I was given the option between surgery with at a minimum radiation (possibly with chemo) and concurrent chemo and radiation.

I saw 4 different cancer centers before deciding on my treatment and cancer center. A general thought that was communicated to me was that having 2 modalities of treatment was superior to 3 modalities with respect to long term effects and complications. If the doctors could keep it to 2, that would be an ideal situation.

I ended up going with chemoradiation as the surgeon ordered a PET and judged that he may have issues with clean margins on the primary and based on that they thought there was a good chance I would still need chemo and radiation. If the imaging and presentation had indicated a low chance of adverse features and bad margins than I may have ended up on the surgery + radiation route.

I was also told that the long term effects and complications of radiation + chemo were worse than surgery + radiation.

It sounds like the surgery went well and there were no adverse features, so I would think that radiation only is a candidate for treatment (which is supported by the NCCN Head and neck cancer guidelines).


Andrew
age 25

early 10/12 - enlarged lymph node area
01/13 SCC of L tonsil, L BOT, 2 L lymph nodes
stage IVa, T2N2bM0, HPV+

2/13 2 doses cisplatin big bag, 2 doses weekly cisplatin + 35x IMRT
4/13 TX finished
7/13 PET/CT - NED!