The difference is it sounds very advanced if its broken through the skin. Plus this also leaves her open to infection. The surgery you are describing sounds horrendous. Are they still hoping to cure her? If not she is being out through necessary pain and suffering to what end? Admittedly she is probably sick and in pain already - but having them cut her open again just seems unnecessary if its not for a cure. I'm not surprised she's malnourished if she has no jaw and no feeding tube. I do agree the feeding tube is necessary. Hopefully this will buoy her strength. Most people here will tell you that I am an optimist and always push to do what you can but this just sounds so painful, I would be hoping that they are being realistic in terms of being able to heal her. The surgery is a good start but the next step should be rads and chemo... The question is can she handle it. Hugs and best of luck.