Hi Debby, and welcome. I'm so sorry about your mother-in-law's diagnosis. I understand that distance is a factor, especially at 88 and with RA. You would most likely need at least two trips, one for a consult and a second for surgery. The surgeon would want to see her again for post-op but that is something that can be handled locally.

Despite all that, I urge you to seek out the absolutely best care within your reach. The quality of this first round of treatment will dictate your MIL's quality of life from hereon. You need a team that treats this cancer all day long and can give her clean margins but also maintain as much of her swallowing and speech function as possible. If Vanderbilt's your top option locally and and you can make that work for her, it's worth the trip.

Just my 2 cents.....