.