Dan,

All of us, with the exception of Brain maybe, can only offer opinions based on how our course of treatment went. From what I have pieced together from your posts my case was similar. I was diagnosed with left tonsil SCC with spread to the tongue. I had one node suspect and post-dissection pathology confirmed 2 of 30 removed to be positive. The none surgical option was taken off the table when they "felt" it in my tongue and I had the mandible resection to gain access to the site, functional neck dissection and forearm free-flap. It was not a real problem because I had already convinced myself that I was going to go with the surgery/radiation deal because I wanted to be aggressive. Now, my thoughts. Firstly, the surgery, properly done in an otherwise healthy person, is not bad and you heal nicely, and with the exception of the one on the side of my neck, you really have to be looking for the scars. Secondly, the radiation sucks and you will be getting it either way so don't think you will be getting off easy by passing on the surgery. Finally, there are no easy ways out of this so don't look for one and don't get sold on one, it is not there.

Some other thing to keep in mind. "A little longer than without surgery" is a good thing (from your post). On working; I went back 5 months post-op 2.5 months post-radiation. I'm a Police Officer so I don't think you should count work out at this stage. Looking forward to getting back to work was key in my recovery and the actual act signaled a major personal victory for me.

Lastly, and to all(you thought this would never end), on IMRT. I probably don't have the background for this so it is a question posed as a comment. I was under the impression that IMRT was only effective against a clearly defined tumor. It seems that in most of the cases on the board the radiation is used to "mop-up" the area and therefore field radiation should be better. I would like to hear more on this since many new comers seem to latch onto it as an option(I don't blame them) that, in most cases, does not really exist. I would worry that the cancer could pop up in a salivary gland I avoided by using IMRT. This is NOT a knock on people that have had IMRT, I just want to understand the deal.

Glenn