They are saying the cancer is in the nodes of the mediastinum which is usually very bad news - I would be asking how many and if they are removable - surgically - also re his cheek and chest lesions, I take it based on your description that it has broken through to the surface... Not sure why photodynamic therapy wouldn't work since this is ideal for that kind of treatment as it has to be accessible to the light. I would be pushing for removal of more tissue in the areas of the cheek, and nodes of the neck and chest (since by the sounds of it they are superficial and surgically removable. I think the dr. Is thinking as advanced as it is it must be in his lungs on a microscopic level which is likely but everyone is an individual so that may not be the case. If your uncle is insistant on fighting I would find the top ENT/surgical oncologist in your country and ask them to do what they can, and since he's had radiation already (did this include chemo?) they may not offer it to him but depending on location and amount they may be able to squeeze in some more. there is another woman here who is going through a similar situation in India (persistent oral cancer with a still existing open wound - however it has not moved from the location) as well but she is much older, and has recently completed radiation and the cancer is still persistent. Since it looks like its been a few years since treatment for your uncle I would push for this. Best of luck

Ps based on your description I assume they haven't done a biopsy are just basing this off scans - it is possible it could be infection in his nodes, and not cancer, since he still has persistent cancer at the primary, though this is unlikely - I would want to know for sure. Hugs.