Hi Cindy.

I met with Dr. Harrison on Monday thinking about the Brachytheraoy. He is brilliant man. Met with one of the assistants first, gave my huge him volume of paperwork, and finally met with Dr. Harrison. You can tell he is an intellect, and thought deep when speaking. Dr Harrison immedistely said I have a comsituated there is only one thing, and one thing only that can be done, and done safely! He would explain it to me first, and then it would be for me to decide, and was unprepared what he said.

It's a four part process. 1. Do surgery again, clean up any reaming cancer. 2. While the neck is open, do external beam radistion 3. Do a flap with a chest muscle to have fresh tissue on the neck 4. Once healed, do Reirridation, and maybe Eributuc, on the fresh tissue.

As discussed, Reirridation without this is too risky for the carotid artery, and the dosage wanted to be done elsewhere at 50Gy will not be enough.

This is called Intra-Operative Radiation Therapy (IORT) and only done in a few places. Dr. Harrison is a pioneer with this, invented some devises being used, and an expert in this, having done many studies at Beth Usrael and while at MSK.

He also chided me having a network of doctors all overvthecfity, and said I need a multidisciplinary team with everything done at one place, not all over.

I like Dr. Harrisin and have confidence in him. I met with Dr Jacobson yesterday, ENT, who doesctjiscsurgety with Dr, Harrison. I plan on doing this, and lookng into Mid August for surgery.

Thanks for all your help!