Tomorrow's the big day when I meet with my multidisciplinary team to discuss my treatment options at Johns Hopkins. I've read your posts here and realize there are no black and white answers, only many shades of grey.

The simple part: dx HPV 16+ scc left bot < 1 cm with highly suspicious areas in level II lymph nodes on both sides, ranging in size from very small to about 1.5 cm max.

The less simple part: I had a myeloablative bone marrow transplant 22 months ago, fully matched unrelated donor. I had a total of 21 5-day cycles of Vidaza, a demethylating chemo drug (I call it chemo light because effects aren't too bad). But the myeloablation required the big guns - fludarabine and busulfan. Then I had high dose cytoxan afterwards to help prevent graft versus host disease (gvhd). I have some permanent after effects - dry mouth and eyes, I don't sweat, sparse hair on my head. It took more than year for my taste buds to be nearly right again. It sounds awful but aside from the eating issues I've done great and feel wonderful. My scans and bloodwork indicate all major organs are fine. I was very healthy until the blood cancer. I have a little gvhd in my eyes, mouth, and skin. A little is good to help keep the cancer away but a lot can kill you. I have just the right amount but worry what the new treatments might do. More info than anyone wanted or needed...on to the questions.

The surgeons will of course want to do surgery. I like the idea of robotic surgery on my tongue because it is such a small lesion and it would hopefully reduce the amount of radiation I need. I know, however, there are down sides to surgery. How the heck do you decide? What about the lymph nodes? Radiate or remove? How much, how many? Why? I may not be a candidate for chemo having had so much already. How will that impact my prognosis?

What are some good questions to ask to help me decide what's best for me? I'm seeing a radiologist, a surgical oncologist, a medical oncologist, and a speech pathologist tomorrow. I think they will say "This is what you need to do." I want to be ready with the right questions so I don't feel pressured into an immediate decision blindly accepting.

Sorry to ramble. I'm feeling more anxious than my usual, possibly because my husband is not coping well and I so hate putting him through all of this again so soon.

All ideas are welcome - please include the whys with the whats.

Thanks much.