hi,

in regards to 1. If the tumor is small, and the surgeon gets good margins, or if it does not extend into other tissue layer, and if there are no lymph nodes involved, then you may not need radiation.

I had a tumor removed from the side of my tongue and 1/2 my tongue was removed; no lymph nodes were positive for cancer, but the dr removed a lot of them (67)- all on one side of my neck. The cancer was staged as T2, N0, MO.

But sometimes it has been referred to as stage T2-3, because it was on the big size, and was a little deep, was close to the center of the tongue (which increases the odds of moving to the opposite side of the neck,)and although the doctor got clean margins, the margins were not extensive, and cell structure was moderately differentiated. Also it seemed to be more invasive/growing downward into deeper tissue which some say is more of a concern than a tumor that is growing outward.

After surgery, based on the good results of surgery (got all of tumor w/margins, no lymph involvement), our surgeon said radiation was not required. He took my case back to the tumor board where the opinions were divided over whether to do radiation or not. The doctor left the decision up to us. Wow! What a tough choice. We consulted with other doctors, including one other tumor board which was split. The opinions given to us were that Stage 2-3s are a gray zone when it comes to radiation - there is no clear cut evidence (no studies or statistics) that radiation improves the outcome/chances of survival/risk of reoccurance, etc. Whereas with Stage 1, or small tumors with no lymph involvement, radiation usually isn't required, and with stage 3-4s (larger/or spreading cancers) rad. is done.

So, every case is specific. So ask lots of questions as to why or why not do radiation.

Good luck!
ps. I am now almost 4 months out from surgery and I am happy to report that the scars on my chin and neck have improved so much! Its not so noticeable. When I was in the hospital in October, I never would have guessed I'd look this good (or this normal) in only 4 months! So don't get discourage everyone, there is hope!
michelle