Thank you all for your suggestions. If I were the one with the problem I'd be doing exactly as you recommend. I went to my friends house 2 days ago and talked seriously with him and his wife for about 15 minutes. My thrust was clear, they are getting bounced around between 3 doctors (surgeon, chemo, radiation) and he's the loser as it moves so slowly. My recommendation was that he call his surgeon right away (he has a followup appointment in a week) and ask him if he is confident that the cancer is/was only local, even though the pathology report said it came from an unknown primary. If he will not decisively say yes, then tell him you want to start the appropriate chemotherapy right away. He and the wife took me seriously but were discussing which of the two should make the call. I saw him briefly today, and he had nothing to say about what we discussed on Tuesday. My sensitive problem is that I cannot intrude too forcefully. Believe me, this is very front and center for me, but I cannot overreach.

In my discussion with them on Tuesday I said that if they went to a major cancer center like Mayo or MD Anderson or somewhere all the docs would be working together and there would be no delays. And his wife indicated that her friend had also suggested that they go to a major cancer center. But I don't think it is going to happen. They have established a good rapport with the radiologist who is smart and competent, and probably they don't want to throw that away. I'm afraid I need to leave the ball in their court, once again. They express appreciation for my caring and interest but never reach out proactively to me.

He's a friend that I've played baseball with for a couple years, but we've not been serious friends about the meaningful things in life. Ethnically different, different education levels, the common ground is not deep enough to encompass this easily.

PS. Thanks Christine for info re the flashing envelope. I will follow up.